A Healthcare RX: Long-Term Problems Require More Than Short-Term Solutions

by | Nov 21, 2023 | Bargaining/Negotiations, Healthcare, Healthcare, Industry, Labor Relations Ink, Labor Relations Insight, Strikes, Union Leaders

It’s time for a checkup on the Kaiser Permanente saga, which means that some staggering numbers are coming your way. In August, we updated you on the consortium’s brief remission and returning strife following a 10-week California mental healthcare strike and a Hawaii sister strike that lasted 172 days. Kaiser also averted a strike by 21,000 nurses with 22% raises.

The constant push and pull must be dizzying for Kaiser workers. They face burnout issues over the staffing crisis, and patients likewise endure lengthy appointment wait times. Kaiser feels all of this pain acutely, and third-party interference comes from the Coalition of Kaiser Permanente Unions, which pushed these recent developments:

  • Kaiser experienced “the largest healthcare worker strike in U.S. history” when 75,000 workers, or 40% of all staffers, walked out for three days in November. This included nurses, pharmacists, housekeepers, lab techs, and more who ended up with a contract for 21% raises over four years. Separately, a Washington-focused strike landed those Kaiser workers up to 25% wage increases.
  • Kaiser ended up on the hook for a $200 million settlement with the California Department of Managed Health Care. This adds up to a $150 million investment in behavioral health and a $50 million fine.

As a consortium, Kaiser manages healthcare facilities and is the U.S.’s third-largest health insurance provider. As such, it can be viewed as a healthcare-industry snapshot and provides some perspective.

Why Kaiser can’t dig out: Ongoing staffing shortages, mandatory ratios, and strikes are all forcing Kaiser and other healthcare providers to choose emergency stop-gaps in the form of temporary workers, who are not a magic-bullet solution and arguably even compound the staffing problem. Those ratios are favored by unions (and legislators who are lobbied by unions) and can be a short-term tactic that creates long-term harm.

A self-perpetuating cycle: Healthcare facilities that hire traveling temp workers pay them a premium that effectively doubles labor costs for those positions. This can breed resentment from permanent workers, which can cause even more burnout, turnover, and a never-ending, revolving door of staffers. This also means that far less money can be applied to longer-term, more holistic solutions.

The burnout cycle also extends to medical education programs reporting faculty shortages, leading them to take on fewer students, which does not bode well for easing the staffing crisis. Add that to reports that up to 50% of healthcare workers aim to leave the profession by 2025.

What comes next? None of the above ills can be solved by ratios alone if an industry is coming up short on overall workers. To that effect, Bloomberg recently quoted Daniel DeBehnke, a VP of Premier Inc. healthcare consulting firm, who suggests “opening up more visas for healthcare professionals, investing in universities to expand their medical programs, or getting creative on a corporate level to free up funds.”

All of this is much easier proposed than done. Sooner or later, however, the healthcare industry will find the wiggle room to move past the illusory solution of ratios and focus on more comprehensive solutions – for the benefit of patients, workers, and hospitals.


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