(Bloomberg) -- More than 75,000 Kaiser Permanente workers began striking Wednesday morning, threatening to interrupt one of the nation’s largest health-care providers and adding to a months-long series of labor disruptions across the US economy. 

The three-day strike could stall services for nearly 13 million people in at least half a dozen states. It’s expected to shut down nonessential services such as routine doctor’s visits as radiology technicians, pharmacy technicians, dental assistants, optometrists, and hundreds of other support staff take to picket lines. Hospitals and emergency services will continue to function through a combination of staff reassignments and replacement workers, according to the company. 

Strike lines are forming at Kaiser Permanente hospitals and medical office buildings across the country, starting with a small number workers in Virginia, Maryland, and Washington, D.C., picketing at 6 a.m. Eastern. Workers in California, Oregon, Washington state, and Colorado followed. 

Under federal restrictions for health-care unions, members will have to return to the job even if no deal is reached by Oct. 7. The union has said it could plan additional strikes later on. 

The unions and management remained at the bargaining table Wednesday morning after working through the night, but the two sides painted different portraits on whether a deal was within reach. The Coalition of Kaiser Permanente Unions said the two sides were far apart, and that company wouldn’t budge on a measure that would allow it to outsource union work. Kaiser Permanente painted a rosier picture, saying they had reached agreements on some measures.

The strike shows how tension between health-care companies and workers has only escalated since the onset of the Covid-19 pandemic, when scores of burned-out workers began leaving the field entirely. The Coalition of Kaiser Permanente unions has accused the company of cutting workers through attrition, creating an understaffed workforce that’s incapable of looking after patients, it says. 

Staff from the Springfield Medical Center in Virginia picketed outside the clinic Wednesday, brandishing signs and chanting as passing cars honked horns and shouted support. Sarah Levesque, secretary-treasurer for the Office and Professional Employees International Union local, said the signs of solidarity have been “uplifting” for the striking workers.

“The small inconvenience of patients being rescheduled today is nothing compared to the staffing crisis we’re having right now and that’s the thing at the forefront of our minds today,” Levesque said. 

Unfair Labor Practice Claims

The labor coalition complained to the National Labor Relations Board, saying Kaiser executives were bargaining in bad faith over fixing the staffing crisis. 

The company has denied those claims, saying in a statement Monday it offered across-the-board wage increases of at least 12.5% over four years, and state-by-state minimum wages of $21 to $23 an hour. 

“There has been a lot of progress, with agreements reached on several specific proposals late Tuesday,” Kaiser Permanente spokesman Wayne Davis said in an email Wednesday. 

The coalition submitted a 10-day strike notice on Sept. 22, as health care unions are required to do under federal law. The advance notice gives providers a chance to develop contingency plans for patient care, but also can undercut the union’s leverage. 

“Patient care is how you win the war of public opinion,” said Dan Bowling, a labor and employment professor at Duke University. “Kaiser can make the argument that these people are abandoning their patients and they would win if the public agrees with that. It’s much more complicated for the union to convince people that they’re striking for patient care.”

David Hawa, an ambulatory pharmacist for Kaiser, said staffing needs are most pressing for the workers in Springfield.

“Since the pandemic, staffing has dropped to levels that are nowhere near sufficient to cover the needs we have in the medical center here,” said Hawa, who has been working at the Springfield location for 28 years. “Short-staffing is making our frontline workers—pharmacists and optometrists–stressed and also making our patients stressed. Patients have to wait in long lines to get the care they need.”

Hawa said the workers can feel support from patients at the facility and from the community at large, despite worries that the public might turn against a large health-care strike. 

“The patients are also part of this and they can feel that,” he said. “They can see us here out on the street delivering our message, and they see their concerns reflected in us. Kaiser can do better–they should be coming to the table to give us the contract we deserve.”

Summer of Strikes Continues

The Kaiser strike is the latest in a string of high-profile labor disputes fueled by a tight labor market, high inflation, and record corporate profits that has left workers both resentful and emboldened. 

The United Auto Workers has steadily expanded a strike against the Detroit automakers that started Sept. 14, demanding raises as high as 40% and the end of job tiers. The Writers Guild of America last week reached a tentative agreement to end a five-month strike over artificial intelligence and streaming pay, while SAG-AFTRA actors remain on the picket line. 

And in Las Vegas, more than 50,000 hospitality workers could soon walk off the job over staff cuts and increased workloads—complaints that aren’t so different from the health-care workers. 

The Kaiser strike is the largest for the US health-care industry by at least 20,000 workers, according to Bloomberg Law’s database of work stoppages dating to 1990. The next-largest strike involved 54,000 workers at the University of California in 2018. Kaiser Permanente has been involved in five of the 15 largest strikes recorded.

--With assistance from William Jeremiah, Derek Wallbank, Aradhana Aravindan and Andrea Tan.

(Updated with additional reporting throughout.)

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