When health-care workers walk off the job, they’re putting lives at stake.
When health-care workers walk off the job, they’re putting lives at stake.
A s the former head of labor relations for the nation’s largest hospital system, I understand the critical role that hospitals play in their communities by providing essential medical care, emergency services, and specialized treatments that relieve suffering and save lives. Unfortunately, the delivery of high-quality, reliable health care is placed at risk when hospital workers go on strike. Congress can and should address this problem by putting an end to such strikes.
Emboldened by the workplace discontent associated with the Covid pandemic, labor unions representing hospital workers have come to believe that strikes are an effective way to gain attention and influence. And they’re making use of them: Between 2021 and 2025, there were 105 nurse strikes affecting at least 212 hospitals. In 2023, the largest hospital strike in American history occurred when 75,000 Kaiser Permanente health-care workers walked off the job. And again this year, Kaiser was hit with a strike by more than 30,000 nurses and other workers across multiple hospitals in California and Hawaii, while 15,000 nurses walked out at New York City hospitals, and more than 2,000 nurses walked out of Prime Healthcare facilities in three states.
Such strikes are obviously dangerous; when a patient’s care team departs a hospital and replacement workers are brought in, it creates a higher likelihood of miscommunication, which compromises patient care. The Joint Commission, which is the principal accrediting organization for hospitals, cites communication failures as the leading root cause of medication errors, delays in treatment, and wrong-site surgeries, as well as the second most frequently cited root cause for operative and post-operative events and fatal falls.
A 2010 study by the National Bureau of Economic Research looked at nurse strikes in New York State over a 20-year period and found a 19.4 percent increase in patient mortality associated with strikes. During a 2021 strike at St. Vincent Hospital in Massachusetts, the Massachusetts Nurses Association ironically stated that it was striking for patient safety while expressing its belief that the replacement nurses necessitated by its walkout were “providing substandard care.”
Further, when hospital workers walk off the job, it imposes major disruption and costs on a health-care system that is already under stress. Kaiser Permanente reported $1 billion in costs associated with its massive 2026 strike. The New York City hospitals affected by the nurse strike earlier this year reported associated costs of $100 million. A recent strike at a hospital in State College, Pa., reportedly cost the facility more than a million dollars a day.
And let’s not forget that more than 40 percent of hospitals’ revenues are derived from federal or state government payments in the form of Medicare and Medicaid reimbursement, so a large portion of strike costs are ultimately paid by taxpayers.
In light of the risks to patients, it should be illegal for hospital workers to strike, just as it is illegal for workers to strike in other critical sectors.
Under the Railway Labor Act, strikes by railroad and airline workers are not allowed unless authorized by the National Mediation Board. Such authorizations are rarely granted, and even when granted, they only come after very lengthy — often years-long — negotiations have failed to produce agreement between management and labor. Congress severely limited the ability of these workers to strike because their industries are so critical to the communities they serve and to the economy in general.
Employees of the federal government have no right to strike; under the Federal Service Labor-Management Relations Act, it is flatly illegal for them to do so in any circumstances. This is why, in 1981, Ronald Reagan fired 11,000 air-traffic controllers who went on strike.
Similar prohibitions against strikes by public employees exist in many states. Indeed, even in deep blue, union-friendly New York State, for example, the Taylor Law prevents firefighters, police officers, and public-school teachers from walking off the job.
In contrast, the unions representing the nurses, physicians, pharmacists, physical and occupational therapists, and others employed by hospitals may unilaterally call a strike whenever they wish to do so. The National Labor Relations Act requires only that they provide ten days’ notice before walking out. To the family of a baby in a NICU or to a heart attack victim being transported by ambulance to the emergency room, having a fully staffed, fully functioning hospital is even more critical than having the trains running on time or being able to book a flight on a preferred airline.
Hospital workers should not be legally permitted to withhold their critical labor from the patients who need them just because their union has a disagreement with management. If railroad workers can’t do it and public employees can’t do it, hospital workers should not be able to do it either. Congress should amend the National Labor Relations Act to prohibit strikes by hospital employees.