Sunday, November 14, 2021

'A slap in the face’: nurses’ strike signals Kaiser’s end as union haven


The management’s initial offer of 1%-a-year raise and 26% cut in salary for new hires seen as a wage squeeze during pandemic


Nurses are applauded by police and firefighters as they leave Kaiser hospital at the end of their shift on May 14, 2020 in South San Francisco, California. 
Photograph: Justin Sullivan/Getty Images


Steven Greenhouse
Sat 13 Nov 2021

Across corporate America, relations between companies and their labor unions range from chilly to ice-cold. Not at Kaiser Permanente – the California-based healthcare giant. Kaiser has long been seen as having the nation’s best labor-management partnership. Now the partnership finds itself in crisis as 34,000 Kaiser Permanente healthcare workers prepare to strike on Monday, in what would be the largest walkout in this fall’s strike wave.

After risking their lives during the pandemic, many Kaiser workers are asking how things could have turned so sour in the much-praised partnership, in which managers and union members team up at hundreds of Kaiser facilities to find innovative ways to improve care and efficiency, saving the company tens of millions of dollars a year.


‘We went from heroes to zeroes’: US nurses strike over work conditions


Last week one of Kaiser’s nurses’ unions served notice it would strike on 15 November, and soon after, several other unions also voted to strike. The nurses’ union – United Nurses Associations of California/Union of Health Care – complained that management’s latest employment offer would “depress wages for current employees and slash wages for incoming workers”.
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Saying that its labor costs were far above its competitors, Kaiser initially proposed raises of 1% a year for three years and cutting the pay of new hires to 26% below those of its current employees.

“The partnership has been built on it being a leading payer in the market,” said Adrienne Eaton, dean of the Rutgers School of Management and Labor Relations, who has written about Kaiser. “If they’ve decided not to do that any more, it’s going to cause a strong reaction among the unions.”

It certainly caused a strong reaction in Semanu Mawugbe, a Kaiser nurse in Los Angeles. “It’s a slap in the face,” he said, noting that the 1%-a-year offer was well below this year’s 5%-plus inflation rate. “They tell us we’re heroes and we’re much appreciated because of everything we did during the pandemic”, he said. “But their offer shows they don’t mean it. We’re the ones who sustained the hospitals and took care of the sick like it’s a war zone.” The unions say Kaiser is seeking to squeeze wages when the non-profit company is doing well, with $45bn in cash reserves and $6.8bn in operating profits the last three years.

Since Kaiser’s labor-management partnership was founded in 1997, none of its 35 union locals has gone on strike. The partnership includes over 100,000 union members. Kaiser overall has $89bn in annual revenues, 12 million health plan members, 39 hospitals and more than 700 other medical facilities spread across eight states and Washington DC.
On September 2, 2019, Kaiser Permanente healthcare workers, patients and their supporters marched in a Labor Day protest in Los Angeles, California against the healthcare giants unfair labor practices and shift from prioritizing patients to profits.
 Photograph: Robyn Beck/AFP/Getty Images

“The challenge we are trying to address in partnership with our unions is the increasingly unaffordable cost of healthcare,” Arlene Peasnall, Kaiser’s senior vice-president of human resources, said in a statement. “The fact is wages and benefits account for half of Kaiser Permanente’s operational costs.”

Peasnall said Kaiser’s wages have risen to the point where its union members earn “on average 26% above the market rate”. “This is unsustainable,” she said. Facing a strike, Kaiser management increased its contract offer to a 2% raise in each of four years with a 2% lump sum payment in the contract’s first two years. Under Kaiser’s revised proposal, new hires would be paid 15% less than current workers.

Several labor experts said Kaiser made some elementary bargaining mistakes that were bound to inflame its workers. Kaiser offered just 1%-a-year raise while its largest union, a service employees’ local representing 46,000 Kaiser workers, has a contract that calls for raises of 3% a year over the next two years. Other unions felt shortchanged to be offered less than that. “It does seem like a provocation,” Dean Eaton said.

Labor experts also said Kaiser’s two-tier proposal to pay new hires significantly less was bound to anger workers and worsen staffing problems. “It generally doesn’t make sense having two tiers of staff and it makes even less sense when we’re going through a pandemic.” said Peter Lazes, former director of the Health Care Transformation Project at Cornell University. “I have to blame management for not being sensitive. It seems hard to understand why they’re doing this when there’s a nursing shortage nationally.”
They tell us we’re heroes and we’re much appreciated … But their offer shows they don’t mean it. We sustained the hospitals and took care of the sick like it’s a war zoneSemanu Mawugbe

Lazes, who has studied Kaiser’s partnership, isn’t so sure that the labor dispute will jeopardize the partnership long-term. “The idea that you’re going to have differences between labor and management partners that might result in a strike or a strike vote is part of the labor-management process,” he said. “Union and management have to know how to dance together and box at the same time.”

Denise Duncan, president of the United Nurses union, called Kaiser’s offer “totally unacceptable”. She derided the proposal to pay new workers less: “You can’t solve a nursing shortage that way.” She faulted Kaiser’s wage survey, saying it should have been done in cooperation with Kaiser’s unions. She said the survey, comparing Kaiser’s pay levels with those at smaller, less sophisticated medical institutions, often in rural areas, was apples and oranges.

“Ultimately, we just had to pull our levers [for a strike]”, Duncan told the Guardian. “Our members were angry. Everyone worked so hard. We feel Kaiser let our principles of partnership go.”

Lazes said that Kaiser’s new CEO and leadership team do not seem nearly as committed to making the labor-management partnership succeed and run smoothly as was Bernard Tyson, a Kaiser CEO who died of a heart attack in November 2019. Duncan wholeheartedly agreed. “We believed Bernard to be a purist on social justice and working people and having the utmost respect for the history of the partnership,” she said.

Duncan said Tyson’s successor, Greg Adams, had been doing little to ensure the partnership’s success. “You got to invest in it. You have to bring in the next generation of workers and leaders,” she said. “If you don’t invest in it, it dies.”

Peasnall said the company was devoted to the partnership. “Don’t mistake passionate advocacy in bargaining with actual changes in a relationship,” she told the Guardian. “Our labor-management partnership remains strong and is a significant source of our strength as an organization.”

Peasnall added: “We absolutely believe that as we conclude bargaining this cycle, and get through the disastrous pandemic, we will emerge stronger and more united than ever before.”

Meanwhile nurses like Semanu Mawugbe are angry and ready to walk out. “None of us want a strike, but there are times it has to be done,” he said. “We’re hoping for a last-minute, 11th-hour turnaround.”


Kaiser braces for strike that could see 100,000 workers walk off job

Other "sympathy" strikers could later boost it to nearly 100,000 walkouts.


SAN FRANCISCO, CALIFORNIA – NOVEMBER 10: Kaiser Permanente nurses and workers hold signs as they stage an informational picket outside of the Kaiser Permanente San Francisco Medical Center on November 10, 2021 in San Francisco, California. Kaiser Permanente nurses and workers are staging informational pickets across California as thousands of Kaiser workers are preparing to strike for higher wages and safer working conditions.
 (Photo by Justin Sullivan/Getty Images)
San Gabriel Valley Tribune
PUBLISHED: November 12, 2021 

Kaiser Permanente is bracing for a potentially crippling strike as nearly 27,000 Southern California workers plan to walk off the job Monday, Nov. 15 in protest of understaffing and wage cuts for new hires they say will worsen the problem.

The Alliance of Health Care Unions, which represents more than 30,000 Kaiser employees in California and Oregon, recently gave management a 10-day notice of their intent to walk out unless the two sides reach a labor agreement.

They’ve since gained support from thousands of other union members, which could bump the total to nearly 100,000 walkouts.

Employees with SEIU-UHW, which represents 58,000 Kaiser employees statewide including 22,000 locally, began voting this week to authorize a one-day “sympathy strike” on Thursday, Nov. 18 in solidarity with 21,000 nurses and others from United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP).

Kaiser, based in Oakland, said in messages to its members Friday that it is doing everything it can to keep hospitals and emergency and urgent care departments open throughout any union activity.

A wide footprint


Monday’s strike will affect 366 Southern California hospitals and medical centers in Anaheim, the Antelope Valley, Baldwin Park, Downey, Fontana, Harbor City, Irvine, Los Angeles, Ontario, Panorama City, Riverside, San Diego, West Los Angeles and Woodland Hills.

Workers ranging from nurses, pharmacists and physician assistants, to occupational therapists, appointment clerks and environmental service employees, plan to participate. They are protesting Kaiser’s plan to implement a two-tier wage system that would lower pay for incoming and future healthcare workers.

SAN FRANCISCO, CALIFORNIA – NOVEMBER 10: Kaiser Permanente union workers hold on strike signs during an informational picket outside of the Kaiser Permanente San Francisco Medical Center on November 10, 2021 in San Francisco, California. Kaiser Permanente nurses and workers are staging informational pickets across California as thousands of Kaiser workers are preparing to strike for higher wages and safer working conditions. (Photo by Justin Sullivan/Getty Images)

UNAC/UHCP President Denise Duncan said the unions oppose the two-tier package, as it would hamper Kaiser’s ability to hire, recruit and retain employees during a severe shortage of nurses and other healthcare workers.

In addressing the plan, Kaiser said the healthcare landscape is changing and the company risks losing ground in its ability to provide affordable care and competitive pricing.

“Looking ahead, we simply must reduce expenses to remain competitive long term,” Kaiser said. “Our wages and benefits represent more than 50% of our overall cost structure.”

Keeping operations going

In a message to members, Kaiser explained how it will shift workloads and cancel some appointments to ensure it remains operational.

“We are actively coordinating with community hospitals and other needed clinical providers to help with patient needs,” the healthcare giant said. “If you need care, visit kp.org/getcare or use our mobile app, where you’ll be able to access all your care options.”

Kaiser is moving some on-site appointments to phone or video visits, while other appointments, elective surgeries and non-urgent needs have been rescheduled or canceled.

“We’ll contact you in advance if there are changes to your appointments,” the healthcare provider said. “We apologize for any inconvenience.”

If a walkout occurs, Kaiser said its pharmacies will be temporarily closed, although prescriptions could be filled through its mail-order delivery service.

Kaiser Permanente is bracing for a strike involving nearly nearly 27,000 Southern California workers who plan to walk off the job beginning Monday, Nov. 15 to protest understaffing and wage cuts for new hires that they say will worsen the problem.
 (File photo)

Wage hikes for existing workers

Kaiser recently offered Alliance leaders an updated proposal the company said would give workers as much as 4% a year in pay increases, with no takeaways to their benefits and retirement programs.

It would provide the potential for 2% pay increases plus a 2% cash payout each year of a four-year contract.

A union representative said the cash payout would be taxable, which means the entire yearly package wouldn’t actually amount to a 4% pay increase.

The two sides are bargaining every day, he said, but it doesn’t appear a resolution will be reached before Monday.


Health Care Giant Kaiser Is the Latest Employer Now Staring Down the Barrel of a Strike

At Kaiser Permanente, some 32,000 workers are preparing to go on strike. In addition to proposing measly raises, the health care giant is resisting workers’ desire to have more say in addressing chronic understaffing
.
Members of the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP), one of the unions representing Kaiser workers that could go on strike November 15.
 (Alliance of Health Care Unions)

JACOBIN
11.12.2021

Barring progress at the bargaining table, some 32,000 workers at health care giant Kaiser Permanente are set to walk off the job on Monday, November 15. The workers comprise the Alliance of Health Care Unions, which consists of twenty-one union locals and spans from California to Hawaii to Georgia. Should they strike, they’ll join another Kaiser work stoppage by more than 750 engineers, which began on September 18. The Service Employees International Union—United Healthcare Workers West (SEIU-UHW) says that its members will engage in a one-day sympathy strike with those engineers on November 18, while California Nurses Association members and two thousand of Kaiser’s mental health workers will do the same on November 19.

There are rumors of impending tentative agreements for some of the locals within the Alliance, but neither Kaiser nor the unions have announced any such deals. As to the issues on which the company has dug in its heels, there are several. For one, workers want raises, and the company is offering a mere 1 percent annual raise for the duration of the three-year contract. There are also wage disparities to rectify: Some workers at Kaiser locations in the Inland Empire make 39 percent less than their counterparts in the same positions at Kaiser locations in Los Angeles and Orange County. Further, Kaiser is pushing for a new wage tier that would drastically reduce pay for those hired starting in January of 2023: The company’s proposal cuts their pay by anywhere from 26 to 39 percent.


Finally, there is the issue of staffing. Safe staffing levels have long been a central demand among health care workers, and the pandemic has only exacerbated the issue. When health care facilities don’t have enough workers, they turn to “travelers,” registry workers who travel from one facility to another on short-term contracts. It’s a vicious cycle: Health care workers leave their facilities to become travelers because pay for such work has skyrocketed, while pay for traditional health care jobs stagnates. The problem is so bad at Kaiser that some workers began placing gravestones in an employee locker room, with one for each coworker who had left.

One traveling nurse who recently took a gig at Kaiser explains that while she was there, “We were always short-staffed.” In the TikTok in which she recounts her experience — the video currently has some 10,000 comments — she tells fellow traveling nurses not to work at the company. “There are a ton of amazing clinicians at Kaiser that are being forced into poor patient care by shitty business practices by a company that puts profits before patients at every single turn in the road,” she says.

Kaiser workers say that the company is not backfilling positions that have been vacated — many by staff who left to work as travelers — and that the result is a crunch that leaves workers stressed and patients without adequate care. At one point during the bargaining process, to illustrate the inadequacy of the nonbinding staffing language in the prior contract, members of the Oregon Federation of Nurses and Health Professionals (OFNHP), one of the unions in the Alliance, printed out every short-staffing complaint members had made over the past three years. The resulting document was nine thousand pages.

The Alliance is proposing that the labor-management partnership at Kaiser include staffing committees to oversee backfilling existing positions and hiring for new ones, a structure that would meet on a regular basis and provide workers’ representatives a clear picture of who does and does not work at Kaiser’s sprawling health care facilities that care for some 12 million patients. More specific proposals for filling vacated positions are being negotiated at the local level. But according to workers, the company has been particularly intransigent about this subject, preferring unilateral control over staffing decisions.

While the latest news from the bargaining table suggested significant distance between the two sides on wages — the Alliance wants 4 percent annual raises and no two-tier — it is staffing that may prove the most intractable issue (of course, a two-tier wage system would also exacerbate the problem by driving away potential applicants). Kaiser wants to do as it pleases, and ceding the slightest bit of power over hiring choices to those who must deal with the consequences of those decisions may prove unacceptable to the bosses. As bargaining continues and future tentative agreements are announced, that is the issue on which many at Kaiser are keeping an eye.


ABOUT THE AUTHOR
Alex N. Press is a staff writer at Jacobin. Her writing has appeared in the Washington Post, Vox, the Nation, and n+1, among other places.


Sanders Leads Senators in Backing Kaiser Permanente Workers Before Planned Strike

"The company wishes to diminish the safety, security, and well-being of its workers, rather than improve them. That's just not right. Your employees deserve better."


U.S. Sen. Bernie Sanders (I-Vt.) speaks to the media outside the West Wing of the White House in Washington, D.C. on July 12, 2021, after attending a meeting with President Joe Biden.
 (Photo: Saul Loeb/AFP via Getty Images)

JESSICA CORBETT
COMMONDREAMS
November 12, 2021

Sen. Bernie Sanders, joined by seven Democratic colleagues, sent a letter Friday to Kaiser Permanente chair and CEO Greg Adams in support of tens of thousands of healthcare workers planning to strike on November 15 unless negotiations for a fair contract improve.

"These employees are heroes and heroines and should be treated as such."

Monday's strike is set to include 32,000 Kaiser workers, though another 8,000 have authorized a strike, the letter notes. They are represented by various unions and work at facilities across California, Colorado, D.C., Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington.

Along with Sanders (I-Vt.), the letter is signed by Sens. Tammy Baldwin (D-Wis.), Cory Booker (D-N.J.), Kirsten Gillibrand (D-N.Y.), Mazie Hirono (D-Hawaii), Jeff Merkley (D-Ore.), Elizabeth Warren (D-Mass.), and Ron Wyden (D-Ore.). It follows a wave of "Striketober" labor actions nationwide last month.



In addition to calling on the Kaiser chief executive to negotiate a fair contract, the senators highlighted the conditions that workers have endured while "working tirelessly in the midst of a life-threatening pandemic" that is ongoing.

"They risked their lives to save patients—showing up to work despite not being provided basic protective equipment. We've been told that some were even forced to sleep in their cars and hotels to protect their families. These employees are heroes and heroines and should be treated as such," the letter says. "Sadly, you have taken another approach."

According to the eight senators:


Instead of treating these workers with the dignity and respect they deserve you have demanded that they accept just a 2% wage increase and a two-tier system that allows you to pay new workers lower wages. Considering your recent profit margins, we find this offer to be demeaning and unacceptable. These dedicated workers deserve a fair wage increase, and the new generation of Kaiser Permanente workers should have the same pay structure as those who are longer-term employees.

To add to these concerns, you have refused to negotiate a fair contract with Kaiser workers who organized unions more than two years ago. Your company has also failed to address unequal wage scales that have a racially discriminatory impact, and you have rejected proposals to work with employees to safeguard patient care by improving staffing.

Noting that the healthcare giant made $2.2 billion in operating profits last year, the letter to Adams says that "now, at a time when Kaiser is sitting on $44.5 billion in cash reserves and your insured membership has grown to 12.5 million, the company wishes to diminish the safety, security, and well-being of its workers, rather than improve them."

"That's just not right. Your employees deserve better," the letter continues. "In this moment, Mr. Adams, you can do the right thing."



According to CBS Los Angeles, Kaiser is warning patients that if the strike happens next week, "its pharmacies would be temporarily closed and some appointments might have to be changed to virtual care, including phone or video visits."

An early November statement from the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) about a 10-day strike notice covering 21,000 nurse practitioners, midwives, pharmacists, physical and occupational therapists, physician assistants, registered nurses, and others accused Kaiser of failing to "address union proposals that would tackle pressing problems such as staffing shortages, racial justice, and equal health access."

UNAC/UHCP president Denise Duncan, RN, said at the time that "the lives of our patients and the health of our communities are dependent on the outcome of these negotiations."

"The lives of our patients and the health of our communities are dependent on the outcome of these negotiations."

"For weeks, we've been beating back a two-tier wage package which would impact our ability to hire, recruit, and retain during a severe shortage of nurses, healthcare workers, and professionals—wage proposals that resemble those of a slash-and-burn corporation, not the leading healthcare provider that our members helped build," Duncan explained.

"For healthcare providers, a strike is always a last resort, but it's clear from the employer's latest proposals that this is the path they've chosen," she said. "Nurses and healthcare professionals have one priority: delivering the best possible care to our patients. Kaiser's actions are destructive to that priority. These next few weeks will define us."

Echoing that sentiment, nurse Kim Mullen of Kaiser South Bay said that "the whole reason I'm going on strike is because of my patients."

"I believe my patients deserve the best care and attracting the best nurses is what's best for them," she continued, "and I need to make sure that we continue to attract the best nurses who want to stay at Kaiser in order for my patients to get the best care."

Alaa Abou-Arab, an occupational therapist at Kaiser LAMC, said: "My son was born at Kaiser. My doctor is at Kaiser. The reality is: we're not just Kaiser staff, we're Kaiser patients."

"This stuff is real for us," Abou-Arab added. "We're relying on the future generation of nurses to take care of us too. We're striking in solidarity with those nurses and for our own families."
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