Friday, March 20, 2026

Source: Originally published by Z. Feel free to share widely.

“Kaiser executives say they’re not using AI to make patient care determinations, but they won’t say what technology is underpinning the online questionnaires that automatically determine whether patients require urgent appointments and assess whether they may be a threat to themselves,” said Carolyn Staehle, a behavioral therapist in San Francisco. “Whatever Kaiser wants to call it, it’s not a human being making these potentially life and death decisions, and it’s not the same level of care as being assessed by a licensed therapist.”

Kaiser Permanente, the nation’s largest health maintenance organization (HMO) is forcing its therapists onto the streets in the ongoing battle to deny mental health parity in its services to 12 million members.

The 2400 striking mental health care workers are members of the National Union of Health Care Workers (NUHW). They walked out on Wednesday, March 18, a “practice” strike, but most likely a taste of what’s to come. In 2022 these workers struck for ten weeks, the longest mental health care workers’ strike recorded. Two issues dominated negotiations from the start: workload for Kaiser therapists and wait time for Kaiser patients. The strikers won on both, forcing concessions until thenall but unheard of. The strikers won break through provisions to retain staff, reduce wait times for patients and a plan to collaborate on transforming Kaiser’s model for providing mental health care.

This time it’s inevitable the fight will be just as hard fought. But the NUHW members are battle tested; each contract fight with Kaiser thus far has included a strike. More, this time the NUHW members were joined in a sympathy strike by thousands of registered nurses, who share their concerns about Kaiser’s increasing use of artificial intelligence to the detriment of patient care. This can hardly be over-estimated. Since the 2009 SEIU trusteeship, Kaiser has faced a workforce has been deeply divided. The registered nurses, are represented by the National Nurses Association. Stationary Engineers, represented by IUOE, Local 39 will also hold a sympathy strike with mental health workers, who will walk picket lines outside Kaiser medical centers in Oakland, Sacramento, Fresno, Santa Clara and Santa Rosa.

“We’re proud to strike alongside registered nurses and engineers in the fight for human-centered care at Kaiser,” said Joshua Gibbons, a therapist for Kaiser in Sacramento. “Mental healthcare is about human connection, and Kaiser is recklessly forging ahead with untested artificial intelligence that it sees potentially replacing us and the care we provide our patients.”

Kaiser is back determined to rescind past concessions, never mind that in 2023 a $200 million agreement with the California Department of Managed Health Care that it lacks sufficient behavioral health providers. Last month, Kaiser entered into a $31 million settlement with the U.S. Department of Labor over violations of mental health parity laws.

Alas in our new world where “billions” has replaced “millions.” Kaiser has $67 billion in reserves. Kaiser’s CEO Greg Adams is reported to receive more than $20 million annually. Kaiser must reimburse patients who had to pay out-of-pocket for mental health treatment they couldn’t get from Kaiser. So, fines, no problem.

“Kaiser has been punished and fined so many times for mental health violations, we can’t let it get away with more,” says Kaiser therapist Emma Olsen. “Our patients need human therapists, who can work seamlessly with their doctors and have enough time to do our jobs right — and it’s clear Kaiser doesn’t want to pay for that level of care.” Yet Kaiser wants to add AI to its array of extreme proposals – it is demanding “flexibility,” meaning all but a free hand in the introduction of AI.

The workers have been without a contract since September. The sides remain far apart with Kaiser sticking to proposals that would reverse patient care safeguards previously won by therapists and open the door to replacing therapist jobs with artificial intelligence and further outsourcing care. When it comes to AI, Kaiser is setting the stage to not just replace work done by therapists, but to replace therapists themselves.

Why is Kaiser doing this? The behemoth was once known as union friendly. Workers supported it and were central in its origins and growth. “It’s a corporation,” says Sal Rosselli, president emeritus of the union. ”It’s the bottom line. Profit and competition.” Kaiser is a competitor, an empire builder. Kaiser which began in California and stayed there for decades, now has hospitals and clinics in Hawaii, Washington state, Colorado, Maryland, Michigan, Pennsylvania, and Georgia. It’s like General Motors in the fifties or Amazon today.

Healthcare is remaking the US economy. It’s the nation’s top employer, surpassing manufacturing and service. In 38 states, the industry is the biggest employer. Manufacturing cities like Cleveland and Pittsburgh have transitioned to healthcare as the driver of their economies. Hospitals are often the largest employers in small towns and rural settings. The industry will continue to grow (it can’t be off shored, not like manufacturing), despite looming cuts in federal health care spending. Healthcare is an engine of the twenty first century economy; its workers are our blue color millions.

2,400 workers, not so big, then. But its 2,400 in a union that fights, and we need fighters. Their example is incalculable.

A note. Seeing daily the rampaging of ICE on our streets and murder of healthcare workers in Minneapolis and in Gaza, Lebanon and Iran as well as the destruction of their hospitals, all the more important that we understand the connections and also support our sanctuaries and the healthcare workers who stand up in the face of repression, especially those healthcare workers who have been discipled or fired for daring to say Genocide.

Thanks to Matthew ArtzEmail

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Cal Winslow is a retired Fellow in Environmental History at the University of California, Berkeley and is Director of the Mendocino Institute. He was trained as an historian at Antioch College and Warwick University where he studied under the direction of the late Edward Thompson. He is a co-author of the re-released Albion's Fatal Tree (Verso 2011). In the 1970s he worked as a warehouseman, truck driver and journalist, a participant in and observer of the rank-and-file workers’ rebellion of the decade. He is an editor of Rebel Rank and File, Labor Militancy and Revolt from below During the Long 1970s (Verso, 2010). He taught labor studies at the Center for Worker Education, City College of New York and was a visiting Senior Lecturer at the Northern College for Residential Adult Working Class Education in South Yorkshire. His is author of many books, including E.P. Thompson and the Making of the New Left (Monthly Review 2014). His most recent is Radical Seattle, the General Strike of 1919 (Monthly Review, 2019). He lives with his family on the Mendocino Coast of Northern California. He and his wife, Faith Simon, a Family Nurse Practitioner specializing in pediatrics, are founding members of Mendocino Parents for Peace and are associated with the Bay Area gathering Retort.

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