Nearly 32,000 nurses and other healthcare workers employed by Kaiser Permanente are set to strike next Monday in southern California, Oregon, Washington state and Hawaii. They are opposing unsafe staffing levels and working conditions in hospitals and other medical facilities. They are also fighting plans by the healthcare giant to impose a two-tier wage system, which would pay workers hired after 2022 a third less than current workers.

The Oakland-based hospital chain, which is set to surpass the $6.4 billion it made last year, is also offering an insulting two percent pay raise to workers, up from its original offer of one percent. For its part, the Alliance of Health Care Unions, a coalition of 10 unions at Kaiser Permanente, has called for a four percent wage increase, well below the current inflation rate of 6.2 percent.

Contracts covering 52,000 workers expired on September 30. By mid-October, at least 35,000 midwives, physical and occupational therapists, nurse practitioners, physician assistants and others had voted almost unanimously to sanction a strike. Since then, rank-and-file workers have expressed mounting frustration over delays by the union, which has only given management time to hire thousands of temporary workers to weaken the impact of a strike.

While the unions are scrambling to reach a last-minute deal, workers are determined to wage an all-out fight. Pressure for joint strike action by other sections of workers has resulted in announcements of one- to five-day sympathy strikes by tens of thousands of other Kaiser workers next week. All told, roughly 100,000 could be on strike against the healthcare giant.

The Service Employees International Union-United Health Workers (SEIU-UHW)—which is not part of the Alliance of Health Care Unions—called a one-day strike by 58,000 janitors, cafeteria workers and other lower-paid hospital staff for November 18. Another 2,500 pharmacy workers in northern California are set to walk out for a weeklong strike on November 18 and 107 local mental health therapists in northern California will conduct a one-day strike on November 19.

Seven hundred stationary and biomedical engineers in Northern California have already been on strike for nearly two months, fighting cuts in real pay and contract provisions that would allow Kaiser to send engineers to facilities across county lines, rather than address staffing issues.

The impending strike is part of a growing wave of struggles by healthcare workers in the US and internationally. These include, in October and November alone:

• 400 workers at McKenzie-Willamette Medical Center in Springfield, Oregon struck for two days;
• 350 workers walked out for five days at Sutter Delta Medical Center in Antioch, California;
• 2,500 workers recently ended a 35-day strike at Catholic Health's Mercy Hospital of Buffalo in New York;
• On November 3, 1,000 workers launched a strike at the Cabell Huntington Hospital in West Virginia;
• On November 8, 350 workers resumed their strike at Sutter Health in Antioch, California; More than 700 workers are continuing an eight-month strike at St. Vincent Hospital in Worcester, Massachusetts, which is owned by healthcare giant Tenet.

Internationally, hundreds of thousands of National Health Service (NHS) workers in the United Kingdom overwhelmingly rejected the proposal by the Conservative Party government of Boris Johnson for a three percent pay increase for 2021. Members of the two largest unions voted the proposal down by 90-91 percent. Healthcare workers in the UK have seen the value of their real wages fall by up to 20 percent under the austerity measures imposed by both Labour and Conservative governments after the 2008-09 financial crash.

In September and October, an estimated 90,000 healthcare workers at more than 1,100 state hospitals in Sri Lanka held mass protests and partial strikes to demand improved Covid protections amid a rising number of infections and deaths, and more pay. Strikes by healthcare workers have also recently taken place in Germany, Portugal, Kenya, Pakistan and Canada.

Healthcare workers have been on the frontlines of the battle against the pandemic and have suffered terrible casualties due to the criminal responses of capitalist governments. At least 180,000 healthcare workers throughout the world had lost their lives as of May 2021, according to the World Health Organization. In the US, more than 3,600 healthcare workers, including at least 400 registered nurses, succumbed to the disease as April 2021, according to a count by the Guardian and the Kaiser Health Network.

The multi-millionaire hospital executives praised nurses and other healthcare workers as “heroes” even as they sent them into overwhelmed Covid wards without sufficient staffing and protective equipment. In the early months of the pandemic, Kaiser workers repeatedly protested the lack of PPE and filed more than 2,500 Covid-related complaints with the California Division of Occupational Safety and Health (Cal OSHA).

Healthcare workers are still being forced to work 12-hour plus days in understaffed facilities. According to a survey conducted in September by the American Association of Critical-Care Nurses, 92 percent of ICU nurses believe that the pandemic has depleted nurses and will cut short their careers, 67 percent fear taking care of Covid patients because it puts their family at risk and 66 percent are considering quitting the profession after their experience with the pandemic.

Kaiser and other corporate executives see enormous profit potential from purging what they see as “overpaid” nurses and replacing them with underpaid new hires who management thinks they can use to pile on even more work. Meanwhile, the executives of “non-profit” hospital chains continue to reap large salaries. According to the latest figures available, Kaiser CEO Gregory Adams pulled in $6.2 million in salary and compensation in 2019, his predecessor CEO Bernard Tyson pocketed $16 million and at least 30 executives made over $1 million.

From the beginning of the pandemic, the major concern of both the Democrats and Republicans has been the protection of corporate profit, not lives. Under the bipartisan CARES Act, 20 large hospital chains, including Kaiser, Tenet, HCA and Providence received more than $5 billion in federal grants even though they were sitting on $100 billion in cash reserves. There was such a public outcry over the $500 million grant to Kaiser, that CEO Adams announced he was giving it all back except the $11.8 million that went to one subsidiary, Maui Health System.

Although the media incessantly claims the pandemic is over, cases are rising again in California and other states and healthcare workers know that a winter surge of infections and death is coming. The fight by healthcare workers for safe working conditions and decent wages and health benefits is inseparable from the fight to eliminate the pandemic and defend millions more lives. This means mobilizing the strength of the working class against the Biden administration and state and local Democrats and Republicans who have rushed to reopen the economy to protect profits, not lives.

The wave of healthcare struggles must be combined with a broader movement of the working class to demand the temporary closures of schools and non-essential businesses, universal testing, contact tracing and quarantining, along with mass vaccinations, until the virus is contained and eliminated. At the same time, the income of all affected workers and small business owners must be protected.

The United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP), Oregon Federation of Nurses and Healthcare Professionals (OFNHP), United Steelworkers (USW), SEIU, United Food and Commercial Workers and other hospital workers unions are all opposed to any struggle which interfere with their lucrative relations with the healthcare companies and the two big business parties.

At Kaiser, this integration of the union into the structure of corporate management has been institutionalized since the 1990s through the joint Labor Management Partnership. The website of LMP explains that it was founded at the suggestion of the unions to avoid “a traditional approach”—that is, strikes—“and launching a campaign against KP that ultimately could damage the organization.”

That is why an essential preparation to wage a successful struggle is for Kaiser Permanente workers to join the growing national and international network of rank-and-file workplace committees, which provide a real voice and leadership for the struggles of the working class against the sabotage of the corporatist unions.

The struggle at Kaiser is part of the largest strike wave in the US and internationally in decades, fueled by the explosive growth of social inequality and the efforts of the ruling class to make the working class pay for the social and economic catastrophe caused by its criminal response to the pandemic.

The fight to end the pandemic, to defend the lives and livelihoods of workers is a struggle against capitalism and requires a fight for the socialist reorganization of society, including the transformation of Kaiser, Tenet and other healthcare corporations into public utilities, under the democratic and collective ownership of the working people.