Amid difficult as-for-more-than-a-decade national contract negotiations, working conditions and consequent patient safety remain a major concern of the membership of the umbrella Alliance of Health Care Unions, representing a huge range of employees other than physicians. See the title photograph of the LA Times 11 October 2021 news story — it shows a 2020 demonstration, Los Angeles police officers arresting Kaiser Permanente workers and their supporters, a man and a black woman in restraints being taken away, with someone else on the ground surrounded by officers, and a crowd in the background.
Thousands of Kaiser Permanente employees in Southern California voted to authorize a strike against the healthcare giant, as the workers continue to protest what they describe as severe staffing shortages that put both medical staff and patients at risk.
The strike authorization comes amid strained contract negotiations. Union representatives said nearly 21,000 nurses, pharmacists, midwives, physical therapists and others represented by United Nurses Assns. of California/Union of Health Care Professionals, or UNAC/UHCP, voted overwhelmingly — 96% — to approve a strike.
The [last] union contract expired Sept. 30 … A strike would affect Kaiser hospitals and facilities in more than a dozen Southern California cities…. The vote does not automatically trigger a strike, the statement said. Unions are required to give the company a 10-day notice before any work stoppage….
<big><big>Skip past this next section unless your first impulse is to rush to KP management’s defense:</big>Cynics may call the strike vote a collective-bargaining ploy,</big> and it’s certainly their right to say so, but they may want to review the factual history of labor/management conflict at KP since at least the 1990s, turning constantly on the endangerment of workers and patients alike.
For those so-minded, there’s a to-date 97-item bibliography at this October 2020 diary, —e.g, #72: goodjobsfirst.org KP WORKPLACE VIOLATION TRACKER (State-imposed penalty total since 2000 as of today’s writing :$77,497,338, Number of records: 341. At the time of that earlier diary, the numbers for 2000-2018 were $37,757,920 in state penalties, 56 workplace violatIon records.)
Operating in 8 states (Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia) and the District of Columbia, KP is the largest managed care organization in the U.S., with 12+ million members, 39 hospitals of it’s own (besides contracts with other hospitals), over 700 medical offices, and over 300,000 personnel, “including 80,000+ physicians and nurses.”
However, doctors and nurses are not employed on the same basis. More specifically, doctors and all other staff. The Kaiser Foundation Health Plan, Inc. (KFHP) —one of the single largest putatively not-for-profit US organizations— and its regional operating subsidiaries, and the Kaiser Foundation Hospitals, are on not-for-profit basis. They employ the nurses and all other personnel except the doctors. In contrast, the regional Permanente Medical Groups are the physician cadre. Each operates as a separate <big>for-profit partnership or professional corporation.</big>
And the C-suite 1% give themselves compensation packages like those of the wealthiest corporations.
The resultant massive conflict of interest in this huge managed care business is evidenced in more ways in that diary (and maaany of the other DK diaries on KP too), e.g.:
...KP’s 2019 $7.4billion PROFIT, driven by investments, had nearly tripled compared to 2018 … and then they lost $1.1B on'em the first quarter of 2020, before the pandemic hit. (Anyone puzzled that California had to pass targeted legislation requiring KP to report to the state on its finances more like a profit than nonprofit business need wonder no longer.)
... The bedrock of KP’s profitability is the money [their covered lives] (“members”) pay, both directly, in the form of co-payments and personal monthly premiums, and indirectly via employer healthcare plans, Medicare*, or any other capitations from a “member’s” monthly resources paid to KP, again including from KP employees**…
*from https://www.medicarefaq.com/faqs/how-is-medicare-funded/:
"...The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.
“Sometimes the Medicare Advantage plan will get over $9,000 from the government to handle the claims of a “high risk” patient. High risk can include patients with heart disease, diabetes, or other chronic condition...."
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...Under pressure from state of California targeted legislation signed by Gov. Newsom September 6, 2019, the KP system pledged to invest it’s 2019 $7.4 billion profit in infrastructure and affordability for its members. Again, members including KP employees. For whom KP could not afford to supply adequate PPE mere months later? [re staff-member deaths]
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** KP’s employee healthplan is KP itself, i.e., for 300,000 thousand employees and their families, a not-insignificant portion of the total 12+ million “members” nationally.
Further evidence of conflict of interest cited in that earlier diary:
wik: ...Around [1997], The Permanente Company was also chartered as a vehicle to provide investment opportunities for the for-profit Permanente Medical Groups [i.e., the physicians]. One of the ventures of the Permanente Company is Kaiser Permanente Ventures, a venture capital firm that invests in emerging medical technologies...
...Jamie Court, president of the Foundation for Taxpayer and Consumer Rights has said that Kaiser's retained profits are evidence that Kaiser policies are overpriced and that health insurance regulation is needed.
State insurance regulations require that insurers maintain certain minimum amounts of cash reserves to ensure that they are able to meet their obligations; the amount varies by insurer, based on its risk factors, such as its investments, how many people it insures, and other factors; a few states also have caps on how large the reserves can be.
Kaiser has been criticized by activists and state regulators for the [huge] size of its cash reserves. As of 2015, it had $21.7 billion in cash reserves, which was about 1,600% the amount required by California state regulations.[85] Its reserves had been [targeted] by Consumer Watchdog supporting Proposition 45 in California's 2014 elections.[85]
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<big><big>Hopefully the above section offers enough meat for defensive opinion-holders to </big></big>START<big><big> chewing on. </big> It’s understandable, after all, that individuals who are pleased with someone/something they see taking care of them —care they know they need— will feel themselves threatened by criticism of that provider.
People often do defend entities that hold power over their lives, the more so if they are confident that that powerful entity is doing them great good and therefore surely cannot possibly be doing anyone else harm.</big>
So, completely understandable. Especially if worried/angry that criticism and labor strikes may deprive them of needed care in a time of great health concerns.
Understandable, but not necessarily fact-based where the larger picture is concerned. Because what the Alliance of Health Care Unions membership has been struggling to bring to fruition, in many years of efforts in the 8 states and DC, is equal healthcare for all neglected members, including themselves, from a provider that literally is more than richly equipped to supply all that’s necessary, to workers and to patients, but became “more than” by not doing it.
For every neglect and negligence that a healthcare provider is allowed toward some it’s committed to serve, that’s how the rest are put closer to hazard too.
In California, what prompted the strike vote is that contract talks between KP management and workers have made “little progress toward the union’s goals, including more robust staffing and retention,” according to UNAC/UHCP President Denise Duncan, a registered nurse,
<big>We should keep in mind, too, when deciding which side of the negotiating table to support, that a great proportion of the employees fighting for years upon years for safe working conditions and patient safety are people of color and minorities, and the majority of the employees involved are women.</big>
And as time goes on, and the overall population goes on aging, women are more and more of the KP members needing safe care.
One more item to add to the bibliography, perhaps: a general item, on why understaffing and hazardous working conditions endanger vulnerable patients: from TheConversation 12Oct2020 see WIKIPEDIA PG ON THIS NEWS SOURCE HERE : Medical errors are a major cause of death in the U.S.
...Medical mistakes, and not the patient’s underlying condition, produce more deaths and injuries than all other types of accidents in the U.S. combined. They are one of the leading causes of death, behind heart disease and cancer.
Studies from the early 1970’s onward estimate that about 200,000 to 400,000 Americans die from medical errors every year, perhaps more than 1,000 a day. By comparison, about 115 people in the U.S. die per day in motor vehicle crashes, 14 from workplace accidents and approximately zero from commercial airliner crashes.
And for every patient who died from a medical mistake, two more suffered moderate to severe injuries. What’s more, all of those mistakes involved hospital patients only. The studies did not include errors at outpatient surgery centers or the doctor’s office, including prescription snafus or lab errors.
There have been glimmers of progress, but no major advances. Despite decades of talk...
perhaps in no small part because rank and file healthcare workers historically have had so little voice in how healthcare is delivered, even though they are who is tasked with the 24/7 delivery.
...in how “managed” care is “managed.”
Isn’t it time we stand not with management but with the workers? As allies. Their interests and ours are aligned. This is our solidarity calling.