Richmond, CA—In California, the Kaiser name has long been linked to innovations in work organization, personnel practices and healthcare delivery.
During World War II, industrialist Henry Kaiser built America’s largest shipyard, virtually overnight, here in the East Bay. That now-famous facility turned out scores of “Liberty” ships, using new production techniques, female welders (a k a “Rosie the Riveter”) and African-Americans who had been excluded from higher-paying blue-collar jobs.
Kaiser’s wartime experimentation with a pioneering group health plan, tied to hospitals in Richmond and Oakland, paved the way for pre-paid medical coverage of millions of workers and their families. As a broader nonprofit Health Maintenance Organization, Kaiser Permanente (KP) now operates the largest network of unionized hospitals in the country and has long been known as “the HMO that labor built.” To keep the peace on its own far-flung properties, Kaiser formed a much-heralded Labor Management Partnership (LMP) with the Service Employees International Union (SEIU) and other unions in the mid-1990s. Through their embrace of “non-adversarial” labor relations, Kaiser caregivers were supposed to gain more say in workplace decision-making so they could improve service to patients. Their unions won the right to organize non-union KP workers without management interference—a “neutrality” deal only available to LMP participants.
By 2007, there weren’t many healthcare employers who appeared to be so “patient centered” or “labor-friendly.” So the union-backed lobbying-group American Rights at Work, bestowed its Eleanor Roosevelt Human Rights Award on Kaiser at a gala dinner in Washington, DC, attended by top union officials. As recently as this past July, the HMO’s “shared purpose” and “partnership approach” was still being praised on the AFL-CIO’s official blog.
Meanwhile, outside the Beltway, the HMO has been attracting more picket lines than plaudits. On September 22, more than 21,000 Kaiser employees conducted the largest work stoppage in California healthcare history. This unusual European-style protest strike reflected widespread worker concern about contract concessions sought by Kaiser despite profits of $5.7 billion since 2009.
At hospitals and clinics throughout the state, the one-day walkout (and accompanying smaller-scale strike activity the day before and after) generated unflattering publicity about Kaiser’s recent cost-cutting, rate increases, understaffing and unfair labor practices. The new National Union of Healthcare Workers backed up its strike-related critique of KP’s managed-care practices with a blistering report, released in mid-November, based on information provided by NUHW-represented social workers and psychologists, plus outside experts.
Titled “Care Delayed, Care Denied: Kaiser Permanente’s Failure to Provide Timely and Appropriate Mental Health Services,” the study documents Kaiser’s “systematic” failures to observe “recommended clinical standards” and thus meet the “mental health needs” of patients suffering from “conditions ranging from autism, anxiety and bi-polar disorder to depression, schizophrenia and suicidal ideation.” Accusing Kaiser of noncompliance with state laws requiring HMOs to provide “timely access” to appropriate care, the union is urging California state and federal officials to “initiate immediate investigations to determine the full extent of Kaiser’s regulatory violations.”