Kaiser workers: Tell us what you’re fighting for in this month’s strike by filling out the form below. All submissions will be kept anonymous.

On October 14, a five-day strike by 46,000 Kaiser Permanente workers is set to begin. One of the largest healthcare strikes in U.S. history, it comes under conditions of an unprecedented attack on democratic rights by the fascist Trump administration.

The walkout, called by the Alliance of Health Care Unions (AHCU), is concentrated on major facilities across California and the West Coast, with thousands more workers joining the strike in Hawaii.

This strike is not simply a contract dispute over wages or staffing levels. It is a political confrontation with the corporate oligarchy which is destroying public health. The 97 percent strike authorization vote last month was an unmistakable signal that healthcare workers have reached the limits of their endurance.

“The least amount of nurses for the most amount of work”

Kaiser Permanente, with its vast, vertically integrated network of hospitals, insurance plans and physician groups, represents the financialization of healthcare in the United States. It functions as both insurer and provider, extracting profits at every link in the chain while invoking the “nonprofit” language of community and compassion. Meanwhile, it forces nurses to work through meals and exhaustion while its executives collect millions in compensation.

Jane, a labor and delivery nurse at Kaiser West Los Angeles, described conditions that expose Kaiser’s “nonprofit” façade. “Kaiser uses the least number of nurses to do the most amount of work,” she said. “We sometimes don’t even get lunch breaks. They pay us for missed meals, but we’d rather have the break. We’re completely drained. And even though we work nonstop, we can’t afford half a house in this city—and we still get taxed at the end of the year.”

“The unions are sleeping with management”

The conditions at Kaiser are due to collusion between management and the union bureaucracy. In 2021, during the peak of the pandemic, the AHCU called off a strike at the last minute to impose a deal with toothless staffing provisions of the type which hospitals across America routinely ignore.

There is no doubt that they are working feverishly to do the same today. Workers must organize rank-and-file committees to give themselves the means to enforce their decisions through independent action.

Georgia, a Kaiser home health nurse, articulated a sentiment widely shared by workers: “Kaiser doesn’t think about people because they’re all for profit—and the unions are sleeping with management.”

When she learned that the union originally had demanded 31 percent over 4 years and later revised it downward to 27 percent, while the current offer is 20 percent, she was stunned. “I thought they [the union] were asking for 35 percent. That wouldn’t have been too much to ask for.”

Her words reveal the chasm between the aspirations of rank-and-file workers and the corrupt, self-satisfied union bureaucracy. “It’s good to strike,” she said, “but in this economy, people have families and mouths to feed. And the union isn’t even paying strike pay, while their leaders make six figures. It’s highway robbery. I owe a thousand dollars in dues and can’t even pay it all at once.”

The AHCU repeatedly boasts of its “historic partnership” with the company and how “we work in partnership with management every day.” The Alliance, along with the rival Coalition of Kaiser Permanente Unions (CPKU), participates in joint schemes such as the Labor Management Partnership, whose explicit aim is to block strikes.

In internal Kaiser meetings held last month, HR and labor relations executives reaffirmed their “long, positive history” of labor-management cooperation and expressed “confidence that an agreement will be reached without a strike.”

“Immigrant patients are scared to come to the hospital”

The strike is due to take place as Trump’s immigration gestapo rampages throughout the country. Iris, a labor and delivery nurse who also works at Los Angeles County Hospital, described the terror now gripping immigrant patients. “Things have become really bad with ICE detentions,” she said. “People are scared to come to the hospital. One mom left her kid with a note saying what was wrong with him, and then left because she was afraid of ICE being there. We’re seeing more incomplete abortions because women are trying to perform them on their own and end up in the hospital with complications.”

Another nurse recounted an experience that will haunt her for years. “ICE brought in a detainee. The person asked us to contact their spouse to let them know they were alive. They were in tears, terrified that their family wouldn’t know where they were. ICE agents told us we’d be breaking the law if we made the call. Administration told us to cave to ICE demands. I’m a zealous patient advocate, but in the face of federal law enforcement and management pressure, I backed down—and I’m not sure I’m okay with that.”

In Los Angeles, immigrants make up more than 56 percent of healthcare workers; about one in four nurses is Filipino. Across California, nearly 37 percent of registered nurses are immigrants. The repression of immigrants is a direct attack on the core of the healthcare workforce.

“An apocalyptic future” for healthcare

Many healthcare workers have voiced outrage over the Trump administration’s open contempt for science and its embrace of anti-vaccine conspiracy theorists like Robert F. Kennedy Jr., now heading the Department of Health and Human Services.

A licensed vocational nurse warned: “It’s only a matter of time until the bird flu pandemic starts. Now we have an administration that wants to stop all measures for tracking and countering diseases. Medicare and Medicaid are about to be gutted. Hospitals won’t have funds to care for patients or pay their staff. An insane number of people will die—and it’ll all be covered up. It’s going to be apocalyptic.”

An ICU nurse with 25 years of experience said bitterly: “I’ve found out how useless and unworthy I am in my own country. RFK Jr. and Trump just confirmed it. We’re not billionaires—so we don’t matter. Here’s your Nazi death panel the Republicans have been projecting about since 2009 [when they made false historical allusions to this to whip up hysteria against Obamacare]. Welcome to the new Gilded Age.”

These are not exaggerations. The Trump administration’s Health and Human Services Department has presided over the dismantling of the public health system. Confidence in HHS has fallen below 50 percent—a 20-point collapse over the past decade. The result is a nation where pandemic preparedness, disease tracking, life-saving research, and vaccine distribution are subordinated to private profit and the falsification of science.

Kaiser and the unions bureaucrats versus the workers

While workers prepare for battle, the machinery of betrayal is already in motion. At the September internal meeting, Kaiser’s Legal and National Labor Relations team briefed managers on its strike strategy. The presentation revealed a high degree of coordination between the company and the unions.

Managers were told to “stay calm” and “not overreact” to worker protests, to treat leafleting and rallies as mere “leverage tactics.” They were assured that “an agreement will be reached without a strike.” In case “Alliance-represented employees have concerns they would like [to be] addressed during bargaining,” managers were instructed to “direct them to their local union.” Behind this calm tone lies months of preparation, including contracting with staffing vendors to recruit replacements; rescheduling elective procedures; expanding outside pharmacy networks; and establishing “National Command Centers” to coordinate operations during the strike.

Despite the overwhelming strike mandate, the unions are at the bargaining table this week, signaling their intent to shut down the movement before October 14.

The union bureaucracy exploits the so-called “strike authorization” only to provide a façade of militancy while it works to prevent a strike. Democracy has been reduced to a hollow formality, as the will of 46,000 workers is brushed aside by a handful of officials whose six-figure salaries depend on their collaboration with management.

The path forward: independent rank-and-file committees

The struggle at Kaiser is part of a growing wave of class resistance, from autoworkers and teachers to healthcare and logistics workers, against unbearable living and working conditions and an escalating crisis leading to dictatorship.

This struggle poses fundamental political questions. The fight for decent working conditions and health care is inseparable from the fight against fascism, war, genocide and capitalism itself.

To succeed, Kaiser workers must take the conduct of their struggle into their own hands. This means forming rank-and-file committees, independent of the union bureaucracy, to link up with other sections of workers across industries and across borders. These committees must fight to expand the struggle to a general strike and transform it into a movement against dictatorship.

The working class cannot defend healthcare within the framework of capitalism. The entire for-profit system must be replaced by a socialist reorganization of healthcare, which is publicly owned, democratically controlled, and oriented toward human need, not private enrichment.