People holding yellow and red signs and wearing red nurse outfits stand outside.

Multiple Bay Area Health Care Strikes Reflect a Workforce Decimated by Labor Shortage

Even though less than 7% of health care workers nationwide were unionized as of 2020, the health care sector also has seen renewed interest in unionization since the pandemic.

“I think the pandemic revealed and exacerbated a lot of problems that already existed, and some of those problems were brewing around stress and burnout and workloads, as we’re hearing from physicians and nurses and other health care professionals,” Dr. Joanne Spetz , director of the Philip R. Lee Institute for Health Policy Studies at UCSF, told KQED.

The pandemic, she added, also laid bare the extent of labor shortages across a wide range of essential jobs within health care settings, including custodial staff, nursing assistants, food-service workers and delivery people.

“When those jobs are all in short supply, that puts even more pressure on physicians, nurses and others,” Spetz said.

And many health care workers are finding that their most common demands — for reduced workloads, more support services, more time for administrative tasks and, in a growing number of instances, tougher security measures — are often not sufficiently met by employers, who often cite nationwide labor shortages and rising costs of doing business.

Unionization is more popular than it’s ever been, even across political lines, with a recent Gallup poll showing that 71% of Americans approve of labor unions, the highest approval rating since 1965.

But questions remain over how financially well positioned hospitals are to hire and train more people and meet their employees’ increasingly vocal — and organized — demands.

“Health care is competing against a lot of other industries and sectors that also are having difficulty recruiting,” Spetz said.

“A skilled trade or retail or a restaurant can change their prices pretty quickly, but for health care, they are in these often multiyear insurance contracts and they cannot immediately drum up more revenue in order to pay those higher wages,” said Spetz. “They’re likely to be going back to the insurance industry in the next few years as their contracts come up for renegotiation and ask for more money. And then the insurance companies eventually are going to need to figure out how to pass that on in the price of higher premiums.”

And, Spetz added, the pressure of keeping costs down at a time of rampant inflation in a labor-intensive field like health care is exacerbated by the rising costs of supplies and equipment.

“Because it takes a while to have the ability to raise revenue … that just puts more financial pressure,” Spetz said, adding that as the pandemic relief money fades, hospitals will be facing financial shortfalls and worrying about “how the money’s going to play out for them.”

“A lot of it comes down to building a workplace where health care workers really feel valued, are able to use all their skills, are respected as professionals, regardless of what level they work within the organization … and have the autonomy to use their knowledge and skills to the highest ability,” Spetz said. “You need to be adequately staffed in general. And so that’s going to be the big challenge for employers, is how to create that healthy, supportive work culture. And you have to do that while you’re dealing with labor shortages and plugging all the holes that need to be plugged.”

Additional reporting was contributed by Bay City News and KQED’s Laura Klivans.

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