An Alliance in Healthcare


In a giant step forward for California healthcare workers, two of the nation’s most militant unions have joined forces in the battle against Kaiser Permanente, the giant California based healthcare corporation. It is a battle of enormous proportion, one with implications for the entire industry, almost certainly beyond.

The alliance joins the California Nurses Association (CNA) with the new National Union of Healthcare Workers (NUHW); it was formally announced January 3, at CNA headquarters in Oakland, CA. It comes in the face of a set of interrelated challenges, each crucial, first of all of healthcare workers of course, but equally important for patients, for workers nationwide, for us all.

“This is an affiliation whose time has come,” NUHW president Sal Rosselli told the assembly of healthcare workers, union staff and members of the press. “Employer attacks are on the rise, nowhere more so than at Kaiser Permanente. NUHW members at Kaiser, with RN co-workers from CNA have already engaged in repeated statewide strikes to stand their ground against threatened reductions to wages, benefits and job protections that other unions at Kaiser have already agreed to in spite of four years of record profits for Kaiser.”

Other unions? Here, already, the plot thickens, for this alliance is not just to battle Kaiser; it is also to fight Kaiser’s incumbent union, the Service Employees International Union’s (SEIU) California affiliate, United Healthcare Worker West (UHW). Zenei Cortez, RN, who chairs CNA’s Kaiser bargaining team, also CNA co-president, explained, “Uniting together, CNA and NUHW are taking a huge step forward in achieving our joint goal of upholding standards for workers and patients.” She made it quite clear, however, that the fight was also with SEIU’s UHW. “We will have to fight Dave Regan /UHW’s imported, thug extraordinaire president/ as well. We will fight Reagan and his cronies, it is disheartening to say that he has undermined our fight, but we will fight him every step of the way.”

It will be an uphill fight. California healthcare workers face an employer’s assault unprecedented in recent history. The state’s huge hospital chains and health corporations are demanding concessions on very front: staffing levels, health and welfare, pensions, even wages, and this at a time when these corporations (all ‘non-profits’) have rarely been more profitable. Kaiser, the country’s largest healthcare corporation, has made $5.7 billion since 2009; it pays its CEO George Halvorson $8 million a year (along with a dozen pensions). Kaiser has twenty top executives who receive annually more than $1 million each.

Sutter Health, another huge Northern California hospital chain, last year alone made 200 million dollars at its San Francisco complex, an astounding feat – as Bay Area labor writer Carl Finamore points out, it presents a profit rate of 20%, far above industry averages. In the past year Sutter RNs have repeatedly struck, defying demand’s for concessions, most recently December 24. Sutter, like Kaiser, sits on huge reserves.

California is not Wisconsin and not Indiana or Michigan; the attack on labor here is not so political as elsewhere, yet it is equally ferocious, as employers representing workers from grocery stores to dockworkers demand wage cuts, cutbacks in staffing, reduced healthcare benefits and pensions, including here the traditional strongholds of labor in a state that still has the country’s highest number of union members.


Center stage, right now, the new alliance will focus on one thing, the rerun of the representation election at Kaiser, where 43,000 service and tech employees will vote again: the issue NUHW’s bid to decertify SEIU-UHW and regain representation rights. Round one, the 2010 election went to SEIU, but only after a campaign that, according to the estimates of Randy Shaw, cost SEIU possibly as much as $40 million, the most expensive union election ever. More, SEIU threw in intimidation and a campaign of personal smears, lies and fears. NUHW leaders were called thieves, though none were ever charged with or convicted of taking a penny. Quite literally hundreds of full-time staff left all behind to come to California – “World War III” SEIU’s current president May Kay Henry called it. Then SEIU president Andy Stern said the fight was akin to the war on terror. NUHW, then barely off the ground, fought alone. It’s remarkable they won as many votes as they did, losing 18,290 to 11,365. In the circumstances it was quite something for 11,000 workers to choose a fighting, democratic union. But that was cold comfort for the members themselves. It was a significant setback.

Still, NUHW challenged the election and to the great surprise of many a NLRB judge found SEIU election violations so many, so egregious, that she threw out the election results and, in a highly unusual decision, ordered the rerun. This was a great victory, though there is no indication the fight will be different this time. SEIU is now, if anything, more desperate. And it is now clearly Kaiser’s union; both appear to revel in the collusion.

The origins of this are found in the 2008 dispute between the SEIU national leadership and the leaders and members of its then militant and powerful, 150,000 strong California affiliate, UHW. A one-party, top down corporate “union”, the country’s second largest, SEIU allowed for no dissent; in a hostile takeover, again accomplished with deep pockets and a small army of imported staff, SEIU seized UHW’s assets, fired its elected offices and wrecked what labor historian Nelson Lichtenstein had called “a model union.”

It’s been all downhill since then. According to NUHW secretary-treasurer, John Borsos, “SEIU granted concessions in every single one of its California hospital bargaining negotiations of 2010 and 2012, including at around ten Sutter hospitals.

“To be clear, not one single contract has been settled by SEIU-UHW without concessions; not since the international SEIU took over the local in early 2009 and kicked out the original elected 100-member executive board and dozens of stewards who then became the founding core of NUHW a few months later.

“For example, while still representing workers at Sutter’s California Pacific Medical Center (CPMC), SEIU agreed to remove long-standing, strong job-protection contract language.

“SEIU has conceded so regularly in the last several years that hospital management, and not only at Sutter, expects workers to give concessions, even when they are making enormous profits.”

Since then, possibly because of this, NUHW subsequently won a representational election at CPMC. According to Borsos, “At a recent bargaining session, our newly elected member-led team got that job-protection, ‘no contracting out’ language reinstated. This was a big victory and a strong signal to Sutter that NUHW members have a firm ‘no-concession’ bargaining stance.”

Certainly CNA has been paying attention. The nurses, no doubt, saw Regan’s Sacramento performance this past summer with the head of the California Hospital Association, as the last straw. There the Cornell grad, $300,000 a year SEIU hack made an impassioned speech supporting an attack on hospital staffing ration rules, suggesting, generously of course, that “everyone needs to sacrifice.” California’s staffing regulations were one of the CNA’s greatest achievements; they set the standard for the country. CNA Executive Director, RoseAnn DeMoro’s response to Regan was blunt: “Regan is trying to pit nurses against low-wage workers.” She concluded, “It is a war, of that I am certain, and it will not be pretty.”

CNA and NUHW have a long history. NUHW, then Local 250, was the country’s first hospital union. In an earlier incarnation CNA was the countries first nurses union. In the 1990s, then both insurgent unions, they once led a sixty-day strike at Summit Hospital in the East Bay. The issue? The right of the union’s to support each other’s strikes. Solidarity. Both made great gains in the 1990s. In 2000 CNA, 85000 strong, initiated the National Nurses Union (NNU), an important step toward a real national nurses union. Despite all, since trusteeship, NUHW claims the title of the “fastest growing union.” though it’s been trench warfare every inch of the way. Nevertheless they have survived, grown; they represent 4,000 Kaiser workers and workers at a host of other hospitals, including two facilities in Michigan.

Can this alliance last? In 2012, NUHW joined with the Machinists union in an affiliation that helped the healthcare workers keep fighting but never really worked beyond that. They parted, but on friendly terms. Before that, in the days leading up to trusteeship, NUHW worked closely with the Hotel, Entertainment and Restaurant Employees (HERE) and CNA – both opposed the trusteeship. But both, then, after albeit generous support, made their peace with SEIU. This didn’t help, nor is there evidence that either gained from it.

This alliance is clearly a better fit, the targets are clear and the stakes are high, equally high for all. And there is another difference. Twice in 2011 there were trial runs; CNA nurses joined NUHW members in strikes at Northern California Kaiser hospitals – the strikes were against Kaiser concessionary demands. In each strike more than 20,000 workers were involved, they two of the largest healthcare strikes ever, dominated by a militant spirit and determination. They were, hopefully, a taste of things to come.

CNA is 85,000 strong, NNU has another 100,000 members, and these organizations and their members have pledged to make the Kaiser decertification election its “number one priority, promising staff and resources.” The CNA’s decision was made by a unanimous Board of Directors vote; the NUHW held a vote of its membership in December; they overwhelmingly approved.

We all need a victory at Kaiser; it will be a victory for Kaiser workers, but inevitably it will have national ramifications. First of all, for health care workers, it reopens the perspective of union growth, closed down since the trusteeship, here in California and everywhere. And then it renews the possibility of an industrial union – one national healthcare union in an industry of 9 million, the overwhelming majority of whom remain non-union.

Then, a victory at Kaiser will be the result of solidarity, the solidarity of the members and the solidarity of two militant, member driven, workplace oriented unions. It will stand in stark contrast to the “political” responses to other unions under attack at a time when concessions are seen as inevitable, by all from conservative labor leaders to their academic and political apologists. A victory at Kaiser will put workplace power and militant direct action back on the table, no small achievement in our times, a victory sorely needed.

Cal Winslow is the author of Labor’s Civil War in California, PM Press, 2012 (second edition, revised and expanded), an editor of Rebel Rank and File: Labor Militancy and Revolt From Below during the Long Seventies (Verso, 2010), and an editor of West of Eden, Communes and Utopia in Northern California (PM Press, 2012). He is a Fellow at UC Berkeley, Director of the Mendocino Institute and associated with the Bay Area collective, Retort. He can be reached at cwinslow@berkeley.edu

Cal Winslow is author of Labor’s Civil War in California,(PM Press) and an editor of Rebel Rank and File (Verso). His latest book is E.P. Thompson and the Making of the New Left (Monthly Review). He can be reached at cwinslow@berkeley.edu

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