Oakland, Calif.–On Dec. 16, 2019, 4,000 mental health workers at Kaiser Permanente HMO here went on a five-day strike, once again calling attention to a serious lack of resources to provide timely care. Over several years, therapists have staged work actions against participating in this system of “unethical delays” in providing care. As Htun Lin reported in 2015, Kaiser paid a $4,000,000 fine “for systemically understaffing its psychiatry department, falsifying patients’ appointment records to conceal long wait times, and providing patients with misleading information regarding the care available to them.”
After so much ado, everything is the same. Kaiser has fulfilled its legal obligations through clever record-keeping. Patients trying to access care for severe depression or other mental health issues continue to face an obstacle course. Kaiser meets the standards for “timely access” through call-center intake assessment interviews which, in effect, ration care. Patients relay their problems in a phone interview to a healthcare professional, but actual treatment doesn’t start. Treatment is put off, sometimes with dire consequences, until a follow-up appointment scheduled weeks, sometimes months later.
Healthcare workers try to unite science with the well-being of the human. For over two decades Htun Lin chronicled in News & Letters how healthcare restructuring, organized by bean counters, has divided them. Healthcare workers, especially nurses, have carried on a protracted struggle against HMO policies that have undermined their efforts to provide care. The barrier they–and we all–face is how capitalism presents itself as “objective” and “scientific.” In contrast to the lie of this reality outside of the material well-being of the human or the planet, stands Marx’s unity of science and life, beginning from human essence, humans freely determining their own life activity.