Seven current and former nurses told CalMatters that spending more than 15 minutes on a call routinely draws criticism from supervisors or triggers formal performance reviews. Call length, they said, feeds directly into monthly evaluation scores. Beyond simply tracking how long calls last, nurses said Kaiser has deployed software that forecasts, on a daily basis, whether a worker appears unproductive or slow to pick up calls. At one point, the company even tested AI designed to grade nurses on their tone of voice and apparent empathy.

The complaints surface as the California Nurses Association opens contract talks with Kaiser this month, with artificial intelligence expected to be a central sticking point. Kaiser nurses staged a one-day strike over AI in March and picketed the issue last fall. The union represents roughly 25,000 nurses systemwide, including about 1,000 who work in call centers.

Meanwhile, state lawmakers are weighing several bills aimed at regulating AI in health care workplaces, including one that would shield doctors and nurses from retaliation if they override computer-generated care recommendations.

Kaiser disputes that it manages nurses by the clock. A company spokesperson said the health system does not use “average handle time” to judge performance and that any technology used in its call centers is meant to support quality assurance, with human oversight built in.

Still, the stakes are significant. Kaiser is California’s largest private employer and serves more than 9 million people in the state, along with roughly 3 million patients elsewhere in the country. How it handles AI in the workplace could set a template for other health systems grappling with the same tension between automation and hands-on patient care.

Raquel Alvarez Sanchez, an advice nurse based in Vallejo since 2010, recalled a call last year with a suicidal patient that stretched past an hour because she stayed on the line until police arrived. Even as she tried to comfort the man, she knew the extended call would skew her average handle time for weeks and could invite scrutiny from management. As a union steward, Sanchez said she has sat in on performance reviews where colleagues did everything right clinically but were still flagged for going over 15 minutes. She hasn’t seen anyone fired over it, but she worries the constant pressure is pushing nurses toward burnout, early retirement or resignation.

“I think at some point all of the nurses have been talked to about their average handle time,” she said. “The only thing I can think of is they’re doing it for profit.”

Another nurse, who asked not to be named for fear of retaliation, described a call last year with an elderly woman who had just received a terminal cancer diagnosis. The nurse initially suspected the patient was suicidal but soon realized she was simply in shock and needed someone to talk to — a woman who also serves as caregiver for her own daughter. The nurse wanted to linger and offer comfort but held back, worried it would hurt her monthly score and draw a reprimand. She had become a nurse to provide compassionate care, she said, but found herself asking, “Am I going to get disciplined for going off script or saying more than what is necessary?”

Kaiser maintains its performance reviews are meant to improve outcomes, not punish nurses for spending time with patients. “Kaiser Permanente does not use Average Handle Time to assess agent performance or enforce call time metrics,” spokesperson Vincent Staupe said, adding that any tools used in its contact centers are subject to human review. Staupe said Kaiser deploys AI responsibly, with attention to patient safety, privacy and equity, but declined to detail its internal systems, citing security and operational concerns.

Whether the pressure nurses describe translates into harm for patients is difficult to measure. Nurses say their contact with patients typically ends once they hang up the phone, making it hard to track downstream effects. A 2024 records request by CalMatters to the state Department of Managed Health Care turned up no formal patient complaints tied specifically to call times. Still, nurses insist the risk to care quality is real.

Michele Ramos, a patient advocate with Consumer Watchdog, said many Kaiser members’ first contact with the health system comes through the advice line, and complaints she later hears about problems inside Kaiser facilities may often trace back to what happens on those calls. She sees the time pressure as consistent with a broader pattern at Kaiser of prioritizing costs over care. The health system was fined a record $50 million in a settlement with the state’s managed health care regulator over delayed behavioral health appointments and overuse of group therapy instead of individual sessions. It also reached a settlement with the U.S. Department of Labor following investigations into its substance abuse and mental health services. In 2002, Kaiser faced criticism for paying bonuses to non-nurse call center staff who kept calls short — though nurses who spoke with CalMatters said they’ve seen no similar incentive structure today.

“Kaiser’s been known through the years to manage dollars over managing care, and I think this would be a contributor to that, which is only going to fail patients,” Ramos said.

Nurses say the 15-minute benchmark is especially difficult to meet on calls that inherently take longer — patients with multiple symptoms or chronic conditions, new parents seeking reassurance, people processing devastating diagnoses, or callers who need an interpreter, which can add 30 minutes or more to a conversation. Nearly four in 10 Californians speak a language other than English at home, and roughly half of them are not fluent in English, according to state data.

“The amount of time that Kaiser is giving us to complete a call is sometimes not safe,” said one nurse who spoke on condition of anonymity.

Charlotte Capulong, who has worked in nurse call centers for 22 years and helped organize opposition to the AI tone-monitoring tool, said she has watched colleagues get pulled into meetings and criticized even when they did everything else correctly except finish a call within the allotted time. “People can get hurt,” she said. “You aren’t calling Comcast. We’re dealing with life here.”

In the summer of 2024, Kaiser began piloting an AI system designed to evaluate empathy and tone in conversations between nurses and patients, according to several nurses interviewed by CalMatters. Workers responded by circulating a petition demanding more transparency, protection of patient privacy and respect for nurses’ clinical judgment, echoing the “Trust nurses, not AI” slogan used at protests outside San Francisco hospitals earlier that year. The pilot ended in November 2024, though union representatives say management has indicated it could return.

“That was intensified when they said we’re going to use AI to evaluate our calls and grade us,” Sanchez said. Another nurse, speaking anonymously, said flatly: “AI did not understand our job and would grade us wrong all the time.”

Kaiser declined to answer questions from CalMatters about the tone-monitoring tool or how AI and other automated systems are used to evaluate nurses, including whether patients were told their calls might be analyzed for empathy and tone.

Nurses also described shrinking breaks between calls — even after conversations involving suicidal patients, mental health crises or dying patients. Where nurses once had roughly 10 minutes to finish notes or simply regroup after a difficult call, they say they now often get 30 seconds or less during busy periods, though more time may be available late at night or with a supervisor’s approval following an especially hard case. That pace, they say, increases the odds of missing important warning signs about a patient’s condition.

Union representatives declined to detail specific AI-related demands ahead of this summer’s bargaining sessions with Kaiser.

Researchers who study workplace surveillance say the concerns raised by Kaiser nurses reflect a much broader trend. Annette Bernhardt, who directs the Technology and Work program at the UC Berkeley Labor Center, has warned that algorithmic management can strip workers of autonomy and reduce them to mere extensions of the systems monitoring them. A 2023 academic study of call centers in four countries found that AI-driven monitoring left workers with less recovery time between calls and higher rates of emotional exhaustion; nearly half of respondents said AI tools made their jobs more stressful.

Virginia Doellgast of Cornell University, who co-authored that research, said what Kaiser nurses describe fits a pattern seen across industries where constant monitoring adds strain to work that is already emotionally demanding. “Stress and burnout can lead to more mistakes across a range of areas, and in the health care setting that is much higher risk because you’re dealing with people’s lives and their health,” she said. Conversely, research shows workers given more control over their pace tend to report higher job satisfaction and fewer absences.

The concerns extend beyond Kaiser. A 2024 survey by National Nurses United found that half of more than 2,000 nurses said their employers use algorithmic systems to analyze patient records, including predicting how much care a patient will need. Two-thirds said their own clinical judgment had, at some point, conflicted with an algorithm’s recommendation, and 60% said they didn’t trust their employer to prioritize patient safety when deploying AI.

Pa Vue, who has worked in call centers for nearly a decade, said she has had her performance score docked for repeating advice to a patient she worried might be having heart problems. As a union representative, she has watched managers question the length of calls and seen nurses penalized for exercising professional judgment that ran counter to software recommendations, or for scheduling appointments without first consulting a doctor. She says the emphasis on efficiency undercuts the quality of care patients are paying for.

“I’m not against the use of AI as long as it’s beneficial to the patient, but in this particular use [empathy and tone monitoring] it’s to increase productivity and improve efficiency and cut costs,” Vue said. “Kaiser is forgetting we aren’t just a call center for customer support, we’re nurses, and we’re there to take care of patients.”

AI is also a flashpoint in separate negotiations covering roughly 2,400 mental health workers at Kaiser facilities in Northern California, who have raised concerns about therapy session transcripts potentially being used to train AI models, and about automation threatening their jobs altogether. A spokesperson for the National Union of Healthcare Workers said those talks are ongoing.

Kaiser’s use of artificial intelligence extends well beyond call centers. The health system uses AI to flag hospitalized patients at risk of complications by analyzing electronic health records, and an AI tool called Preventus helps determine discharge timing. Doctors and therapists use a program called Abridge to transcribe in-person visits instead of taking handwritten notes. Nurses say Kaiser has also tested AI-based remote monitoring for higher-need patients at some Bay Area facilities.

California Nurses Association President Cathy Kennedy, who also leads National Nurses United, sees the tone-detection experiment as part of a broader effort by Kaiser to squeeze more efficiency out of nursing staff at the expense of professional autonomy. She argues AI systems should be proven effective and fair before they’re rolled out on real patients and workers.

Under its existing contract, Kaiser is supposed to notify the nurses’ union before deploying new technology, though the union says that doesn’t always happen. As a result, CNA has been trying to compile its own inventory of AI tools in use across the system, asking members to flag anything unfamiliar. That grassroots tracking helped the union push back against the empathy-tone AI last year and stop a separate pilot that would have replaced in-person nurse monitoring of confused patients with cameras.

Debru Carthan, a Kaiser radiologist and member of the Service Employees International Union, sits on a labor-management committee examining AI use across the company as part of the Coalition of Kaiser Permanente Unions. The coalition runs a “see something, say something” campaign encouraging frontline workers to report AI tools introduced without notice. Carthan said she worries the tone-detection technology could disadvantage nurses from different cultural backgrounds, and she has grown increasingly convinced that AI adoption in health care is driven more by cost-cutting than by improving patient outcomes.

State lawmakers have taken notice, though efforts to pass new protections have stalled repeatedly. Assembly Bill 1018 and Senate Bill 7 — both backed by the nurses’ union — would have required employers to notify workers before using automated systems to make decisions about hiring, discipline or performance evaluation. Gov. Gavin Newsom vetoed SB 7, and AB 1018 failed for a third straight year amid opposition from major employers, including Kaiser.

Lawmakers have since revived the effort with a new version of the bill, now numbered Senate Bill 947. Another proposal would bar employers from using AI to predict employees’ emotional states, while a separate bill would protect doctors and nurses from retaliation for overriding AI-generated recommendations and require health care employers to give staff an annual inventory of the automated systems in use. Kaiser declined to provide CalMatters with such a list.

In total, the nurses’ union and the California Labor Federation are backing roughly half a dozen bills aimed at regulating workplace AI. Earlier this year, labor leaders — framing AI regulation as a defining issue heading into the next presidential election — held a Sacramento news conference urging Newsom to strengthen worker protections if he hopes to pursue national office. “It’s an ongoing fight, and it’s a fight well worth having,” Kennedy said. “Whenever there are other unions in discussion about artificial intelligence, we are in solidarity with them.”

The nurse who held back compassion from the cancer patient she feared was suicidal said she believes the monitoring and scoring systems are turning nurses into box-checkers rather than caregivers.

“I used to use humor as a way to help patients heal, and I don’t feel comfortable doing that here because I know the calls are being recorded,” she said. “You can always tell when a patient appreciates the humor or your personal compassion, but I don’t feel like call centers have tolerance for that because that’s not part of the script. That really takes away from the whole point of being a nurse and what patients come to know from nurses.”

Original source: CalMatters

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The graduates represent a broad range of healthcare disciplines, including nursing and allied health programs that prepare students for careers dedicated to patient care, community wellness, and critical healthcare support services. As healthcare systems across California continue to face workforce shortages, MSJC’s newest graduates will play an important role in serving local hospitals, clinics, and healthcare organizations.

“Healthcare professionals are essential to the well-being of our communities, and we are proud to send 157 highly trained graduates into a region where the need for skilled healthcare workers continues to grow every day,” said Roger W. Schultz, Superintendent/President of Mt. San Jacinto College. “These graduates are stepping into careers centered on service, compassion, and excellence, and their work will make a meaningful difference in the lives of countless individuals and families throughout our region.”

In addition to celebrating this year’s graduates, MSJC also recently received a significant investment to expand its nursing program capacity and help address California’s ongoing nursing shortage. The college was awarded approximately $1.1 million through the Rebuilding Nursing Infrastructure (RNI) Grant Round 2 to develop a new hybrid Licensed Vocational Nurse (LVN)-to-Associate Degree in Nursing (ADN) pathway within the college’s ADN program.

The grant will expand educational opportunities for working healthcare professionals seeking to advance their careers while increasing the number of registered nurses entering the workforce.

As a result of the grant, MSJC will be able to admit 12 additional students to the nursing program each year. Beginning in the spring semester, the total number of students admitted into the program will increase to 84.

“This investment strengthens our ability to respond to regional workforce needs while creating additional pathways for students to pursue careers in nursing,” Schultz said. “By expanding access to nursing education, MSJC continues to support the health and economic vitality of the communities we serve.”

MSJC’s healthcare programs combine classroom instruction with hands-on clinical training, providing students with real-world experience in medical settings throughout the Inland Empire. Many graduates will remain in the area, contributing directly to the local workforce and helping address critical healthcare staffing needs.

For more information about MSJC’s nursing and allied health programs, visit https://www.msjc.edu/nursingandalliedhealth

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Mental health workers represented by the National Union of Healthcare Workers prepared for the strike over the weekend after declining Kaiser’s terms on Friday.

Kaiser in a written statement said it is notifying patients whose appointments could be affected by the strike. “Patients will have the opportunity to be seen by another professional in our extensive network of highly qualified, licensed therapists, if their regular provider is engaged in a strike,” the statement read.

The previous strike in 2022 among mental health clinicians in Northern California lasted 10 weeks and led to a commitment from Kaiser to hire more therapists and to give employees specific work hours away from face-to-face patient care.

Southern California Kaiser workers now are asking for more time in between appointments to prepare for patients. They also want wage increase and a pension benefit that the company provides to its Northern California clinicians. 

“It’s pretty simple,” said psychological social worker William Johnson, a union steward who serves on the bargaining committee. “We’re looking for the same three top priorities that Kaiser already said ‘Yes’ to for our Northern California mental healthcare workers.”

Johnson said his current workload includes seeing 32 to 35 patients a week in one-hour sessions.

Kaiser released a statement in response to the union’s plans to strike, saying, “unfortunately this comes as no surprise, as this seems to have been their intention all along.”

The company has offered wage increases amounting to 18% over four years and a number of other perks, according to the statement. Kaiser representatives said they have invested more than a billion dollars expanding mental health capabilities in California and increased the number of  licensed mental health clinicians in Southern California by 30% over the past four years.

But union members say turnover has been a problem, with a quarter of therapists hired between January 2021 and August 2024 leaving their jobs. 

“Kaiser leadership has consistently been dismissive whenever we voice our concerns or experiences,” said Johnson. “They like to tell us things like, ‘We get that it’s not ideal,’ and they also add, ‘But it works for us.’”

Jared Garcia, another union steward on the bargaining committee, said he’s hoping the strike lasts less than a month, but he’s prepared to see it go on as long as it takes.

“Scabs aren’t going to work,” said Garcia. “Kaiser knows the limitations of finding mental health professionals – let alone to replace 2,400 of our union members at this time.”

A year ago, Kaiser entered into a $200 million settlement agreement with the state of California, agreeing to pay a $50 million fine and invest another $150 million over five years to address delays in behavioral health appointments.

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Citing California’s budget deficit, the Democratic governor wants to save around $613 million in state funds by delaying pay increases for a year for about 150,000 disability care workers. The state will forgo an additional $408 million in Medicaid reimbursements, reducing funding by over $1 billion.

Some lawmakers say this decision will increase staff turnover and vacancies, leaving thousands of children and adults with disabilities without critical services at home and in residential facilities. Disability advocates warn it could violate the Lanterman Act, California’s landmark law that says the state must provide services and resources to people with disabilities and their families.

Newsom is “breaking a promise,” says Felisa Strickland, 60, who has been searching for more than a year for a day program for her 23-year-old daughter, Lily, who has autism and cerebral palsy. “It’s creating a lot of physical and mental health problems for people, and it’s a lot of undue stress on aging parent caregivers like myself.”

Disability care workers, known as direct support professionals, provide daily, hands-on caregiving to help children and adults with intellectual and developmental disabilities, such as autism, cerebral palsy, and epilepsy, remain independent and integrated into their communities.

In California, more than 400,000 people with disabilities need accommodation, and this population, along with seniors, is increasing. It’s unclear how big the worker shortage is because the state hasn’t released workforce data. As the demand for these workers grows generally, experts predict a shortage of between 600,000 and 3.2 million direct care workers by 2030.

Advocates say California pays most providers from $16 to $20 an hour, which meets the state’s minimum wage but falls short of what some economists consider a living wage. In 2021, the state committed to raising wages after identifying a $1.8 billion gap between the rates received by nonprofits that contract with the state to provide care and the rates deemed adequate.

Thus far, the state has provided around half that total, most of which has gone to raising wages and benefits. Workers had been expecting one more increase of $2–$4 an hour in July until Newsom proposed a delay.

Also, nonprofits say California has made it harder to compete for workers after raising wages in other service and health industries. Newsom approved a $20 minimum wage for fast-food workers that went into effect in April, and he struck a deal last year with unions and hospitals to begin raising health care workers’ wages to a minimum of $25 an hour.

Ricardo Zegri says Taco Bell would pay him more than the $19 an hour he makes as a disability care worker in a supervisory position.

“Every paycheck, it’s a discussion at home about what bills we need to prioritize and whether it’s time to start looking for work that pays more,” says Zegri, who works a second job as a musician in the San Francisco Bay Area.

Newsom wants to preserve key health initiatives, including the state expansion of Medi-Cal to low-income immigrants regardless of legal status, and CalAIM, an ambitious $12 billion experiment to transform Medi-Cal into both a health insurer and a social services provider. However, the rate delay for providing disability care is the largest savings in the Health and Human Services budget as Newsom and legislative leaders look to cuts, delays, and shifts in funding to close a deficit estimated between $38 billion and $73 billion.

Dozens of legislators from both parties are asking Newsom and legislative leaders to preserve the increase. Assemblymember Stephanie Nguyen, a Democrat from Elk Grove, signed a letter supporting the raise. Although lawmakers are negotiating with the administration, she says reversing the decision to delay the pay boost is unlikely. Everybody “has to take a hit somewhere,” Nguyen says.

Krystyne McComb, a spokesperson for the Department of Developmental Services, says that even though the state would lose federal matching funds this year, it would resume drawing funds when it reinstates the plan in 2025.

The department did not respond to questions about how it plans to retain workers and fill vacancies.

Newsom’s proposal risks a collapse of the disability service system, which would violate the Lanterman Act and make the state vulnerable to lawsuits, says Jordan Lindsey, executive director of the Arc of California, a statewide disability rights advocacy organization.

Families say the state has already fallen short of the services they need. Strickland quit her job to care for Lily, the Santa Barbara mother, says. “It’s not reasonable to expect someone to care for somebody else 24 hours a day, seven days a week,” she says.

Lily graduated from high school and, in 2022, completed a program that prepares youth with disabilities to transition into adult life. She had been looking forward to joining a day program to make new friends but has yet to find a spot. And due to a shortage of workers, Lily receives only four hours a week at home with a provider, who is paid around $16 an hour.

When Lily hangs out with the provider, her demeanor changes to the happy person she used to be, Strickland says.

“The system is already in crisis,” she says. “There are tons and tons of people that are sitting at home because there’s nowhere for them to go.”

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SACRAMENTO, Calif. (AP) — California will require health care workers to get a booster shot of the coronavirus vaccine, Gov. Gavin Newsom announced Tuesday, pledging to make sure hospitals are prepared as a new version of the disease begins to spread throughout the state.

California already requires health care workers to be vaccinated against the coronavirus, a directive that took effect in September and has since led to the firing or suspension of thousands of people. Now it will join New Mexico as at least the second state to require booster shots for health care workers.

Newsom made the announcement on his personal Twitter account. His office declined to give more details, including how many workers would be affected and whether frequent testing would be allowed as an alterative. Newsom has scheduled a news conference in the San Francisco Bay Area on Wednesday.

“California will require healthcare workers to get their booster,” Newsom said. “With Omicron on the rise, we’re taking immediate actions to protect Californians and ensure our hospitals are prepared.”

California has so far fared far better than many other states that are dealing with a coronavirus surge, with areas in the Midwest and Northeast seeing the biggest jump in cases and hospitalizations amid frigid temperatures that have kept people indoors.

The U.S. Centers for Disease Control and Prevention lists California as a place with “high” transmission of the virus, along with nearly everywhere else in the country. But in the last week California averaged 114 new cases per 100,000 people, less than half the national rate.

Meanwhile, coronavirus related hospitalizations have been rising slowly in California, up 15% in the last 11 days to 3,852. That’s less than half as many as during the late summer peak and one-fifth of a year ago, before vaccines were widely available.

But while hospitals overall have fewer patients than last winter, many have fewer workers to treat the patients they do have. The staffing shortage comes as businesses are having trouble finding workers, including hospitals. A recent study by the University of California-San Francisco estimated the state’s nursing shortage could persist until 2026.

“The staffing shortages we are experiencing are worse than ever,” Kiyomi Burchill, group vice president for policy for the California Hospital Association, said in an interview Tuesday before Newsom made his announcement about booster shots.

California is poised for a surge in new infections amid holiday parties and family gatherings forced indoors by a series of winter storms.CORONAVIRUS PANDEMIC

But experts say the nation’s most populous state is likely to avoid the worst scenario — spikes in hospitalizations and deaths — because most Californians have either been vaccinated or already been infected. That gives a higher level or protection against the omicron variant that, while not guaranteeing people won’t get sick, means they are less likely to need to go to the hospital.

“It’s a highly transmissible respiratory virus and people are going to get it. And they are going to get it every winter,” said Dr. Monica Gandhi, a professor of infectious diseases at the University of California, San Francisco. “We have to go toward measuring our true success with a disease, which is how we’re doing with hospitalizations.”

More than 70% of the state’s nearly 40 million residents have been fully vaccinated while 42% have gotten a booster shot. As of Monday omicron is now the dominant variant of the coronavirus in the United States.

Much about the omicron variant remains unknown, including whether it causes more or less severe illness. Scientists say omicron spreads more easily than other coronavirus strains, including delta. Early studies suggest the vaccinated will need a third shot for the best chance at preventing infection but even without the extra dose, vaccination still should offer strong protection against severe illness and death.

Computer models used by state officials to forecast the virus say hospitalizations will stay steady through the holidays and dip slightly in mid-January.

“I’m on the fence a little bit about how horrible is this,” said Dr. Brad Pollock, associate dean for public health sciences at the University of California, Davis School of Medicine. “We’re going to have more people infected because of the more transmissible variant. It may be a little less virulent, which means it causes less symptoms.”

In San Diego, researchers recently discovered the highest levels of coronavirus since February in a wastewater treatment plant that serves about 2.3 million people.

“Every time we’ve seen that kind of increase in the wastewater, a couple of weeks later we see an increase in cases,” said Rob Knight, a professor at the University of California-San Diego School of Medicine.

Last week, Newsom, who imposed the fist statewide shutdown order in March 2020, warned that cases would likely rise and re-imposed a rule requiring everyone to wear masks at public indoor gatherings. Los Angeles, the nation’s second-largest city, once again canceled its in-person New Year’s Eve celebration.

Mayor Eric Garcetti said Tuesday that he didn’t anticipate another lockdown because “I think we’re so much better protected than we were.” However he said he believes restrictions such as masking indoors will continue into February and perhaps even March, depending on vaccination, hospitalization and infection rates.

While 70% of Californians have been fully vaccinated, that still leaves 30% — or roughly 12 million people — who haven’t been. The California Department of Public Health says people who are not vaccinated are seven times more likely to get infected, nearly 13 times more likely to be hospitalized and nearly 16 times more likely to die from the coronavirus.

Places in California with lower vaccination rates, including Riverside and San Bernardino counties, have seen jumps in hospitalizations recently.

“The problem is there are counties in California, particularly in central California and eastern California, where they have had neither high vaccination coverage or a lot of prior infections,” said Dr. Jeffrey Klausner, a professor of infectious diseases at the University of Southern California’s Keck School of Medicine. “We can expect in those communities that there may be an increase in hospitalizations for people at high risk for severe consequences.”

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On Monday, 24,000 Kaiser Permanente nurses and health care workers in the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) voted by 96 percent to authorize strike action. Voter turnout was high at 86 percent, an indication of the determination of health care professionals to fight against dangerously low staffing ratios.

The UNAC/UHCP membership includes a significant part of Kaiser’s Southern California workforce, including physician assistants, pharmacists, midwives, physical and occupational therapists, optometrists, as well as the vast majority of Kaiser’s registered nurses. With 24,000 workers, this would be the largest strike of the year in the United States and the largest health care strike in US history.

Workers are fighting against wage increases below the rate of inflation, chronic understaffing and the threat of a two-tier wage system, which Kaiser Permanente is keen on imposing, which many nurses fear will further exacerbate the staffing problem by amounting to significant pay cuts for future nurses. While COVID-19 cases have been slowly declining in California in recent weeks, the hospital system faces the likely prospect of being overwhelmed in a winter surge predicted by pandemic modeling and made all the more inevitable by the reopening of schools and the elimination of all remaining restrictions by Democratic Governor Gavin Newsom.

The vote took place October 1-10, after the UNAC/UHC and Kaiser Permanente failed to announce a new contract proposal before the expiration date of the former contracts last month. However, according to the terms agreed to by the unions, the earliest date the strike would occur is October 21. This reactionary pro-company provision, which keeps nurses on the job for three weeks with no contract, makes a mockery of the credo “no contract, no work” and serves no purpose other than allowing management ample time to hire strikebreakers, reducing the effectiveness of the strike.

Nevertheless, the strike vote at Kaiser is a major development in the growing push by workers for nationwide strike action in the United States against unbearable working hours, the erosion of wages by high inflation and against the continued spread of COVID-19 in workplaces. It follows a strike authorization vote by a similar margin by 60,000 TV and movie production workers, an overwhelming rejection by 10,000 John Deere workers of a concessions contract backed by the United Auto Workers, a nationwide strike of 1,400 Kellogg’s cereal workers and others. Thousands of nurses and health care workers are already on strike throughout the country, including 2,000 in Buffalo, New York and hundreds of Kaiser workers in Oregon.

This is part of a wave building across the world. More than 155,000 metalworkers are currently on strike in South Africa to demand wage increases above inflation. In Warsaw, Poland last month, between 30,000 and 40,000 doctors, nurses, caregivers, pharmacists, physiotherapists, hospital technicians, paramedics and many other professional groups held a massive protest in front of the Ministry of Health and the Polish Sejm (parliament) demanding better working conditions and wages for health care workers.

The World Socialist Web Site spoke to Kaiser Permanente workers in San Diego. One nurse said, “The strike is all about patient safety. We need a higher staffing-to-patient ratio for better patient care.” Another anonymous nurse explained, “Kaiser is putting profits over people. We were last year’s heroes, and now they want to divide us with a two-tier wage system!”

The contract being offered by Kaiser Permanente includes only a 1 percent annual wage increase for three years, while the current inflation rate is currently 5.25 percent, making these pay “raises” significant pay cuts. Another anonymous nurse told the WSWS, “A 1 percent raise is a slap in the face after saving so many lives last year, after we put ourselves and our families at risk.”

The same nurse added that the UNAC/UHC is also “demanding” wage increases below inflation, at 4 percent. “Kaiser is offering 1 percent; the union is offering 4 percent. We want 10 percent,” she said. She also expressed her support for other strikes taking place throughout the country, including by 700 nurses at Saint Vincent Hospital in Worcester, Massachusetts and the strike by Kellogg’s cereal workers.

Despite the high demand for nurses during the pandemic, a labor shortage which has been exacerbated by the exodus of nurses from the profession due to unbearable levels of stress, the ruling class is working hand in glove with the union bureaucracy to lower real wages, attempting to ram through contracts at one company after another with wage increases below inflation. In spite of disruptions to the global economy caused by the pandemic, US corporations continue to make billions of dollars in profit. Kaiser Permanente, for its part, reported a revenue increase of 5 percent to $46.87 billion in the first six months of the year. Net revenue went up a whopping 47 percent to $5 billion in the first six months of 2021. While Kaiser Permanente is technically a “non-profit,” the average salary of its executives is $230,162 a year, with some salaries as high as $652,000.

Since the start of the pandemic, the UNAC/UHCP has done nothing to defend workers against the intolerable conditions in the hospitals. Instead, they, along with other large unions such as the AFT, have sought to deflect workers’ anger into toothless appeals to the corporate political establishment by carrying out a public relations campaign to sue the federal Department of Labor and the Occupational Safety and Health Administration (OSHA) for failing to protect health care workers during the pandemic.

The UNAC/UHCP is deeply integrated organizationally and financially into Kaiser Permanente management. It is part of an organization called Labor Management Partnership (LMP), a formal corporatist partnership between the executives and the workers’ unions formed in the aftermath of a 1997 strike by 7,500 nurses in California. According to LMP’s website, this corrupt arrangement was originally proposed by the unions themselves:

The Labor Management Partnership started in 1997, emerging from mounting strife between Kaiser Permanente and its unions that threatened to derail the organization. Instead of continuing a traditional approach and launching a campaign against KP that ultimately could damage the organization—and the workers it employed—the Coalition of Kaiser Permanente Unions (link is external) approached KP leaders with an idea for how to do things differently.

LMP’s website could have been produced by any major management consulting firm and is mostly devoted to providing management with techniques to improve workers’ performance. One prominent video on the website provides tips to managers for how to improve attendance. This is what the official unions have functioned as for decades, little more than adjuncts of management and an industrial police force. In order to win their demands, the struggles emerging in the working class around the world must be unified, through the development of the organized initiative of workers independent of the unions, which have enforced decades of attacks on working conditions by management. Kaiser workers must move now to form rank-and-file committees that are democratically controlled by the workers.

Max Jones | Contributed

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