Healthcare unions representing nearly 46,000 Kaiser Permanente workers filed a 10-day strike notice on Friday. The walkout, organized by the Alliance of Health Care Unions (AHCU), is scheduled to begin on October 14 and last five days. It would primarily affect California and other West Coast states, with thousands of workers also participating in Hawaii. The notice follows last month’s overwhelming strike authorization vote, in which 97 percent voted in favor.
The strike is a powerful expression of the growing opposition of healthcare workers, and of the working class as a whole, to intolerable conditions. The WSWS and the Socialist Equality Party hail the courageous stand taken by Kaiser workers and call for the broadest possible support. Workers across the country should take up solidarity actions to link the struggle at Kaiser to a wider counteroffensive of the working class against corporate dictatorship.
UNAC/UHCP, the largest of the unions with more than 31,000 members, said that this will be the largest strike in its history at Kaiser. However, it follows a series of major walkouts at the healthcare giant in recent years. In October 2023, 75,000 workers in the separate Coalition of Kaiser Permanente Unions (CKPU) struck for three days. From late 2022 to May 2023, 2,400 Kaiser mental health professionals in Southern California carried out a bitter six-month strike. Just last month, workers in the San Francisco Bay Area staged a one-day walkout.
The conditions Kaiser workers are fighting are universal across the healthcare industry: unsafe staffing ratios, pay raises that lag far behind inflation, and relentless overwork that has driven countless workers to leave the profession. Kaiser, a vast healthcare consortium serving nearly a quarter of California’s population, can more than afford workers’ demands. Last year, it tripled its “net income” (so named because Kaiser is officially a “nonprofit”) to $12.9 billion and increased its net worth to $74.1 billion, including $66.4 billion in cash and investments.
The corporate assault on healthcare reached a new stage during the pandemic, as hospitals were overwhelmed due to the refusal of the ruling class to take measures to stop the spread of the virus. The consequences have been catastrophic: for the first time in US history outside of wartime, life expectancy has undergone a prolonged decline.
The fight at Kaiser is, at its core, a fight against inequality and the subordination of healthcare to profit. Healthcare is deliberately starved of resources, producing preventable illness and death, while billions are funneled into the profits of the healthcare giants and the inflation of Wall Street bubbles. In the very cities where Kaiser workers care for patients, schools and other public services are being gutted, even as the federal government accelerates the dismantling of essential social programs.
The Kaiser strike is part of the broader struggle of the working class against fascism and the corporate oligarchy. Under Trump, the assault on centuries of health science is a central component of his bid for dictatorship, now reaching a new stage with the government shutdown. The Department of Health and Human Services alone is targeting 32,500 furloughs, with Trump seeking to make many permanent while consolidating personal control over the government and seizing Congress’s power of the purse.
On September 22, Trump held a bizarre press conference in which he falsely claimed that Tylenol causes autism. This was only the latest salvo in a systematic assault on vaccines and public health. The ravings of Trump and his HHS secretary, Robert F. Kennedy Jr., is a form of socially conditioned insanity. They serve a definite class function: to slash life expectancy and eliminate what the ruling elite regards as a “surplus population.”
The diversion of resources away from healthcare is being funneled into war and repression. This recalls the Nazi regime’s Aktion T4 and related euthanasia programs, which sought to eliminate those deemed “life unworthy of life.”
The working class must be the central force of resistance to Trump. Its fight for equality inevitably brings it into conflict with the corporate oligarchy, which is using Trump to sweep away the remaining vestiges of democracy in the United States. As in Italy and Germany in the 20th century, the real target of fascism in America is the mounting resistance of the working class.
It is significant that the strike would take place in many of the same cities targeted for invasion by the National Guard, especially Los Angeles. The occupation of these cities is aimed at dealing with what Trump calls the “enemy within.”
Also highly significant is the fact that the last day of the strike would be October 18, the day of nationwide “No Kings” protests, which are expected to draw millions against Trump’s drive to dictatorship.
Against the fascist policy of destroying healthcare, workers must demand healthcare as a social right for all. This requires the expropriation of the private healthcare industry and the creation of a public healthcare system under the direction of healthcare workers themselves, not corporate politicians. This is inseparable from the expropriation of the billionaires and major corporations, whose existence is not compatible with democracy.
Such a fight requires new organizations animated by an independent strategy based on the fight for workers’ power. Rank-and-file committees across the country must become the basic organizational form for the working class struggle against Trump.
There is a precedent for such organizations. In 2021, Kaiser workers formed the Kaiser Workers Rank-and-File Committee in opposition to the last sellout contract. The International Workers Alliance of Rank-and-File Committees (IWA-RFC), which includes committees all over the world, conducted the Global Workers’ Inquest into the COVID-19 Pandemic, taking testimony from some of the world’s leading health experts to cut through the lies of the corporate media.
Workers must also break completely from the Democratic Party, which refuses to oppose Trump because it fears the growth of uncontrollable opposition from below. Beneath the civil war atmosphere in Washington, both parties are united on the essentials of austerity. It was under Biden, after all, that COVID protections were prematurely dismantled to protect corporate profits, leading directly to mass infections, deaths and a deepening health crisis.
A fight will never be organized by the union bureaucracy. They have done nothing to oppose Trump’s coup plans and, in many cases, have openly collaborated with him. The mass mobilization needed to defeat Trump runs directly counter to their six-figure salaries, government ties and corporate partnerships, all of which rest on their ability to enforce “labor peace” and suppress workers’ struggles.
This is especially clear at Kaiser Permanente, where for decades, the unions have participated in the Labor Management Partnership funded by millions in Kaiser money.
These bureaucracies have sold out one struggle after another. In 2023, the CKPU shut down a powerful movement with a token three-day strike before imposing a pro-company contract. In 2021, at the height of mass opposition to profit-driven COVID policies, the AHCU blocked a strike altogether and rammed through a sellout deal. The contract’s supposed “staffing ratio” provisions were deliberately unenforceable, both because of how they were written and because the unions refused to enforce it through industrial action.
The bureaucracy is doing everything possible to limit and blunt the impact of the current strike. There is no guarantee the AHCU will even allow it to proceed. In 2021, the unions called off a strike with less than 24 hours’ notice. Having now issued the legally required 10-day notice, they will use that time to feverishly search for a way to block the walkout, whether through a sellout deal or some other maneuver.
In their strike vote, however, workers made their decision clear. They must organize rank-and-file committees to give themselves the means to enforce their decision through independent action.
They must also not allow the strike to be limited in advance to five days, which Kaiser will easily be able to ride out. The committees must fight for an indefinite strike until all of their demands have been met. They must fan out for support in the working class neighborhoods they serve, as well as in major workplaces across the country, and build support among healthcare workers everywhere.
Summing up the experience of 2021, the Kaiser Committee declared:
This entire experience with the contract has proven to us that our interests are in direct conflict with management and the unions. A real struggle for safe working conditions, living wages and an adequate provision of resources for public health must be carried out in opposition to both management and the pro-corporate trade unions, which are two sides of the same coin.
These lessons must now be acted upon. Workers must begin organizing now to enforce rank-and-file control over the strike and to build it into a powerful movement of the entire working class.