The Kaiser-Permanente/coalition agreement represents the largest, longestlasting labor–management partnership in the United States. The Coalition of Kaiser Permanente Unions, AFL-CIO, is a federation of 32 local unions associated with health care in California. This coalition includes 11 international unions and represents 120,000 health care workers.
This partnership has a history going back to the early 1990s. At that time, in response to increasingly strained labor relations, the coalition was formalized in 1996. It sought to adopt new policies, including a new constitution and bylaws. It also proposed a “new” idea to work with Kaiser Permanente to develop a partnership that included participation in decision making throughout the organization and to “have a say in how to deliver affordable, high-quality care.” The key was that coalition members were involved in the development of ideas rather than just talking about them after the organization had proposals already developed.

This partnership has been lauded as an effective example of how working together can be more powerful in long-term win-win solutions than against one another. In fact, both its San Diego and San Rafael, California, medical centers have been featured in case studies at Cornell University titled “How Labor–Management Partnerships Improve Patient Care, Cost Control, and Labor Relations.” Of course, having such a partnership does not always mean that labor relations go smoothly. In 2017, Kaiser Permanente reached a collective bargaining agreement with 1,200 registered nurses at the Los Angeles Medical Center after 17 months of heated contract negotiations and two short-term strikes.

Case Discussion Questions 

1. What experience(s), if any, have you had with unions?
2. Do you think that the collective agreement with Kaiser is a positive or negative thing for patients? Kaiser? Its employees?
3. How might positive employee relations help avoid negative consequences for organizations and employees? Please think of a few examples to share.