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35,000 members of the Alliance of Health Care Unions, a coalition of 21 local unions representing over 52,000 workers at the healthcare giant Kaiser Permanente in states around the country, have set a strike date. Unless the company addresses the serious issues that workers have raised at the bargaining table, Kaiser workers will walk off the job on Nov. 15, and thousands more may join in what could become one of the largest strikes ever in the healthcare sector. The core issues that led to the potential strike not only involve adequate compensation for union workers, but also the dire concerns about healthcare workers being grossly overworked and under-resourced, as well as two-tier employment and the struggle to draw in and retain trained staff. On top of the essential concerns that directly impact the jobs and livelihoods of healthcare workers, the outcome of this high-stakes labor struggle will have huge implications for the future of healthcare in the US as we know it.

In this special edition of Working People, TRNN Editor-in-Chief Maximillian Alvarez speaks with two Kaiser workers, Hannah Winchester, DPT, and Nicholas Eng, RNFA, about the work that they do, the changes they’ve experienced in the healthcare system, and the dire conditions that have led to a potential strike. Hannah Winchester is a home health physical therapist by trade; she is also her department’s Labor Partner, a shop steward, and a member of the bargaining team for the Oregon Federation of Nurses and Health Professionals (OFNHP) Professional Bargaining Unit. Nicholas Eng has been a nurse for nearly 10 years; he is also an OFNHP shop steward and is currently on release for OFNHP to be present for contract bargaining and to help with organizing union members and actions, including strike planning.

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Maximillian Alvarez:        Well, welcome, everyone, to another special episode of Working People, a podcast about the lives, jobs, dreams and struggles of the working class today. Brought to you in partnership with In These Times magazine and The Real News Network, and supported entirely by listeners and viewers like you.

So, Striketober has come and gone, and many of the struggles that folks were excited about over the past month are still very much ongoing. Ten thousand workers at farming equipment giant John Deere are currently still on strike as of this recording, as well as 1,400 cereal workers at Kellogg’s plants in Nebraska, Michigan, Tennessee, and Pennsylvania. Coal miners at Warrior Met Coal in Alabama have been on strike since April. Eight hundred nurses at Saint Vincent Hospital in Massachusetts have been on strike since March. As we record this, New York taxi drivers are in their second week of a hunger strike. And of course as we all know what many are calling the great resignation, that is historic levels of American workers voluntarily quitting their jobs in 2021, is still a phenomenon that is ongoing as well.

The point being that something is happening amongst the American workforce right now. Many are excited about it. Many are feeling very sympathetic towards this increasing labor strife as workers coming out of the COVID-19 pandemic are feeling more emboldened to demand the pay and the treatment and the respect that they always deserve.

Among those workers who are currently in the process of authorizing what could be one of the largest strikes in the United States are healthcare workers at the healthcare giant, Kaiser Permanente. As Noah Lanard at Mother Jones reports, “For current employees, Kaiser is proposing a 1% annual raise for the next three years, which amounts to a pay cut after accounting for inflation. The Alliance of Healthcare Unions, the coalition of 21 locals now considering whether to strike, has been pushing for 4% raises, no two-tier wage system, and contract language that ensures safe staffing levels.

The deal being negotiated between Kaiser and union leaders will cover more than 50,000 workers in states spanning from Georgia to Hawaii. It could lead to one of the largest healthcare strikes in recent US history. Workers’ biggest problem with the wage proposal that Kaiser has presented is that it would cut starting pay for new hires by between 26% and 39% beginning in 2023.

They believe it would deepen an existing staffing crisis at Kaiser’s facilities and put patients at risk by making the nonprofit unable to recruit and retain talented workers. There are also fears that it would lead to resentment among those paid less for the same work, or cause Kaiser to replace the more expensive workers covered by the old contract with new hires.”

So, folks listening to the show, or if you are watching the video version at The Real News Network, will be familiar with workers’ demands to undo this two-tier wage system that folks have been hearing about. It’s been an issue at the John Deere strike. It is the primary issue at the Kellogg strike. It was an issue at the Heaven Hill Distillery strike in Kentucky. And it has been a long running issue in the auto manufacturing industry, as well as industries around the country, and healthcare is no different.

And we’re going to discuss all of this and give you all the context that you need to understand what is happening right now with this potentially massive strike at Kaiser Permanente, what workers there are going through, why the proposals from Kaiser are so bad for workers and for patients and for everybody. And to talk about all of this, I’m honored to be joined by two guests today. And I wanted to turn things over to them and let them introduce themselves to you. So, Hannah, could you introduce yourself to the good listeners and viewers please.

Hannah Winchester:     I’m Hannah Winchester. I am a home health physical therapist. I am also an OFNHP shop steward and I am my department’s labor partner. I’m very excited to be here and consider me one of those people that is very excited still with what’s happening not just here at Kaiser, but across the nation, across the world with people using their voice to take power over their workplace and fight for themselves and fight for their communities and their families, which is exactly what we’re doing here today.

Nick Eng:            Yeah. So, I’m Nick Eng. I’m a registered nurse at Kaiser, technically a registered nurse first assist. I went through an internship program with this company, and I do surgery. Been doing this for almost 10 years now. I’m also an OFNHP steward. And I’ve been a steward for four or five years now. And this was the first job that I had where I really learned that I was laboring for my employers. In healthcare, it’s kind of a unique situation. But I’ve learned more about what it means to be labor, especially in healthcare. And I’m really excited to be active in this contract fight.

Maximillian Alvarez:        Well, Nick, Hannah, thank you both so much for joining me today. I really appreciate it, especially with everything going on right now. I know that y’all are involved in constant bargaining. You got a lot of people texting you and calling you all hours of the day. So I genuinely appreciate y’all making the time to sit down and talk with me and help us keep our listeners and viewers informed on this really important struggle.

I mean, we’ll obviously dig into this. And I think it’ll be self-evident from what we discuss to listeners and viewers why the potential strike at Kaiser is so significant. Not just for the over 50,000 healthcare workers, who deserve fair pay, who deserve working conditions that dignify them and their humanity, and don’t run them into the ground, so on and so forth. So, it’s obviously and primarily super important for workers like yourselves and the people that you serve with your labor.

But there’s also, for everyone watching and listening, there are really huge implications for this strike for the American healthcare system writ large and all of us who depend upon it. And it’s important for us to understand why that is. And before we dig into, I guess, the current contract negotiations, the potential strike that I believe, it’s sort of like the IATSE strike that we discussed a couple of weeks ago on this show. For viewers and listeners, it’s not just like one big union that says, yes, we want to go on strike. There are a lot of different locals involved here. And so, the number of strike authorizations has continued to rise as different locals have voted to authorize that strike. And voted overwhelmingly to authorize those strikes, I might add.

So, Hannah, Nick, before we dig into all of that, I wanted to in the grand tradition of Working People, we really want to make people understand that when they see a number like 50,000, healthcare workers that seems big, but every single one of those workers is a flesh and blood human being with a life, with a family, with work experience that matters. And it’s important for us to see past those numbers and really see the human faces behind this struggle. And so, I actually wanted to go around the table and ask if y’all could tell us a little bit more about yourselves, how you got into doing this work, what sorts of work you do, both at Kaiser and with the union. And also, if you can maybe give listeners a sense of how things at Kaiser have changed since the time that you started there to now.

Hannah Winchester:     So, I grew up in a medical household. My mom was a nurse. And I got to see how proud she was of what she could do at work. And I loved that she was able to take something that was important to her as a person and apply it to her workplace. And personally, I was a klutz as a kid. I had PT more times than I care to admit, and really loved that start to finish holistic approach of making yourself whole again and getting better.

And I have been in a lot of different fields of physical therapy and home health, where I’m at now, is really great. I get to go into people’s homes, go into their safe spaces, go into places that they’re in all the time, and make sure that what they want out of their life is what my goal is as well. It’s so personalized and it’s so unique. And I love it. I love being able to really walk away knowing someone is safe and happy and healthy in their home.

And what I feel like I’ve really been able to do at my job, progressively over the last five years, has changed. I find myself not being able to give as much, not being able to focus as much, and not being able to help as much as I did five years ago, because I am not always able to spend as much time as I want to or as they need to with that person. There’s a lot of things that happen in our workplace where it’s do more with less. And that’s not the way that we should be productive.

We aren’t working with plastics. We’re not making a tennis shoe or anything like that. We’re working with people, and that’s not cookie cutter, and that looks different for every single person. I don’t think anyone as a patient would want their doctor or their healthcare professional to come in and treat them exactly like they treated the person before. They want a tailored approach because that’s what’s important to them. We’re all unique. And I think a lot of times I struggle to be able to do that now because of the pressures.

Nick Eng:            Yeah, so my story is a little bit different than Hannah’s. I did not grow up in a medical household. I found myself going to college because that’s the thing that you do, and just kind of wasting a year, year and a half, and not knowing what I’m doing with my life, not really having a lot of direction, but doing it because that’s what you do.

And the university I went to had a nursing school. And it was literally just like my mom being like, why don’t you try that. And I was like, okay. And when I learned a little bit more about it, the things that drew me to it were these labor-related things like oh, you make a pretty decent living and you have job security. And this is like a stable decision for my life. And I laugh about it because it’s like, yeah, I was a dumb kid who didn’t know anything and just got lucky enough to make this decision that made a huge impact on my life. Think it’s one of the best decisions I’ve ever made.

So, yeah, I did that. And worked in a teaching trauma hospital in the middle of the city for a couple years, learned and saw some crazy stuff. Like I said, I work in surgery. So, really crazy stuff and grew up in this amazing environment that shaped my practice. I travel nursed for a while as a young man, saw different parts of the country, and eventually landed up at our Kaiser facility that I work at now.

And the thing that really struck me about it was so many things that work really well with Kaiser, unionized workers with good benefits, contracts, defined rules for your job, having enough materials to do what you need. I started there six years ago, and I said, I want to work here. I want to stay and I want to work here. And I was able to grow with the company, too. I was able to do an internship, get a certification, and do this class, and I expanded my scope of practice. I actually get to assist in doing surgery.

So, it’s been really great. I was able to grow a lot. And since that point in time, 2016 when I finished that, I can just describe my own team. My team went from 14 people to eight people. And actually, one person said they’re leaving today. So, we’re doing more with less. We’ve been doing more with less because the work, it’s not been getting smaller. We’re not doing less surgery. We’re doing a lot with fewer and fewer people, and we’ve struggled to recruit and retain them. And it’s a hard situation to find myself working in.

I’ll speak to another one of my working conditions. Because people could need surgery literally any time of the day. You never know when somebody’s going to have an emergency. We have to be able to cover our department 24 hours, even though the particular place that I work at, we do not stay open at night to do surgery. In case there’s an emergency, we have to have people. So, I’m on call for surgery often. My team, we have to cover the department.

And you can imagine how many hours that amounts to over the course of a month. Now, I mean, looking at six people having to split up all this time. It’s taking so much. And it wasn’t always like this. That is just one representation of the constraints that we’ve been seeing. It gets tighter and tighter in terms of how we do our work. And it can’t continue.

Maximillian Alvarez:        Well, for folks watching and listening, I mean, you’re clearly hearing the same echoes that I’m hearing from workers that we’ve spoken to in other industries that on the surface don’t resemble healthcare at all. But this was something that I think a lot of the public was being educated on in real time during “Striketober,” where initially what appears like different pockets of worker struggles combusting at once, people started to see that, in fact, a lot of the demands, a lot of the grievances, a lot of the issues that workers are facing, were very similar to one another.

I mean think about, after what you just heard Nick say, think about when we spoke to Cherie Renfro, a worker at Frito-Lay in Topeka, Kansas, who said that Frito-Lay is churning people out because it works us so hard. So, it has a problem with drawing in and retaining workers. And so, what that translates to is the staff that stays on, including a lot of the longtime staff, they get pushed into forced overtime. They take a lot of that burden of extra hours and extra production on.

This is what workers at Kellogg’s have been saying. There are people who said that they’ve been working 12 to 16 hours a day, seven days a week, for as long as they can remember. And that’s not even what the Kellogg’s workers are striking over. I mean, but this has also been a common complaint for educators who talk about even before the pandemic, but especially afterwards, more and more work was piling up. And more and more folks were being pushed into early retirement, or more folks were getting burnt out and leaving. So, the people who were left were being burdened with even more work.

And here’s the real rub though, and this is something that we’ve tried to really highlight on this show and at The Real News Network, is when you hear that upfront, you think, well, businesses got to do what they got to do to survive. Everyone’s got to tighten their belt. We just came out of a pandemic, which we’re still not out of, and God knows if we ever actually will be. But people’s sympathies tend to direct them to thinking that this is just a necessary measure in the interim until we “get back to normal.” That is very much not the case.

As we have tried to highlight for you, at the same time workers were being pushed to their limit and ground down to dust, whether at Amazon, or Frito-Lay, or John Deere, or Nabisco, anywhere. A lot of these businesses are raking in huge profits. So, workers are being asked to do more with less, while these companies are taking more and giving less. And this is very much the case in industries. Frito-Lay was experiencing record profits. Kellogg’s has been experiencing massive profits. John Deere is experiencing billions of dollars’ worth of profits. I think this year is its most profitable year on record.

And Kaiser Permanente, the healthcare giant, raked in $3 billion in profits in the second quarter of 2021. I mentioned the nurses strike at Saint Vincent Hospital in Massachusetts. That hospital is owned by the Texas-based Tenet Healthcare, which is raking in massive profits from all of its endeavors. And yet, they are trying to push their workers to the limit and refusing to supply adequate staffing, do more to retain staff, lower nurse-patient ratios, so healthcare workers can give the kind of care that they are trained to give. You see where I’m going with this. So, something’s not quite adding up here.

And Nick and Hannah, I guess to really crystallize this for folks viewing and watching, I was wondering if we could go a little deeper into your own experience. And if you could maybe describe both before, maybe the year before the pandemic, and then during the pandemic. I know there’s no such thing as a typical week in healthcare, as y’all both mentioned. Every person is different. Every day is different. But I guess could you humor me, and maybe try to describe for viewers and listeners what your weeks look like before the pandemic and during, and then we’ll get to the struggle that’s at hand right now.

Hannah Winchester:        I think in, we’ll say 2019. And I would say, I do home health, I travel to people’s homes for their visits. I had a smaller geographic territory. My coworkers were in the two-dozen range. I was able to see my patients twice a week, if necessary. And since then, and I don’t think this is just due to the pandemic as well, this is perchance brought things to light. But this is not necessarily the only cause, because I don’t think it’s going to change back if and when COVID ends.

We’re struggling to see people once a week. My territory has doubled in size. We’ve had, I think, probably in the last year, year and a half, three or four people out of my small team leave and not be replaced. That’s that doing more with less sort of situation. It’s been really hard. We’re also not able to get to patients as fast as we were before. People usually are being referred to us after a hospitalization or a fall, something really acute and quick, and they need services quickly.

I mean, at some point in time, our services were out two to three weeks. By that point in time, who knows what could happen without us being able to go and provide those interventions. So, I don’t feel as if I’m able to provide my patients with what they really need. And I don’t think what they have needed has actually changed since 2019. I think that still remains the same.

Nick Eng:            Yeah. So, given the nature of my department and the work that I do, you kind of quantify, how many surgeries were we doing? So, there was a time where it would do… I mean, I don’t know how specific I can get. We would do, say orthopedic surgeries, we’d do like three in a day per each room or something like that. And as we developed teams and processes and grew our people better and grew our practices better, we’re able to up that and do more surgeries in a day. And that’s directly due to the quality of the people that we have working with. I work with some great working people. We’re really good at what we do.

And then, the pandemic happened, and there were a lot of really scary concerns as we were looking at a lot of things. I think it was scary for everyone. We didn’t know a lot of things at first, but it’s different when you work in healthcare and you work in a hospital during a pandemic. I can recall questions of if we would have enough supplies of PPE and the stress that that would put on people, but just like fearing for… Am I going to bring this home to my family or something like that? And are we all going to get sick? Am I going to get sick and then my partner can’t care for me or something like that? Just all of these.

And I don’t even have kids. My coworkers with kids, just the way it complicated everybody’s lives, it was crazy. I know a lot of people have similar stories. But being in healthcare at the time, it’s a unique and more intense experience. And so, naturally, that prompted a lot of safety questions. And I don’t envy being a leader in those times, but there were not a lot of good answers. And then eventually some of the answers became conflicting, and I don’t know. You can see I follow a number of nurse and healthcare meme Instagram accounts. And there are a lot of really good memes, because what can you do but laugh at how depressing some things are, like reusing PPE. Just, I don’t know.

Anyway, we didn’t up the amount of surgeries we were doing during the pandemic, because of the nature of the pandemic. We need hospital workers. We need to care for sick people and we can’t be adding electives. There were moratoriums on elective surgeries all over the country. States would not let you have an elective surgery because we need to preserve hospital space for these surges.

But one thing they did do when that was happening was kind of force flexibility on the staff. We would take people who work in some areas and go put them to work in other areas. And it’s not what we would like to do. It’s at times what was needed to do. But it’s hard on folks to do that, because that didn’t include just maybe going to a different worksite or a different department. That included schedule changes, which is hard for folks.

And stresses them out and sometimes make people retire from healthcare altogether or seek new employment or I don’t know. I can’t tell you post-pandemic. Well, we’re not post-pandemic, but now, what I can speak to is I know the alliance and/or our own union surveyed our workers, and over 50% of them report that they’re burnt out, 60% say the pandemic has affected their mental health in a bad way, and over 40% are considering leaving healthcare altogether. And that’s really scary to think about.

Maximillian Alvarez:        It is. I mean, and I can hear just in your guys’ voices as I’ve heard from other healthcare workers. It’s so clear how much you care about the work that you do and the patients that you serve, but it’s also clear how exhausted you are by how much you’re being asked to do and how little you’re being given to do it. And you said something that I thought was really important, Hannah, that this didn’t start with the pandemic. This is a long-running trend in American healthcare. And my mind immediately went to a conversation that I had with Zenei Triunfo-Cortez with the nurses union out there in California, where she talked about, this is for a book of interviews with workers during COVID, that I have coming out later this year.

But she described how different it was when she started as a nurse back, I think, in the ’70s. She was like, you could take as much time as you wanted with the patients that you were serving. You could attend to their needs. You could listen to them and provide the like, yeah, customized, personalized care that so many of us grew up expecting of the American healthcare system.

And what has transpired over decades is this Ford-like push by largely profit-seeking healthcare entities that are trying… That figured out that they can essentially jack up prices for patients and cycle through as many people in as short an amount of time as possible, and just keep bending their workforce, assuming that people will never break. And I think that this is kind of the larger trend in the American workforce in general, pushing workers to do more, giving them less while profits go up to the top.

And I think that we have been seeing in 2021 more and more working people in industries around the country saying, we’ve had enough. We’ve been pushed to our breaking point. But I think that it’s just so devastating to hear, because I think about how y’all were talking about earlier, when we were kids, like you, Hannah, I went to the hospital more times than all of my siblings combined. I got hurt a lot. And it was always very meaningful to me that I knew even as a kid that when I went to the doctor, I wasn’t just going to see him for two seconds and get a prescription and then get kicked out the door. I was going to be able to explain what I was feeling. He was going to listen, and we were going to have time to discuss everything that was wrong with me and everything I needed to do to heal.

It does not feel that way anymore. More and more from the patient side, you do feel like a number. You have been trained to expect that you’re going to be just funneled into that Fordian system and have to be happy with whatever you get. And I think one of the real things I want to stress for viewers and listeners is that from a patient’s perspective, when you are thrust into that system, you tend to project your dissatisfaction with that system onto the most immediate face in front of you, which is workers like Nick and Hannah, who are right near you.

It is not their goddamn fault that they are being worked to the bone. I hope it is clear to people who are watching and listening that this is part of a larger system that has been implemented that is grinding workers down as much as it is dissatisfying patients. And again, as I mentioned, profits are being made here. These are deliberate choices that are being made. But anyway, I’ll spare everyone my sort of tirade there. You can see the points connecting yourselves.

But this longer trend of treating healthcare like in a retail fashion is really, I think, worrying. And I think it also highlights why workers pushing back at a healthcare giant like Kaiser is something that all of us should be deeply invested in. And on that note, Nick and Hannah, I wanted to ask if you could help us walk through where we are now. How all of this is coming to a head in the current contract negotiations. What do you think folks need to know? And what are workers fighting for? And why is it so important?

Hannah Winchester:        So, one of the things that Kaiser continues to say when they ask why they’re proposing what they’re proposing is that they want to stay affordable. But I think I’m a little confused. Because it sounds like the only people that are responsible for being affordable or making this company affordable is us, is the healthcare workers. We’re not talking about managerial pay cuts. We’re certainly not talking about CEO pay cuts. They gave themselves over 100% raises very recently.

Somehow it’s us. Somehow it’s our responsibility to keep this company afloat and make it affordable. And despite everything that has happened, not just in the last 20 months, but everything that we’ve done basically in the entirety of our careers, to elude and say that whoever comes after us is worth less is ridiculous. And that’s not fair. That’s not appropriate. That certainly isn’t going to bring people in the door, nor is it going to make them stay.

And I think that these decisions continue to keep coming because no longer are the people making the decisions actual healthcare workers. They’re MBAs. They are people that are sitting in an office that look at charts and graphs and numbers, and they’re not looking our patients in the face like we are. And that’s where this fight is coming from, is that the people that are actually doing the work are saying, we cannot sacrifice quality. We cannot sacrifice access. We cannot sacrifice the time that we spend with these people. Because that’s unsafe for us and for them.

But unfortunately, it keeps feeling like these are business decisions, not quality decisions. And so, that’s where we’re at right now. I think the union, myself and Nick included, are saying, we’re not going to sign what you’re giving us because this is unsafe. This is so unsafe for our future, for our community, for the quality of healthcare, not just for us, but I mean, everywhere. This will have very rippling effects far past just our current scope.

And we’re not willing to sacrifice. We’re not going to take something subpar because it’s the first offer. And we’re doing this for our patients. And I know that people might look at this situation and say, oh, we just want more money. And it’s not that. It’s really not. And I think it’s tough as a healthcare worker to walk away from patients or potentially walk away from patients. That kills us. That’s what keeps us up at night, is the thought of not being able to do what we do best and what we want to do. But it’s a fork in the road. Do we just keep our head down and keep doing what we’ve been doing? Or do we stand up for what we know we have to do for the future? And right now, it’s that one. It’s keep fighting.

Nick Eng:             Yeah like I mentioned earlier, we’re burnt out. As you’re kind of hammering on all these other workers, we’re overworked, we’re underappreciated, and there’s not enough of us. And we need to get more people, man. It’s about staffing. We need more staff. We need more nurses. We need more physical therapists. We need more nurse practitioners, more physician’s assistants, more technologists. We need people to do what we do well because we don’t have enough and it’s killing us.

They complain about labor costs. Aren’t we the ones providing the service of the company? Yeah, I mean, you should value that. We spent 18, 19 months of a pandemic being called heroes. And then, they turn around and say that we’re overpaid and we want you to be endlessly flexible to do everything so that we can continue this lean staffing model. Healthcare is full of mission-driven people. They believe in what they’re doing. I think you articulate that really well. You ask 99% of providers, their favorite thing is interacting with people, knowing they’re making a difference in people’s lives.

They take advantage of us by forcing us to violate our own boundaries because they know that we’re mission-driven people and that we have hearts and we care for our patients. Because somebody is pushing you to quantify your time and see X number of patients in a day and you only have X number of minutes. And it’s like, well, what if that person has more questions? It’s obvious. That’s what we’re fighting for, man. We want to be able to give the best care that we can give to our patients and we need more people to do that. And the implications are huge not just for the region. I mean, not just for the country, but the industry on the whole.

This is a large company. We operate in eight states. If we do something that makes it less attractive to be a healthcare worker, what message are we sending to the healthcare workers of the future? To kids in school today? How do we attract people to become nurses? With a 26% pay cut? Definitely not. We have to fight. We have to stand against this. This is not okay.

Maximillian Alvarez:        Well, this, as I mentioned earlier in the conversation, I mean, we need to understand that at direct issue here are the livelihoods of workers like Hannah and Nick, and the patients that they serve and the people they work alongside. I mean, we are talking about things that are going to directly impact them on a day-to-day level. And so, we want to keep that front and center.

But as I also mentioned, thinking about what that future looks like, if companies like Kaiser are able to continue down this road, for folks watching and listening, where do you think we’re going to end up with that? I mean, there’s going to be a breaking point. And I think that that’s what I wanted to tease out here. Because you can clearly hear in what Nick and Hannah are saying that they are going to sacrifice more than they should to provide the care that they are dedicated to giving and serving the patients whom they are dedicated to serving. And companies like Kaiser are going to keep pushing them to do that, asking them to do more and to serve more people and serve a larger area. And in what world does anyone have that infinite capacity to keep giving without inevitably being exhausted?

I mean, even Michael Jordan at his prime. Yeah, he was the best basketball player that we had ever seen. But if he’s playing like five games in a row, by that fifth game, he’s going to be looking pretty tired. It doesn’t matter who you are, doesn’t matter how dedicated you are. If you are being asked to do like two, three, four, five times as much as you were initially expected to, you’re going to eventually burn out trying to give that same standard quality of care that has made Kaiser Permanente what it is.

The workers have made Kaiser Permanente what it is. Workers have always made our healthcare what it is. And this sort of voracious, insatiable, profit-seeking system is really just exhausting the best of our healthcare giving talent and the labor that they provide. And after a while, we’re not going to have anybody. I mean, people are going to get burnt out.

Or this is, I think, where perhaps I wanted to obviously approach sensitively, but I’m just thinking about it from my own end. What really seems to be the potential fallout to this is that, because it’s not just Kaiser. I mean, this is something that we’ve heard about in healthcare systems around the country. Folks, Working People, listeners will remember the interview that we did with Schuylkill Valley Hospital nurses in the Lehigh Valley Health Network in Pennsylvania. This is exactly what that network did. They did not address safe staffing levels. They did not address high turnover rates or any of that. They just went full bore into this sort of, yeah, again, retail health model.

And knowing that what was going to happen is that workers are going to get burnt out and overall the quality of care is going to decrease. But if you were the only game in town, what you are effectively doing is lowering patients’ expectations of the care that they’re going to get. And essentially just forcing them to accept that. So, all of us as patients are… Workers are being squeezed to this breaking point. And inevitably, what is going to follow is that anyone who needs healthcare is only really going to have access to and have healthcare facilities where workers are in this position. You’re not going to be seen as much. You’re not going to get the quality of care that you want. But there’s really going to be no other option. And that’s going to mean more profits for some people, but it’s going to mean worse working conditions and worse care for all of us. That’s me editorializing. I don’t want to put words in Nick or Hannah’s mouth, but that’s what it looks like to me. And that’s why, speaking personally, why it seems so important that y’all are talking about not just fighting for yourselves and your coworkers now, but really, it feels like you’re fighting for your future and the future of all of us, really.

Hannah Winchester:        Yeah, I think you really hit on the word access. What does it look like if things continue the way that they are? And I think the biggest thing that is going to be affected is our access to care. We’re Kaiser patients as well, the majority of us are. So, when we say patients, we mean ourselves. And what we’re already seeing right now is six to eight weeks for people to get a mental health provider appointment. Six weeks for people to get into see their outpatient physical therapist. ED wait times 9, 10 hours sitting in the emergency room.

I mean, that is so unsafe. And if we’re talking about money, that’s not what patients pay for. That’s not what they deserve. That’s not what drives high quality outcomes to where people can actually recover from things. Our access is going to continue to bottom out. And that is really scary for ourselves. That’s really scary for communities. And like you mentioned, that affects community standards of care, not just within Kaiser, but across all other healthcare systems and things like that. There’s a lot of other major healthcare players here in Portland where we are and we all talk about the market, our local market, and what’s happening in other places. So, they’re looking at this just as much as we are.

And to address the burnout that we’ve mentioned, that’s a bit of a trigger word for me. Because sometimes I take burnout a little personally. It makes me feel like I just can’t handle my stress. That’s what I feel like I’m getting told sometimes. Oh, well, you’re just burnt out. You just can’t handle your own stress. But what we are seeing every single day is moral injury. We are seeing and being put in situations that absolutely morally injure us. And that is why people are leaving this system. That is why people are leaving healthcare.

It’s not because we had a hard day and need to take a nap, or need to get a pedicure, or take a couple of deep breaths. It’s because we can’t go to sleep at night knowing the quality of care that we’re providing at work and what we’re going to be asked to do tomorrow. And with what they’re offering us right now in this contract, that’s not going to get any better. It’s hard enough to get people to walk in the door. But the larger problem is how do we get people to stay. And I think that a lot of the other things that aren’t being addressed in these current proposals, is what’s the root cause of people leaving and how do we fix that so that we start to fix this problem and not just put a Band-Aid on it and cycle through people constantly. We’ve got to dig a little deeper. We’ve got to do more work on fixing this problem, not just trying to Band-Aid it.

Nick Eng:            Yeah. That was a lot, Hannah. Stressing moral injury that, yeah, that I had to take a deep breath on that one because I’m like, yes 100%. It’s not just that I hear it so often. We know that tens of thousands of people across the country are experiencing the same thing. I rounded this morning at the hospital, and it’s the looks on my coworkers’ faces like… Sorry. [Sighs] Yeah, I mean, you bring up a good point, Max, that I mean, obviously as healthcare workers we’re deciding this, but as a working people, as a country, should we allow this?

In so many industries, should we allow this? We shouldn’t allow this to be a situation where my coworker had to take their kid in for something. And I think it was absolutely an urgent care issue. But they know that the wait for urgent care is going to be very long. And so they just go to the emergency room instead. This is inappropriate usage of our resources. And it is partially connected to the pandemic. I’m not going to omit that. But it’s also very much related to staffing. You can get people through urgent care faster when you have more nurses. I don’t know. I’m scattered now. I do appreciate that you compared us to Michael Jordan, though. That was pretty cool, healthcare workers.

Maximillian Alvarez:        I mean, I’m not blowing smoke up your ass. I mean, anyone watching or listening to this knows what it feels like to feel cared for well, and they know how appreciative they are when workers like yourselves treat them as human beings and tend to their needs. It’s a very vulnerable, scary situation when you are in one of those hospital rooms. I mean, there is something that, yeah, that fucking, pardon my French, that MBA-ification of management across industries doesn’t see. They don’t see that necessary human interaction and tenderness and care that is a necessity for providing the quality of healthcare that y’all provide, even if it means giving more of yourself than anyone should be asked to give. And ultimately, whether you’re Michael Jordan or someone else, human beings are finite. We only have so much to give. And that is really what we’re talking about here for working people everywhere.

I mean, you look at gig workers. They started as a side hustle, as it was pitched to us. Rates used to be a lot better. Then what did they do? They created a race to the bottom. They flooded the market. And then they changed their algorithms so that people are working longer to make less than they were making five years ago. This is the trend. This is the downward trend where workers are being pushed to do more and to make more for people at the top while we take home less, while real wages have been stagnant for most workers for decades, and the cost of living keeps going up.

Right now, we are talking about an inflation crisis. This is one of the issues, the things that issue in the contract negotiations. I think Kaiser has proposed a 1% raise which, with inflation, that amounts to a goddamn pay cut. That’s not a raise. And to say nothing about the reduced pay for new hires who would be coming in. And so, I could talk to you guys about this for days. But I know you’re super busy. So, I guess I wanted to focus on that really quick, so that folks listening and watching have the crucial information they need.

Because we mentioned that Kaiser’s first proposal, which they justified by saying that they have the highest industry rates for their healthcare workers. The union has taken issue with that and demanded more statistics to show where exactly they’re getting that number from, but we’ll leave that for another day. But there’s the proposed pay rate, which if Kaiser or others are trying to paint workers is greedy, again, this pay increase amounts to a pay cut. So, that’s not really the goddamn problem.

There are reduced rates for new hires that would deepen those problems with bringing in and retaining new staff. It would also, as we mentioned earlier, sow greater divisions within the workforce. That two-tier system is the perfect example of divide and conquer. We’ve seen it at companies like General Motors. You have the old timers, who have their more full benefits and pay packages. You have the second-tier workers. That tier was created after the Great Recession. They’re getting paid way less. They have no retirement packages and so on and so forth.

Then you also have temp workers, who don’t get any of that shit and everyone, this is the crazy thing, is everyone is on the shop floor doing the same job, but they’re getting paid three wildly different rates. And so, what that does is it keeps you looking at the guy to your left or the woman to your right being pissed off at them. When as I think we always say at the show and at The Real News, it’s the people at the top who are getting away like bandits. Again, that’s me saying that. I’m not making Nick or Hannah or anyone else say that. But hopefully, it’s apparent to all everyone watching.

So, with all that in mind, I wanted to ask if y’all could talk a little bit about that first contract. Why this two-tier system is such a problem in your day-to-day work, and what the union is pushing for. And then, we’ll round up by asking what folks watching and listening can do to show solidarity with y’all and your coworkers.

Hannah Winchester:        I think you really hit a lot already on how dangerous the two-tier system is and what it would do for us in the working class, which is really who it would affect. And it divides us. It absolutely divides us. I don’t think it appropriately compensates people who would have experience, a skill, a talent. It kind of negates that, and just more puts your compensation on when you were hired. And I don’t think that’s fair.

And again, this is not going to be having people line up at our door to come in and work. There’s a lot of big names in our city. There’s a lot of big games in our city. There’s many other places that these people could go work at. And I wouldn’t blame them one bit if this went through and they decided to work somewhere else. So, I mean, I think it’s dangerous for us to divide us as a workforce, as a union workforce.

Of course, obviously, this is likely an attempt to try and weaken our bargaining power in the future by not being in solidarity on certain topics. But I really do think that if we are trying to fix the staffing crisis, if we’re trying to appropriately address the staffing crisis, this isn’t it. This is actually going to make it worse. So, it still doesn’t make sense to us why that’s their sticking point. They offered 1%, we proposed 4% as our raise. But again, there’s more proposals surrounding what are the other pieces of staffing? How do we make sure that if someone leaves, [we] get their position posted quicker? There’s not this giant delay where everyone else has to pick up that work. How do we make sure we have adequate staff at adequate locations? Really addressing those items and those topics so that we can repair this system for the future. I think that we really just want to protect the quality of work that we can do and make sure that the quality of work that we provide, which is patient care, is appropriate.

Nick Eng:            Yeah. I see good people leaving and it being very, very challenging to fill those positions. Their proposals, they’re in the opposite direction of making this company attractive to work at. You don’t attract LeBron with a 1% raise. You attract Nick Eng who plays basketball with the 1% raise, and I’m not an athlete. We have 40 years of evidence of why two-tier wage systems are terrible for unions and for working people. You’ve already spoken about it.

We need to incentivize people to come work at our company, and you don’t do that with 1%. I think you could do that with 4%. But you mainly do that by people knowing that they’re supported working at a company. Money is one aspect of it, but knowing you have enough people that you can all do your jobs well, that you can take a vacation, get time off, have some work-life balance. Those are attractive things that I feel I really believed were more available to me as a worker to support me when I started. Yeah.

Maximillian Alvarez:        Well, and again, we will try to continue bringing Working People listeners and Real News audiences more updates on this vital struggle as it unfolds. But to Nick and Hannah, I wanted to first just thank you both so much for taking this time to sit down and chat with me, and say that we’re sending nothing but love and solidarity to you and to every Kaiser worker out there, who is really going to the mat and fighting for what’s right.

And we hope that Kaiser does the right thing and comes back to the table and addresses these very serious issues for the benefit of their workers, their patients, and everybody. So, with that in mind, I wanted to actually round out by asking y’all what folks watching and listening out there can do to show support for you and for other Kaiser workers.

Hannah Winchester:        So, if we ended up going on strike, we just started a Strike Hardship Fund. It’s a GoFundMe. And that will go to our members that, if we end up striking and they don’t have an income, that can help protect their quality of life, make sure that they can make some ends meet.

And, also, I mean, we have our social media platforms as well, Facebook, Twitter, Instagram. We keep those pretty current as far as happenings with the bargaining table. We talked about we had a rally here that was super successful and just what’s going on not just here, but also nationwide with the Alliance, since like it was mentioned before, it’s across eight different states with 21 different unions. So, trying to stay current on where every union is at is on our social media pages.

And I think also just having the conversation of what we want out of healthcare and where we should go from here is really important. And that’s more of just a personal ask. I think this is a really great topic that maybe COVID did bring a little bit higher into the light, but it’s something that I think we really need to keep discussing and figuring out what we want out of healthcare, and how do we get there.

Nick Eng:             Yeah, 100%. I think the biggest thing people can do is to talk about this, especially if you’re a Kaiser member. Ask your providers, hey, what’s going on with the bargaining situation? And they’ll probably fill you in a little bit. Ask the doctors, ask the receptionist. If you see a manager, ask the manager. Max, there’s a couple of links I can forward you as well, especially if you’re in the Northwest, it’s a little bit more relevant to you.

But again, to hit on talking to people, talk to your state representatives. We had our Rally to Save Lives on the 28th of September and Shemia Fagan, the Oregon Secretary of State showed up and gave a speech. She spoke. It was awesome. And we know that they are invested in our fight. That is another great way. We need to make sure people are getting taken care of, man. We got to keep talking about it.

And obviously, the Strike Fund is helpful. I would stress that is for our most vulnerable members, the most vulnerable without an income. I intend to take zero dollars from the Strike Fund. I do not need that. But maybe people with kids and in a different situation than myself, maybe they would. And then, that’s who that is designed to help. But yeah, thank you so much for having me on and for talking about this important stuff.

Maximillian Alvarez:        Thank you, guys. Thank you, Nick. Thank you, Hannah. And thank you to all of you out there for watching and listening and caring. For The Real News Network, this is Maximillian Alvarez, editor-in-chief. Please before you go, head on over to, become a monthly sustainer of our work so we can keep bringing you important coverage and conversations just like this. Thank you so much for watching.

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Ten years ago, I was working 12-hour days as a warehouse temp in Southern California while my family, like millions of others, struggled to stay afloat in the wake of the Great Recession. Eventually, we lost everything, including the house I grew up in. It was in the years that followed, when hope seemed irrevocably lost and help from above seemed impossibly absent, that I realized the life-saving importance of everyday workers coming together, sharing our stories, showing our scars, and reminding one another that we are not alone. Since then, from starting the podcast Working People—where I interview workers about their lives, jobs, dreams, and struggles—to working as Associate Editor at the Chronicle Review and now as Editor-in-Chief at The Real News Network, I have dedicated my life to lifting up the voices and honoring the humanity of our fellow workers.
Follow: @maximillian_alv