Pay and staffing increases on the table in massive Kaiser Permanente strike

WSJ article screenshot

Screenshot of Melanie Evans’ Oct. 4 Wall Street Journal article, “Kaiser Permanente Union Workers Strike, Mounting Largest U.S. Healthcare Walkout on Record”, captured on Oct. 4, 2023.

On Wednesday, 75,000 Kaiser Permanente workers walked off the job, and it’s being called the biggest strike by health care workers in decades. Or the biggest in U.S. history, depending upon your news source.

The strike is part of what is clearly a wider labor movement in the country, with auto workers, Hollywood writers, actors, hospitality workers and some CVS pharmacists all making their frustration official this year. 

When health care workers walk off the job, the stakes are higher than having to wait for the new season of your favorite Netflix series. Melanie Evans, who has been a health care reporter at the Wall Street Journal for seven years, did what she described as a “hard pivot” to the headline-grabbing Kaiser Permanente story this week.

She found some time in a busy afternoon of chasing sources to answer some questions about the Kaiser Permanente strike, how it fits into the wider labor movement of 2023 and what she thinks the contributing factors are.

First of all, who is striking?

The striking workers do a range of jobs, [including] food service and janitorial workers, and then it does include nurses and pharmacists. If you’re looking at the range of people that keep hospitals and clinics running, it’s a broad range. There are also technicians and some laboratory workers.

What are they asking for?

They’re striking about wages and staffing.

On the wage front, the last time I checked — which was yesterday evening — Kaiser and the unions were far apart on annual raises for workers. The union [is asking for a wage] increase over four years of 24.5%. Their employer’s last offer was in the range of 12.5% and 16% depending on location [in the U.S.]. The union has said that they are seeking wage increases as a cost-of-living increase. This has been really common for unions in other industries also asking for larger wage increases. So it clearly fits into a moment in which labor is now both responding to inflation and also what’s been happening in labor markets and saying, “We will use our clout to push for increased pay.”

This is a defined strike. Is that correct? 

It is up to three days. So in the mid-Atlantic, it is a day, and then in the rest of the locations, it is a three-day strike.

Is the length of the strike out of sensitivity to how the public reacts to health care workers walking off the job and leaving hospitals?

If you look at the Bureau of Labor Statistics data of the larger strikes that preceded this one, they are also limited [rather than] open-ended, and when I spoke with John August at Cornell University — he is director of their [School of Industrial and Labor Relations] and a former negotiator for the Coalition of Unions that are currently bargaining with Kaiser — he said unions are clear that striking in health care impacts patients. So they do these more targeted, limited duration strikes. 

Does that diminish their clout? What have you seen in the past?

I will likely be doing more reporting on that, but I can’t really answer that now.

So how big a role did the pandemic play in what’s happening now with health care workers striking this year and last year? Because in 2022, something like 30,000 health care workers went on strike, according to Health Care Dive. Did the pandemic really break health care workers?

In reporting for this story and then having reported through the pandemic, [I’ve picked up on] a real high degree of exhaustion and that there are health care workers that retired early or are no longer working in health care. And if you look at the Bureau of Labor Statistics data, hiring in hospitals did not reach its pre-pandemic peak until last December. So, there was this drop early in the pandemic and then hiring, hiring, hiring … it didn’t matter if I was talking to nurses or to HR inside of hospitals, it was just [a story of] hospitals and clinics being really short staffed. …

What I kept hearing was, you just get a certain point, you just can’t pay people enough to keep working. You can’t offer any more overtime because [staff] just can’t take anymore overtime. … What I’m trying to say is that there’s the pandemic, and the eruption of the labor markets followed, and it really did leave hospitals short staffed. That meant more strain on those who were working. You hear that very clearly. In the Kaiser strike, the [company] has actually said they are hiring — they are working to hire aggressively, and they will continue to hire and yes, [they know people] are burned out and they do keep speaking to that strain in their public statements.

Beyond the pandemic, what other factors are contributing to this strike?

Inflation. The cost of living is just higher, right? And so, unions are asking for higher pay.

Do you think strikes in health care are going to continue this year?

I can’t speak to that other than to say that my colleagues at the Journal who report more broadly on labor have pointed out that the success of some unions have emboldened unions to take action. The Journal has covered this moment for unions as being one that is both active and having some successes.

As a practical matter, what do hospitals do when their health care workers walk out?

They bring in contract workers. What Kaiser is doing is they are rescheduling certain services. They have actually put out quite a bit of public information on what locations are closed, and their website is currently updated. So, if you go and you look up a clinic, it says temporarily closed, and then it says some locations are closed, and then there’s a whole page with all the closures. So, they’re bringing in temporary workers, rescheduling appointments, and Kaiser is also expanding its network’s members, where they can go. So they may, in some cases, go to a non-Kaiser hospital or they may go into a retail pharmacy because their Kaiser pharmacy at their Kaiser location is closed.

Can you remind me, how much money did Kaiser Permanente make last year?

In the first six months of this calendar year, they posted a profit of about $3 billion, and they had a net loss in 2022 of $4.5 billion. 

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