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Tens of thousands of nurses, pharmacists, therapists, and other essential healthcare workers began a strike Tuesday, October 14, against Kaiser Permanente across California, Oregon, Southwest Washington and Hawaii. The walkout by 46,000 workers is one of the largest healthcare strikes in US history. It is a sign of growing opposition in the working class to capitalist inequality and the emerging Trump dictatorship.

The strike was called only after weeks of delay by the Alliance of Health Care Unions (AHCU), which waited well beyond the contract’s expiration to act. Out of 500 Kaiser facilities, only 23 were reported to hold pickets for the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP), the largest component of the Alliance representing 31,000 members.

The bureaucrats have also limited the strike to five days in advance, limiting its power and impact. Kaiser is offering a 21.5 percent raise over four years; the Alliance now demands 25 percent, having already retreated from its initial 38 percent demand. Both sides are signaling that a deal is near, one that will inevitably leave intact the overwork, understaffing and unsafe conditions that define daily life in America’s hospitals.

The mood among Kaiser workers, however, is explosive. On the picket lines Tuesday, healthcare workers were determined to fight not only for adequate wages and safe staffing, but in defense of the rights of all workers against the attack on health science by the Trump administration.

WSWS campaign teams distributed copies of a statement calling for the creation of independent rank-and-file committees, independent of the union bureaucracy, to “serve as the nucleus for uniting 46,000 Kaiser workers with millions of other workers across the United States to prepare mass, collective action, including a general strike, to drive Trump and his fascist cabal from power and defend the democratic and social rights of the working class.”

At the Kaiser Clairemont facility in San Diego, Jennifer, a labor and delivery nurse with 26 years of experience, explained why she joined the picket line. “Kaiser is not following A1 staffing,” she said. “It’s making it very unsafe for patients sometimes. Labor and delivery nurses have to care for two patients each, but there would be far better outcomes, particularly with hemorrhaging, if the ratios were one-to-one.”

Jennifer described a workplace hollowed out by exhaustion and attrition: “A lot of nurses have left the bedside.”

She also rejected the anti-science poison spread by figures like Robert F. Kennedy Jr. and the far right. “It’s pretty sad,” she said when asked about the claim that Tylenol causes autism. “I have never seen babies develop autism from Tylenol.”

“They made billions. We gave up everything during COVID.”

In Anaheim, Jerry, another Kaiser nurse, cut to the heart of the matter: “To get profits, they want to cut down their cost at the cost of laying off the rank-and-file workers that built the company. This is a systemic problem, not just in nursing but in every industry worldwide.”

Jerry denounced the hypocrisy of Kaiser’s public relations. “They’re telling the public how much they’re offering us, but not how much they made. They made billions of dollars. We gave up so much during the last contract because it was COVID.” Nurses risked and lost their lives while the corporation expanded its reserves and executives pocketed record compensation. “We were averaging one to two nurse deaths a day because we were short on supplies,” he said.

Commenting on Trump’s infamous boast about the “big beautiful bill,” Jerry said: “It’s for the upper class that gets the tax breaks when we’re the ones who have to pay.”

At the San Diego Clairemont facility, Tracey, a nurse with 15 years of experience described conditions that have driven many to the breaking point. “Better staffing and patient safety, as well as wages,” she said, “are at the center of the strike.”

She explained that living in Southern California on a nurse’s salary is now a daily struggle. “I am basically living paycheck to paycheck and have to carefully budget in a way I did not have to do before.” During COVID surges, she added, “there can be five patients to one nurse, which is not safe.”

Asked about the fascistic attacks on science and medicine by the Trump administration, she responded bluntly: “All of it is pretty disgusting. We have to stand up and fight back. It seems thinking about people and their well-being has gone down in our society.”

Tracey’s sign read: “People Over Profits.” She said that the interests of the healthcare corporations and those of the working class “are incompatible with one another.”

Sonya, another Anaheim nurse, spoke with deep emotion about the Trump administration’s immigrant raids. “As a Hispanic woman, as a child of immigrant parents, it hits me really deep and very personal. Sometimes I can’t even really talk about it because it gets me emotional. Of all the craziness, this is the one that hits home the most.”

“All of this has impacted me,” she said, “and has gotten me in a place where obviously we want to activate and do what we can.”

“The anti-science rhetoric hurts patients.”

Lorena, a home-health nurse in San Diego with 20 years’ experience, summed up the impossible conditions facing her colleagues. “It’s always been tough to fill positions, and it’s getting harder. We’re not getting enough staff, and things are not really safe.”

Her account was harrowing. “We’re seeing five patients a day, but they need double the time. We’re not able to give that same educational level or time to teach people how to manage their conditions. People end up back in the hospital because we weren’t out there to notice something significant going on.”

Travel time, unpaid overtime, and lack of continuity of care compound the strain. “People are working what is supposed to be an eight-hour shift, working for 10 hours. A lot of people are doing it unpaid.”

Lorena also spoke about the devastating effects of anti-science propaganda: “People listen to that rhetoric and not really understanding or doing credible research. I’ve seen this hurt my patients, especially during COVID. At least half of my patients didn’t believe in the vaccine, and later said, ‘I regret it.’ They were young, sick, on oxygen. It was tragic.”

A political turning point

The limited, tightly controlled pickets organized by the AHCU cannot conceal the deeper reality: healthcare workers are ready for a real fight, while the union bureaucracy is determined to prevent one. The Alliance is functioning not as a representative of workers, but as an industrial police force for Kaiser, intent on smothering rank-and-file opposition before it threatens corporate interests.

The WSWS spoke to many workers who expressed disgust with the entire political establishment, Republican and Democrat alike, and an openness to socialist ideas. The attacks on science, the persecution of immigrants, and the steady march toward dictatorship under both Trump and Biden were recognized as expressions of a single crisis: the collapse of capitalism and the rise of dictatorship.

One nurse, when told of the need to form independent rank-and-file committees, replied, “That’s exactly what we need!” Such committees are a necessity. They are the means through which workers can link their struggles, across hospitals, industries and nations into a unified movement against the corporations, the unions and the capitalist state that serves them.