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The strike of 46,000 healthcare workers against Kaiser Permanente, the largest in the country this year, is a powerful assertion of the strength of the working class against both the price-gouging of the healthcare industry, the attacks on public health by the Trump administration and the capitalist system as a whole.

That the union bureaucracy felt compelled to call the strike reflects the determination of broad masses of workers to fight against the social and economic conditions within which they find themselves. Workers confront skyrocketing costs of living, falling wages and eroded benefits.

To uphold such escalated social inequality, the Trump administration has deployed troops to Portland and Chicago as the precursor to even greater repressive measures against the mounting opposition that is emerging to fight the fascist conspiracy setting up a dictatorship in the US.

At the outset, however, the militancy of the rank and file is facing sabotage from the trade union apparatus. The bureaucrats that lead the Alliance of Health Care Unions (AHCU) did everything they could to prevent a strike from happening, and having ensured that the strike is only limited to five days, minimizing its impact.

Among the hundreds of facilities organized under the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP), which has 31,000 members, there are only pickets at 23 locations. And at some locations, such as Anaheim Medical Center in Orange County, California or San Diego Medical Center, there are not even pickets everyday.

The lack of pickets underscores the importance of the call made by the WSWS Healthcare Workers Newsletter in its statement last week, calling for the creation of rank-and-file committees, independent of the union bureaucracy, to direct the strike.

Such committees would “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.”

The Alliance has also already walked back the initial demand of a 38 percent wage increase down to 25 percent, very close to the offer from Kaiser of 21.5 percent. And both management and the bureaucracy have indicated that the critical issues of overwork, safe staffing ratios and unsafe conditions will not be seriously addressed.

Another critical issue that has also emerged is the lack of strike pay. Like millions of other workers across the country, healthcare workers are often living paycheck to paycheck and on the precipice of financial disaster.

Some on the picket lines commented that their co-workers have not joined the strike because they are unable to afford not working. One worker told the WSWS that more than half of his department has reported to work for this reason.

The responsibility of such a state of affairs rests solely with the Alliance bureaucracy and behind them, the AFL-CIO apparatus. This layer, which is still being paid, views workers’ dues money as their slush fund with which to build lavish “training centers” and pay themselves six-figure salaries. According to filings with the US Department of Labor, UNAC/UHCP President Charmaine Morales made $293,282 in 2024 and Executive Vice President Parminder Sidhu made $267,031.

Such sums expose the class forces arrayed against the rank and file. They not only face an intransigent corporate network but also a layer of upper middle class bureaucrats well removed from the life-and-death struggles of those they claim to represent.

Healthcare workers are engaged in a critical fight, and not only against Kaiser. They are also on a direct collision course with the Trump administration. A key part of his fascist strategy is the destruction of what remains of public health and promote anti-vaccine quackery in order to drive down life expectancy, redirecting money “wasted” on the sick and elderly to Wall Street and the military.

Trump is using the current government shutdown has provided the avenue to greatly accelerate this. In doing so, the social programs that these workers operate will cease to function and be shutdown. Such measures are directed not just at the workers themselves, but the healthcare, education and infrastructure systems they support, sending millions deeper into poverty.

The Kaiser strike shows the potential for a much broader offensive by the American and international working class against war, dictatorship and social inequality. Healthcare workers are in a prime position to unite workers across all industries to fight against the attack on democratic and social rights.

To succeed, this new movement must be politically independent from the Democrats, Republicans and all organizations of the capitalist parties. It must fight to unite black, white and immigrant workers across the US and internationally.

The International Workers Alliance of Rank-and-File Committees (IWA-RFC) is fighting to build a new, independent structure and strategy for the working class which will allow it to closely coordinate their struggles with workers around the world.

The fight against Kaiser is ultimately a fight against capitalism itself. There will be no safe and affordable healthcare while society’s wealth is oriented toward the accumulation of private profit and not social need. To fight for healthcare, there must be a fight for socialism.