More than 31,000 Kaiser Permanente healthcare workers in California and Hawaii finished their fourth day on strike Thursday, which is a major part of expanding working class struggle across the United States.

At issue are wages, staffing levels, pensions and patient safety. These demands, however, raise the issue of inequality and the domination of American society by a tiny oligarchy, issues with which workers are beginning to grapple with. The walkout coincides with the ongoing strike by 15,000 nurses in New York as well as growing support for a general strike in response to the murder of ICU nurse Alex Pretti by federal agents in Minneapolis.

The Kaiser strike involves a broad cross-section of healthcare workers, including registered nurses, pharmacists, nurse practitioners, rehabilitation therapists, physician assistants and midwives. These workers are employed by one of the largest healthcare corporations in the country, operating across multiple states and serving millions of patients.

On the picket line at Kaiser Permanente Hospital in Irvine, California, John, a nurse with 30 years of experience, told the WSWS: “I’ve been working for Kaiser for about 16 years, but I’ve been a nurse for like 30 years. First, I qualified and worked in the Philippines. I worked a little bit in the UK for about six years, and then about 20 years ago I came here and worked for Kaiser.”

On the murder of Alex Pretti in Minneapolis, John’s response cut through official evasions. “I think it’s just not acceptable. I feel like with this administration there’s no accountability, there’s no compassion and to kill people like that, the people that actually serve our communities is not acceptable.”

He linked Pretti’s murder to a broader erosion of democratic rights. “Basic human rights are just not respected anymore. And I feel like it’s not just these people that they call ‘illegal’ immigrants, but little by little it’s the people that have been born here and grew up here. We are all going to be affected. So it’s time to do something about it.”

John added: “I also support the New York nurses who have been on strike for over two weeks. … Now we’re here striking against Kaiser for the same reason, fighting for a fair contract for our patients and for our communities that we serve.”

Asked about calls for a general strike to bring down the Trump administration, John was unequivocal. “Oh, yeah, I think we should do it. I’m all for it. I agree. For the same reason we are: fair contracts for our patients and communities.”

In San Diego, the same combination of issues arose. Gina, a registered nurse, spoke about deteriorating living standards. “Under current wages it’s hard to put money away. Everything is so expensive right now … to try to eat right, eat non-cancerous food, the cost adds up significantly.”

On the absence of strike pay by the UNAC/UHCP union, Gina said, “It does make it difficult to last out here for weeks, but the longer we fight, the better of a chance we have at getting what we deserve.”

On Pretti’s murder, Gina added, “There aren’t many words that truly can convey how emotional, how truly terrible that is. … Yeah, and it was a murder, just that. We stand with Alex.”

Brian, another striker, echoed these sentiments. “What happened to Alex Pretti is not right. … They’re taking our rights away. They’re not treating us as humans anymore. They’re telling us that we’re not part of the USA.”

Hillary, a nurse, emphasized solidarity across the country. “To the nurses in New York: We’re in the same situation, we know what you’re going through. Coast to coast we’re fighting for change, for patients and for all our interests.”

She denounced the hypocrisy of management’s reliance on temporary workers. “If scabs are complaining about the (nurse-to-patients) ratios, then imagine how we’re feeling! … We stand for the safety of patients. We need healthcare because the patients need us.”

A passerby in solidarity underscored the growing popular support for the strike. “I love nurses, my mom is a nurse. I see what you’re going through. Keep fighting.”

On Pretti’s murder, the passerby added, “I can hardly believe this is happening in our country. I support a national strike against Trump. The fight for better care for patients is incompatible with the profit system.”

Amechi, an Air Force veteran and registered nurse, spoke to the material sacrifices being made by healthcare workers. “Last contract during COVID, we took less to help out the hospital. So this time we’re trying to catch up because it literally at times is a struggle for us to pay our bills as nurses here in California.”

On surviving without strike pay, she explained, “We rely on family, our partners … slimming back on a lot of things to be able to be out here to support our patients.”

Addressing New York strikers directly, Amechi said, “Hold the line … this is an important time right now. Don’t give up the fight.”

Her response to Pretti’s killing was shaped by her own military service. “Being a veteran myself, that one really hurt … it shows that this administration does not care about the people and it is not making America great.”

Another nurse with 26 years at Kaiser highlighted the systematic dismantling of hard-won gains. “When I first started, Kaiser offered a pension … and in the last two, three contract negotiations, they’re trying to wipe out our pension.”

The crushing cost of living, she said, is “Very hard … mortgage, groceries.” With no strike pay and a single income, she said, “I’ve called my mortgage company … they don’t help you.”

On Pretti’s murder, she was blunt. “This man was shot in the back and that is inexcusable, that is murder. … He helped our veterans.”

Asked about the need to build rank-and-file committees against Trump and ICE, she replied, “Absolutely. This needs to stop. People need to be able to go to work, to school. … How can it be wrong that someone’s going to work? And not even making fair wages!”

While workers are beginning to draw political conclusions, the UNAC/UHCP officialdom has sought to confine the struggle within narrow contractual limits. On multiple picket lines, WSWS correspondents were told to leave, and union officials shut down discussions of political implications. “We’re trying to separate the economic issues from other stuff,” one official said.

But such a separation is impossible. The struggle for safe staffing, living wages and retirement security collides directly with corporate power and state repression.

The growing support for a national general strike reflects an emerging understanding that workers face not only Kaiser Permanente or individual employers but an entire political and economic system. The expansion of rank-and-file committees, independent of the union bureaucracy and oriented toward unifying struggles nationally and internationally, is the decisive task posed by this strike. Now, more than ever, the struggle raises directly the question of political power itself.