In the first big strike of the year, 3,500 California health care workers took to the picket line at Kaiser Permanente, the nation’s largest health care provider (HMO).
Therapists, psychologists, optical workers, dieticians, social workers, psychiatric nurses, health educators and other members of the National Union of Healthcare Workers (NUHW) began their week-long strike early Monday morning, January 12, striking three dozen California facilities. On the Friday hundreds marched from Kaiser’s massive Oakland flagship facility, down Broadway to the corporate headquarters, One Kaiser Plaza.
This was the third such NUHW led strike in three years. The workers demand that Kaiser, flush in profits and overflowing with patients (thanks in large part to Obamacare), hire sufficient staff. They are protesting Kaiser’s long standing refusal to do this, even as workers, patient advocates, even the State of California demand that they do so. In September, Kaiser agreed to pay a $4 million fine, having been charged with blocking patients from timely access to mental health services. The complaints originated with Kaiser mental health care providers, NUHW members underscoring a shameful national mental health crisis.
Clem Papazian, a clinical social worker at Kaiser Oakland, the elected president of NUHW’s mental health workers unit told the marchers:
“As you all know, Kaiser really doesn’t staff their psychiatry departments with enough psychologists, therapists, and social workers to handle the demands for services.
“There are simply not enough of us to provide timely, adequate care for the number of patients seeking our care — care that patients pay for with their monthly premiums and that Kaiser is required by law to provide in a timely manner.
“Our patients can’t get appointments because our schedules are already booked solid. And the caseloads are growing rapidly as Kaiser enrolls hundreds of thousands of new members under the Affordable Care Act.
“Kaiser’s latest clinical proposal promises to have clinicians working so fast and so hard that the clinics become sweatshop-style mills, where everyone performs in lockstep, delivering cookie-cutter care to compromised members who may not have the knowledge or energy to expect anything better…”
The workers are also demanding a concession-free contract – seemingly an unexceptional demand given Kaiser profits – exploding to $3.1 billion in the first three quarters of 2014, $15 billion in the last five years. It added 422,000 new enrollees in 2014. Yet Kaiser has stubbornly refused to agree to anything (including staffing demands) in four years of off again on again bargaining.
These strikes follow a strong pattern of growth by NUHW; founded in 2009 with fewer than 1,000 members, it has since grown in size to more than 10,000, certainly the fastest growing union in the state. Moreover, growth has come as the union has deepened its commitment to becoming a “model union” – the strategic focus in the highly successful statewide leadership meetings in October. A model union, that is NUHW’s commitment to building a militant worker-led movement for democracy, quality patient care and with a powerful voice in the workplace.
We might add that the strike reflected the enthusiasm, the courage and the solidarity of these workers, qualities sorely needed in an era of ongoing trade union decline.
So far so good. Alas, no one promised it would be easy, certainly not here in California where the stakes are so high. Kaiser alone employs 120,000 workers in the burgeoning – nearly 1.5 million workers – high profit healthcare industry, most of it non-union. And in a state where glitter of the corporate recovery has blinded few to its place near the top of the inequality charts.
It’s a time for action, then. Right?
Astonishingly, the California Nurses Association (CNA-NNU), a union with a reputation as a militant fighter for nurses, a union that, along with NUHW, rejected “partnership” with Kaiser, and a union that has in fact been affiliated with NUHW for more than two years, has settled short with Kaiser.
On January 26, in an “Open Letter to Members of NUHW,” signed by Zenei Cortez, Co-President, CNA, concludes, following the single charge that “staff leaders of NUHW have chosen to engage in attacks on our new Kaiser agreement and our leadership…” (offering no detail, no evidence) “We hope you will take this opportunity to join us.” Curiously, as a sort of footnote, the letter stated it would “help” NUHW’s Kaiser members in their contract fight. The letter is now being passed out at the University of Southern California’s Keck Medical Center.
This is all unfathomable. At Keck, NUHW workers have just now begun negotiations with management; the aim there is to build on the strong existing contract, a contract won in 2012. in part based on a powerful collaboration of CNA nurses and NUHW service and tech workers. It was an excellent example of just why to have an Alliance.
Why is this happening? Why, in the face of an anti-union tide still building, has the CNA, following in the footsteps of its one-time foe, the Service Employees International Union (SEIU), chosen to attack the NUHW? In the Affiliation there was the basic agreement to collaborate – the principle of solidarity. The strategy involved building toward common action at the time when the nurses’ contract expired, August 2014.
The CNA instead repudiated its agreements in the Alliance – and in the process it repudiated the fundamental notions of solidarity between unions, allied or not and above all when workers face a common employer. Rather, in the run-up to NUHW’s January strike, CNA officers gave NUHW an ultimatum – either end the Affiliation or liquidate themselves, in this case by merge with CNA’s invisible unit, CHEU (Caregivers and Healthcare Employees Union). CNA leaders flatly refused to support the January strike, though in the event 100s of nurses joined NUHW on the picket lines. This is “help”? Instead they called for an altogether separate strike, though this seems to have been at best a distraction, or perhaps a way to keep their own members away from NUHW picket lines; it never happened. Moreover, CNA kept its negotiations secret, including its tentative agreement and not only from NUHW. Its own bargaining team only learned of the agreement the Friday morning of the NUHW strike – at a time when several nurse leaders were planning to speak .
The CNA and NUHW formally joined forced just two years ago, in an “Alliance” I (mistakenly?) called “a giant step forward for California healthcare workers.” (see here “An Alliance in Healthcare”) It was “an affiliation whose time has come,” said Sal Rosselli, president of NUHW. There was much to be said for the alliance; an industrial union in the healthcare industry dominated by giant firms made total sense. The pressing issue, however, was the NLRB ordered rerun of the Kaiser election – the contest between NUHW and SEIU to represent 43,000 service and technical workers. SEIU won the first round, but the NLRB had thrown out the results.
The fledgling NUHW certainly needed support, and CNA had no love for its old enemy SEIU; the nurses – with their own contract on the horizon – had good reason to stand up to Kaiser’s favorite union, the 150,000 California local, UHW-W, seized in trusteeship by SEIU and now led by the imported, thuggish Dave Regan. Regan, a champion of “cooperation” with the employers, who rejects any notion of adversarial relations and denigrates “us versus them” thinking, continues to be if anything a primary obstacle facing California hospital workers. (See here my “How Not to Save the Labor Movement”)
In the event, SEIU won again, albeit by less. NUHW, born in the aftermath of SEIU’s trusteeship of UHW-W, regeared to fight on; though on a reduced scale, but now representing the 4,000 Kaiser workers who did vote to leave SEIU and join the new union.
What, then, is CNA up to?
What now appears to be a major area of CNA concern are the 1200 nurses who work at Kaiser’s big Los Angeles Medical Center, Kaiser Sunset. These nurses, in the shakeup following the SEIU trusteeship, were among the 4,000. Since then Kaiser has refused them a contract.
With hindsight, the question arises; did the CNA have the Sunset nurses in its sights all along?
Again, the Alliance clearly began to unravel shortly after the Kaiser election. But why the LA nurses? CNA represents no Kaiser nurses in Southern California and unquestionably the LA nurses must seem to offer a good foothold there, also they might have been a plus for CNA in its recent contract negotiations. Whatever the case, NUHW offered a “service” agreement, that is, they allowed CNA to represent the nurses and agreed to abide by the decision of the nurses themselves concerning representation. They asked just that CNA not ask for an election in the midst of current contract negotiations.
CNA, however, began circulating authorization cards, and then two more unions joined the fray; now it’s all in the NLRB’s hands, settlement months away. More to the point, CNA did not include the LA nurses in its agreement just signed with Kaiser; they remain without a contract, their fate in the hands of the NLRB. Kaiser, happy, is content to wait until the NLRB decides. Then what?
Whatever, in the meantime, CNA signed on – separately – with Kaiser, agreeing to, what must be said, a decent contract, but agreeing to a number of concessions – new co-pays, cuts in retirees benefits, concessions then contested by the NUHW professionals. The tentative agreement has now been ratified by the union’s membership
The Cortez letter charges that NUHW staff criticized CNA for this? True? Certainly not publically. Privately? Perhaps. But it must be remembered, NUHW is not the monolith CNA is. Then, there is the question, why, in view of Kaiser’s staggering profits and projected growth, why did CNA agree to any concessions? Isn’t there a time to be on the offensive? And finally, is this cause for attack – attacks that, if successful, could destabilize NUHW at Keck, just as it enters bargaining? Will more attacks follow? Attacks on what is indeed a model union, a growing, democratic, worker led, union, the kind of union so many say they want – the kind of union we all need?
So there’s more. Not so long ago, SEIU organized a few busloads of workers to break up a Labor Notes conference in Michigan, a conference where CNA Executive Director Rose Ann DeMoro was a featured speaker. CNA and SEIU were involved in a dispute, a dispute that highlighted SEIU’s management friendly organizing style, the style that led to the disastrous trusteeship in California. At that point DeMoro referred to SEIU as “a management surveillance team” an organization that “will do anything to collect dues.”
But SEIU remains a powerful force; unfortunately it’s top-down, highly centralized form, plus its gimmicks and publicity campaigns, its growth and any cost, retain an attraction for some. And the rumor now is that a new deal is in the works – old enemies, new friends, SEIU and CNA sitting down to draw up new plans, set their sights on new spoils, new dues units. Has the SEIU changed? Not likely.
But this also comes at a time when CNA has lots on its plate. Its National Nurses Union is in disarray, few of its affiliates seem anxious to accept the sort of leadership and centralization (SEIU style, that is) it now proposes and that CNA once found so objectionable. Already, CNA has effectively purged its Pennsylvania affiliate. Despite this, the Massachusetts affiliate, to its great credit, sent the NUHW strikers a check for $5000.
Meanwhile the NUHW marches on. Back in gentrifying Oakland, our march down Broadway (“Auto Row,” BWW, Audi Mercedes Bens…). Several hundred cheerful workers in pursuit, though with very serious things on their minds. Several signs read “No More Suicides!” Yes, “No More Suicides” and at the rally at One Kaiser Plaza, we heard several heartbreaking accounts of theses, stories from people we know, from the places where we live – Santa Rosa, Richmond, six in Redwood City alone…
This, some readers will note, is an ongoing story, often an unhappy one. It doesn’t, however, have to end badly. NUHW is determined that it won’t.
Papazian reminded the Oakland strikers:
“You know, some people thought we would never be organized enough to unionize and we did it.
“Some people thought we would never be strong enough to decertify from SEIU and we did that…
“Some people thought we could never sort through the complexity of the mental health service model in order to mount a convincing argument to the state about the seriousness of the problems in mental health service delivery at Kaiser and we did that…
“Some people thought we could never find enough agreement in our ranks to authorize a one day strike of all of our mental health workers and we did …
“Some people thought we could never get everyone to agree to an escalated, five day action and we did that too, in truly remarkable fashion… Some people thought nobody would ever pay attention to a small unit of mental health workers at Kaiser, but as a result of your action this week, now 800 media outlets throughout the country have covered this strike… – Kaiser, the whole world is watching!”
According to spokespeople, the NUHW remains committed to making the Alliance work. It’s about solidarity after all, solidarity in the face of a behemoth. And common sense. NUHW’s Kaiser workers deserve a contract. They’re fighting for all of us. And they need our support. An injury to one is an injury to all.
Cal Winslow’s latest book is a collection of the writings of Edward Thompson, E.P. Thompson and the Making of the New Left (Monthly Review Press, 2014). He is the author of Labor’s Civil War in California, PM Press, 2012 (second edition, revised and expanded), an editor of Rebel Rank and File: Labor Militancy and Revolt From Below during the Long Seventies (Verso, 2010), and a co-editor of West of Eden, Communes and Utopia in Northern California (PM Press, 2012). He is a Fellow at UC Berkeley, Director of the Mendocino Institute and associated with the Bay Area gathering, Retort. He can be reached at email@example.com