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What it means for patients as 75,000 Kaiser Permanente workers go on strike

By Jen Christensen, CNN

(CNN) — As a strike gets underway, Kaiser Permanente, one of the United States’ largest not-for-profit medical systems, says it has contingency plans in place so it can continue to provide safe, high-quality care for its 12.7 million members and patients.

The strike is the largest health care strike in American history, involving more than 75,000 workers at locations across the country — about 40% of Kaiser’s staff. Workers began to walk off the job early Wednesday morning and are scheduled to continue through early Saturday, with plans to strike for a longer period in November if necessary.

A walkout does not leave the Oakland, California-based health-care system completely without employees. As of June, Kaiser Permanente employs more than 281,000 nurses, technicians, administrative and clerical workers, as well as nearly 24,000 doctors at its 39 hospitals and 622 medical offices. About 60% of staffers would still be working in the event of a strike, it said.

Where workers are striking

Although this walkout would be the first national strike effort at Kaiser Permanente, the health system said last week that no patients in Georgia, Hawaii or Washington would be affected, and operations would continue as usual in those states. A Kaiser Permanente spokesperson later clarified that two medical offices in southwest Washington will strike, but are considered to be part of the health care system’s Oregon region.

In Virginia and the District of Columbia, optometrists and pharmacists are the only workers preparing to strike.

But the effects for patients in Colorado, Oregon and California “could be more substantial,” a Kaiser spokesperson said.

“We have detailed continuity plans in place in all of these markets that include the use of non-represented and management staff along with contingency workers. In addition, all our physicians will be available,” the spokesperson said.

How patients might be affected

But the unions that are striking represent people who are crucial to patient care, including EMTs, nurses, respiratory therapists and support staff.

“Should a brief, 1- or 3-day strike occur, our hospitals and emergency departments will remain open,” Kaiser said in a statement early Wednesday. “Our facilities will continue to be staffed by our physicians, trained and experienced managers, and staff, and in some cases we will augment with trained contract workers to serve in critical roles specifically for the duration of a strike.”

“Our members and patients who need urgent or timely medical care should continue to seek it at our hospitals and medical facilities,” it said. “A strike should not dissuade anyone from seeking necessary care.”

During a strike, it may expand its network to include non-Kaiser Permanente hospitals if patients need to be redirected or transferred.

The system said non-emergency and elective services may have to be rescheduled, but it will contact patients in advance if so.

It also may encourage members to use its mail-order pharmacy. Inpatient pharmacies in hospitals will remain open, but it said it may expand Kaiser Permanente’s pharmacy network to include retail pharmacies during the strike.

‘It’s extremely disruptive’

Working with fewer employees wouldn’t be easy, according to John August, director of health care labor relations at Cornell University and former executive director of the Coalition of Kaiser Permanente Unions.

“Managers are still going to be there. The doctors are still going to be there. From the outside looking in, it’s easy to say that it’s not going to be that disruptive,” he said. “The reality is, it’s extremely disruptive.”

As with many health care systems in the US, Kaiser Permanente has been operating short on staff ever since the Covid-19 pandemic began, it said. Inadequate staffing is one of the issues workers are negotiating.

Kaiser Permanente says it has been working to bulk up staffing. It set a goal of hiring 10,000 additional workers by the end of the year and should reach that mark this month, it said. About 29,000 staffers were hired in 2022 and an additional 22,000 this year.

Studies that have looked at the effects of walkouts on patient care have found that they’re disruptive but have only a marginal impact, if any, on patient outcomes.

One analysis that looked at longer strikes suggested that they had little impact on patient morbidity. Another 2022 analysis of several studies involving 1.8 million patients globally found no clear negative effects on patient mortality.

CNN’s Carma Hassan, Chris Isidore and Samantha Delouya contributed to this report.

Correction: A previous version of this story misstated the day the strike would end.

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