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Healthcare Workers at Kaiser in Northern California Set To Strike in Solidarity with Striking Engineers

Kaiser Permanente has recently averted a strike of over 50,000 healthcare workers in Southern California, Oregon, and Hawaii after reaching a tentative agreement with workers. In Northern California, though, thousands of healthcare workers from various sectors are still set to strike this week. Striking Kaiser engineers in Stationary Engineers Local 39 have been picketing since September 18. Now, starting this week, around 40,000 workers from multiple unions will walk off the job in sympathy with Local 39. Healthcare worker Mike Pappas speaks with a mental health worker who will be striking.

Mike Pappas

November 17, 2021
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Photo by Fred Greaves for CalMatters

Of note, this interview was conducted Saturday 11/16, since the time of this interview the Guild for Professional Pharmacists has reached a tentative agreement (T.A.) and are no longer striking. 

Mike: Tell me a little bit about yourself: your name, your position at Kaiser, how long you’ve worked there and so on.

Maggie My name is Maggie Mullen. I use they/them pronouns. I’m a licensed clinical social worker in the state of California. I work at Kaiser Permanente, and I’m part of the National Union of Health Care Workers (NUHW). In NUHW, we are primarily mental health workers. So, people who are in departments of psychiatry, doing behavioral medicine, things that are sort of mental health-adjacent work. I’ve worked at Kaiser 9.5 years now. 

Mike Could you speak a little bit more about the labor struggle that’s going on at Kaiser? What have the working conditions been like, and based on those things, what are the workers demanding today? 

Maggie I work in Northern California as part of NUHW at Kaiser Permanente for 9.5 years, and one of the biggest things that happens is that every time we have a contract to negotiate — and I’ve done this, I think, 3 or 4 rounds now — it is a huge struggle with Kaiser to get really any improvement in patient care, increased staffing, better ratios for being able to see patients, or more time for charting, notes, etc. It’s been a struggle each time, and this time is really no different. So, what we see, in terms of clinical work, doing work in the Department of Psychiatry, doing work with folks with mental health issues, is just extraordinary wait times. People come in for an initial appointment and then for all of their return appointments — this may be someone with severe depression, anxiety, grief or bereavement, particularly during the pandemic, PTSD — they’re waiting between six and eight weeks to have a return appointment, so they’re getting seen essentially every 6 to 8 weeks on an ongoing basis. 

But that is really such a far deviation from the standard of care, what our research is based on, that it’s actually quite embarrassing. And the thing I think that’s hardest for a lot of us around this, is the pandemic has made everything worse. So, everyone’s mental health is worse, in terms of people who are coming to seek services — and understandably, right, this is like one of the scariest moments in history for so many reasons, in addition to this kind of national racial reckoning that’s happening as well — and so there’s just a ton of trauma right now, and it’s trauma that I think a lot of our patients coming in are experiencing, but also our clinicians too, right? We’re going through many similar things to the things our clients are going through. And so what makes it tough is that we also don’t have any support from Kaiser at the same time that we are seeing people leaving or quitting the mental health profession at Kaiser in droves. Particularly we’re seeing that among Black, Indigenous, and people of color (BIPOC) clinicians who are like, “I can’t do this right now. There’s not adequate compensation. There’s so much work. There’s so much emotional toll that this is taking on me that it’s just not something that I can sustain.” And so the reason that we’re really going out on strike right now is because we’re asking for increased staffing, for an increase in pay for bilingual therapists, so we can have people who are actually representative of the linguistics and cultural backgrounds of the clients that we work with. We’re also asking for things like cost of living raises. Which in California, as inflation goes up and things go up, we’re asking for these small benefits as far as that goes as well. 

Mike It’s interesting that you bring up some of these things, like the patient wait times or how long people are able to see patients for. Seeing the uptick that we’ve seen in labor struggles around the country and then even more specifically among health care workers, it’s a common thread that we hear throughout the health care system around how patients are shuffled in and out of the clinics, they’re not able to be seen again for a long amount of time. It seems to be almost emblematic of our healthcare system more largely and how it functions. And then, as you say, the pandemic has just made everything worse on top of it. 

Maggie Yeah, absolutely. I think one thing to add that we’ve seen is that Kaiser Permanente in particular, is not a county clinic. It’s not a community clinic. It’s not a nonprofit with a small, struggling base. We make billions of dollars in profit every year. And I think one of the things that we are really pushing for as a union is to say, use your money to build a healthcare system, particularly for mental health, that can be a model, right? We have the money for it. We  have the resources to make that happen, and people deserve that. And I thinks one way that Kaiser could really shine too is to say, “Look, we’re going to do a good job by people who are struggling with their mental health overall.” But they’ve chosen not to take that path, which makes it, I think, all the more difficult to stomach as a worker there. 

Mike Yeah, I was reading some info before this interview, and I saw that Kaiser generated $2.2 billion dollars in operating income in 2020 and the CEO, Greg Adams made like $6.6 million in 2018 alone. So it seems almost like it would be a slap in the face to workers, especially to say, “Oh, well, we don’t have enough money to to do X, Y, or Z to give you guys what you’re asking for,” which much of the time is just working conditions to provide better patient care, especially when the CEO is making that much and they’re bringing in that much money in revenue. 

Maggie Yeah, it’s discouraging, to say the least — demoralizing and probably more accurately so. And I really love working at Kaiser. Look, I’ve stayed there for almost a decade now, as somebody who’s relatively new in my career, because I am motivated by serving my patients, right? I, like most people who come into our profession, care about serving the people that we’re working with. But for me, it’s so tough to end an appointment with somebody and say, “You know, see ya in 6 to 8 weeks,” right? Just every time I have to do that, a little piece of me feels like it’s dying, because I’m like, “I know I’m not giving you what you deserve and what also you need as far as your recovery process as well.”

Mike How has Kaiser responded to the demands thus far or to the struggle thus far? And I heard recently that maybe some type of tentative agreement (T.A.) was reached?

Maggie So I can comment really briefly on the tentative agreement that was reached. That was actually for a different group of unions in Southern California. It sounds like they’ve reached a tentative agreement, which is awesome for them. But because Kaiser is in multiple states with many unions and many different contracts, our particular contract hasn’t been resolved yet, which is part of the reason why we’re going on strike on November 19, next Friday. And then in terms of how Kaiser has responded to our demands, yeah, not well, is the short version. I think this has been similar to how most of our kind of contract negotiations have gone in past years. There’s a lot of attempted refuting of facts. So a lot of, I think, lack of information on the side of people who are negotiating on Kaiser’s end and a lot of statements that I think are generally insulting towards us as workers around what we should be able to do and what we should be able to tolerate. I think a lot of also walking away from the table, not meeting us halfway, not negotiating in good faith, not being willing to sort of say, “We’ll give you this if you can negotiate on this.” It’s a lot of, overall, “We’re not willing to really do anything at this point.” And one of the things that’s now on the table that’s new is kind of creating this two tier pay system, which essentially creates a divide among workers based on where you live, how much you get paid. And what we know is, that’s inherently racist, right? That you are going to pay people in a certain community less because you see the cost of living is cheaper there versus people who live in wealthier areas who tend to be more white. So we’re kind of creating more of a class system in addition to all of that as well. 

Mike It’s interesting that you mentioned that two tier pay system because it seems that that is an effort that’s becoming more and more widespread among bosses. Left Voice has been covering some of these other strikes going on around the country, and, for example, Kellogg workers are on strike right now. And one of the things that they’ve been striking against is this two tier wage system that they’re trying to institute there. And the workers at Kellogg were saying, in addition to everything that you brought up, is that the system divides people against each other and almost is a way that the boss pits people against each other. 

Maggie Yep, and we’ve seen that in the past, right? In our last round of contract negotiations, there was a desire to take away the pension for all new staff coming in. So you have a system where all of your kind of older staff who are working there have a pension and then everyone coming in has like a lower option, right? Like a 401k, but doesn’t contribute as much and doesn’t support us in the same way. And it does feel like measures like that divide us as workers, too, because people find out these things. One of the benefits of being in a union is things are very straightforward, right? We have our contract that we can look at that says, you get this and you get this, and here’s your step of pay. That creates, I think, a lot more transparency in the process that makes sure that everyone gets paid appropriately, but not when we have things like a two tier pay system as part of that, for example. 

Mike I kind of mentioned this a little bit, but around other parts of the country, healthcare workers have been either authorizing strikes or have gone on strike all over the place. We were just in Buffalo speaking with nurses who were on strike there, actually. I’m wondering how you see the struggle that you guys are in right now connected to the fight of other healthcare workers around the country for better working conditions? 

Maggie Yeah, it feels like it’s a movement right now. And I personally feel incredibly proud to be part of that. Part of the reason that NUHW, my union, decided to strike on November 19, next Friday, is actually because Local 39, which is the engineers union for Kaiser, has been on strike for I think 56 days as of today. So they’ve been on strike for almost two months, which is just nuts, right? People are not getting paid for that whole period of time. And for us, we want to step in and be in solidarity with them. And so ourselves and a couple of other unions are also going to be striking as of next week in solidarity with them to bring ourselves together as workers, knowing we have more power together. And to me, I think that’s really reflective of, again, the idea that all of us as workers across the country, across the world really, need to be in solidarity with one another, supporting each other’s unions, not crossing picket lines, contributing to strike funds, things like that that we can do to support one another because we know that the mental health system, as well as the healthcare system, period, is really broken across this country. 

Mike Yeah, that’s amazing. I hadn’t heard about the cross-union solidarity piece of this. Could you speak more to what other unions are also going on strike? 

Maggie Yeah, there are a few other unions striking. The Guild for Professional Pharmacists is striking on Monday, so the 15th they are starting and going to the 22nd. Kaiser sent out a big email to all patients, basically saying pick up your prescriptions early. The Stationary Engineers Local 39 is the union representing engineers who have been on strike for the past 56 days or so. California Nurses Association is striking November 19. SEIU-United Healthcare Workers West (SEIU-UHW) is striking November 18. Physical therapists (PTs) and occupational therapists (OTs) are going to be part of one of the unions who are going on strike next week as well.

And physicians at Kaiser in particular are shareholders actually, right? That’s the way that our company works. And so they are definitely not union members, they are people who profit off of this. And I don’t say that to say all physicians are bad. We have incredible physicians who I think often encourage us to do what we need to do because the work we’re able to push forward in contract negotiations makes better patient care for their patients. But they also have kind of a complicated vested interest in making money from a company too, so it’s a bit more complex. 

Mike I’m curious, because of this dynamic, what has the response of the physicians been thusfar? 

Maggie There’s nothing official that comes out from them. I would say I’ll speak just for my own department. So I work in Richmond, California, and the folks there I think are generally pretty supportive, right? It’s hard for them because they are picking up all of our slack when we’re out, and we appreciate them for doing that. But I think generally, look anecdotally, people have been pretty supportive because again, it’s about patient care. And when we do things to improve mental health access, it improves their ability as psychiatrists or as physicians to do better work with their patients. So I think in general, it tends to be pretty good, although there’s no official word from them necessarily on this. 

Mike Yeah, it would be great if somehow they joined in the struggle despite their the position that they have in the company, because, in some sense, they’ll be acting a little bit as scabs because of their inherent position in the company. 

Maggie Yeah, it’s definitely complex, for sure. 

Mike Whenever healthcare workers try to fight for better working conditions, which as you’ve expressed, is going to lead to better patient care, one of the things that bosses often cry is about how health care workers are “abandoning patients.” I bring this up because even in Buffalo, one of the things that that the nurses there saw was when they said they were going to go on strike because they wanted like better ratios to better care for patients, the hospital tried to even send propaganda to the surrounding community to say, “Oh, well, the nurses are going on strike. They’re pretty much said they’re abandoning you, so it’s going to be harder to get care.” Bosses use that type of language to try to turn the community against the health care workers who are fighting for better conditions. I’m wondering if you’ve seen anything like that? 

Maggie Yeah. One thing I have seen is when we talk to patients about going on strike, just letting them know when we’re going to be out of the office, for example, they tend to be actually very supportive because they are people who know that patient care is bad, right? They know that they’re not getting the services they should. And oftentimes they’re considering if they should pay somebody in private practice to do therapy with, for example. So I see a lot of our patients as being incredibly supportive, like we’ve had a lot of patients who come out in the front lines to strike and picket with us before. And I am very grateful for that part. I do see the messaging, right, and I know there’s legal limits around what exactly  Kaiser can say and whatnot, but it feels like it always goes right up to that line of what is allowed speech to say. There’s a lot of blame, like “we’ve” [Kaiser] negotiated in good faith and “they’re” [the workers] making this decision. There’s a lot of that type of language that I think is really difficult to stomach. Again, knowing what happens in these contract negotiations, knowing how we’re treated as staff across the board, can be really tough. But the argument that I always make is that the decision for me, ethically right as a provider is, do I provide substandard care or do I take a potential brief break from working in a strike in order to push for better quality of care in the long term? And the answer is always, I’m absolutely going to do the thing that has the longest term best outcomes because I know we can make it work short term, people can get through that period. And so, that feels like very false logic, this idea like abandonment that always comes up, because we only want to do what’s best, and we know that Kaiser has the money to do it. It’s just a matter of saying, “we’re going to allocate those resources to make sure you are well staffed and you can provide more readily available care to your patients.” 

Mike Yeah, it’s interesting that the abandonment argument is made when the exact conditions that are created by the boss are what’s difficult. In my hospital when I was working, the CEO ran to his mansion in Florida during the pandemic. So if anybody is abandoning their post, it’s the bosses….You know, so it’s not just health care workers around the country that are striking, there are the Alabama miners who have been on strike. John Deere just voted down their T.A., and they’re remaining on strike. In IATSE, right now they approved a T.A. that a lot of workers pushed back against, and then I mentioned Kellogg. I’m wondering how you see the struggle of health care workers connected to the struggle of other workers fighting for better working conditions?

Maggie Yeah, I mean, I personally see them as one in the same. We’re working in the same racist, capitalist system where people are put against each other and made to compete for very scarce resources overall. And I think health care and other workers in any industry are facing very similar struggles. I don’t actually see there has been a lot of differences between the two in that regard. I grew up in a union family, and being a part of a union is something I am very proud of personally. And being able to support those other workers as much as possible feels like it’s part of it. Because for me, I think when one union strikes, it inspires other people to be willing to do the same thing, put their necks on the line to some degree. And I think the same is true for the gains that we get in contracts, right? Because other people can say, “Well, this union got this thing,” right, if we’re working in a similar field. And so there’s kind of an ability to pull each other all up when we’re doing this work rather than being in separate spaces or across the board. For example, one of the things that I just saw yesterday was Bernie Sanders and seven other senators signed on to a letter that they sent to our CEO, Greg Adams, basically saying, “You know, all of these unions are about to go on strike, including, the engineers union,” who I mentioned before have been on strike for eternity, it feels like now. And they were really pushing to say, “this is a problem you need to solve.” And Kaiser is a huge organization who, again, has the resources and should be solving this problem as a model because what we’ll see is trickle-down improvement and care for other workers when we support one group at one corporation. So that’s kind of how I see things as being very interrelated. 

Mike Thanks for that. I guess the last question I had was if you have any other message to other health care workers fighting for better working conditions and patient care, and then any message for just workers fighting their bosses in this economic system that puts profit over everything else?

Maggie Oh, yeah. I don’t know if I have anything more profound. I’d say, keep your head up man, we stand with you. As NUHW, as mental healthcare workers, for me, as a social worker, I support you 100 percent and doing what you need to do to support your families, your communities, the people that you’re working with, etc. And the more that we continue to push for, and be united as one group of workers, I think more generally, the more that we’re all going to benefit. And so, you know, keep doing what you can do. 

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Mike Pappas

Mike is an activist and medical doctor working in New York City.

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