In the first major strike of 2025 in the US, over 5,000 nurses, doctors and midwives are continuing their walkout at multiple hospitals and clinics across the state of Oregon. The strike against the Providence hospital network, which began Friday, is the largest healthcare strike in Oregon’s history.

The demands by strikers, who are mainly members of the Oregon Nurses Association (ONA), are familar to all health care workers. They include improved staffing levels, better wages and health benefits. Strikers report that substandard healthcare coverage forces them to pay out-of-pocket expenses up to $5,000 for services at their own workplaces.

The strike has hit eight hospitals, including the Providence Portland Medical Center, and six clinics across the state. It comes on the eve of the inauguration of Donald Trump and a sharp escalation of the assault on public health, medical workers and the working class as a whole.

This poses the need for striking workers to convert their struggle into a broader industrial and political struggle against the subordination of healthcare to corporate profit, which is supported by both the Democrats and Republicans and the union bureaucracy. This means electing a rank-and-file strike committee to outline workers’ non-negotiable demands, ensure that the ONA officials do not countermand the will of the rank and file and expand the strike.

The ONA has called on Providence to comply with the toothless Oregon Safe Staffing law. Instead, strikers should fight for ironclad nurse-to-patient ratios, which are enforced by rank-and-file committees of nurses and health care workers on hospital and clinic floors, not targets proposed by corporatist labor-management bodies that bow to corporate interests.

Healthcare workers have been at the forefront of strike activity for the past several years. In just the last six years, there have been 38 major strikes involving more than 1,000 nurses and other healthcare workers, all of which have been driven by understaffing, low pay, burnout and, since the start of the ongoing COVID-19 pandemic, the lack of protections against the deadly pathogen.

Nurses in Oregon have been particularly militant. In 2022, 1,600 nurses at Providence St. Vincent Medical Center voted four to one to strike in July before the ONA bureaucracy declared “victory” on a contract that included below-inflation wage increases and did not guarantee better staffing ratios.

In 2023, 1,800 ONA members at the Providence Portland Medical Center took part in one of the 15 major US strikes involving healthcare workers that year. In 2024, 3,000 ONA nurses at numerous Providence hospitals took part in a four-day strike, one of eight major healthcare worker strikes that year.

A common thread among all of these struggles is the basic demand of “patients before profits.” Workers are well aware that Providence and other healthcare entities (Kaiser Permanente, University of Pittsburgh Medical Center, UnitedHealth Group to name a few) have reserves of billions of dollars, with executives making tens of millions.

Providence hospitals and clinics in particular are run by the umbrella organization Providence Health & Services, one of the many not-for-profit healthcare institutions run by the Catholic Church. It was founded in 1859 and includes 51 hospitals and more than 800 clinics in Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. In total, it has assets of $9.5 billion and received $1.3 billion in CARES Act bailout money.

At the same time, patients’ lives are put at risk because nurses are forced to work 12-, 16- or even 24-hour shifts because of lack of staffing, which is never addressed. Healthcare workers themselves are also prone to getting sick when hospitals refuse to equip them with proper personal protective equipment. Nurses also face an enormous amount of workplace violence, generated by the social crisis, mental health issues and patient frustration at the very conditions nurses are striking against.

A second commonality of every healthcare strike, however, is the continued sellout of each strike by the Oregon Nurses Association apparatus.

The aborted strike in 2022 serves as a particularly stark example of the role of the union bureaucracy, which had been forced to call a strike in mid-June, and then set the date of the strike for July 11. It then used the time to announce an agreement after a “historic” 24-hour bargaining session and forcing nurses to vote on the new contract.

Once again, ONA officials are seeking to subordinate striking workers to the Democratic Party, which, just like the Republicans, is a tool of the giant healthcare monopolies that exploit workers and patients alike.

At an ONA rally Sunday at the Portland convention center, several federal state politicians, including state representatives Travis Nelson and Rob Nosse, demogogically postured as friends of the striking workers. These Democrats joined with the ONA, the Service Employees International Union and other unions promoting Oregon’s Safe Staffing Law, which went into effect on June 1, 2024.

Like similar laws in other states, this will do nothing to address chronic understaffing and overwork. Instead, the measure simply requires hospitals to form union-management committees to come up with staffing plans and imposes no serious penalties for exceeding patient-to-nurse ratios.

Also present were AFL-CIO President Liz Shuler, American Federation of Teachers President Randi Weingarten and other union bureaucrats. As leading figures in the Democratic Party political establishment, they have spent years betraying strikes are now cozying up to the incoming Trump administration.

ONA officials have undermined the position of striking workers by agreeing to federal mediation, and there is a real danger that they will accept separate settlements at some of medical facilities as they did in 2022.

It was reported Sunday that the ONA has agreed to the demands by Providence and the federal mediator to restart negotiations for separate deals at the smaller Medford and Newberg facilities, in a clear move designed to isolate workers at the much larger Providence Portland and St. Vincent facilities.

This has provoked widespread opposition from rank-and-file workers. “It feels like gaslighting honestly, and it feels like a very calculated division designed to separate the larger population hospitals from the smaller population hospitals,” said Daniel Taylor, an acute care RN at St. Vincent, told KGW8 News.

“Fixing problems at one hospital versus fixing problems at another hospital doesn’t solve the problem. What we need is for all of us to get a retirement package we can use and benefits package overall that allows us to keep staff from going to other hospital systems.”

The Biden administration is also closely involved with the negotiations. Federal mediators were brought in immediately when the strike began, above all, to ensure that the strike does not expand to broader sections of the working class. Mediators played a similar role in the strike of 33,000 Boeing machinists last September and October and played a critical role in getting the International Association of Machinists to shut down that strike.

The timing of the strike is also a concern for Biden. The fact that the nurses’ strike is taking place in the week before Trump’s reascension to the White House threatens the touted “smooth transition of power” for the fascist and would-be dictator. If the strike became the catalyst for a broader movement of healthcare and other workers, as it must to win, it could develop into a direct conflict with the newly inaugurated Trump and expose his populist “pro-worker” rhetoric.

That was the primary concern of the International Longshoremen’s Association (ILA) officials, who called off a potential January 15 strike by more than 40,000 dockworkers on the East and Gulf Coast ports. ILA President Harold Daggett, who praised Trump as a champion of the working class, has given the incoming government a carte blanche to carry out its openly declared plans to rip up democratic rights, carry out mass deportations and establish a dictatorship on “day one.”

The artificial divisions of workers imposed by the unions, with different contracts for different lengths at different hospitals, factories and other workplaces, must be abolished and a unified struggle waged by the entire working class. Workers must fight to take profit out of health care through the establishment of a socialist medical system.

This involves establishing rank-and-file committees, organizations of workers, by workers, and for workers, designed for a full democratic discussion of workers’ demands and to connect with other sections of workers nationally and internationally. These committees would act under the umbrella of the International Workers Alliance of Rank-and-File Committees (IWA-RFC), which includes committees from multiple continents and numerous industries, cutting across the isolation imposed by the trade union bureaucracies and national borders.

Nurses and healthcare workers looking to wage such a struggle should contact the World Socialist Web Site Health Care Newsletter, which will provide all possible support for such a fight. For more information, fill out the form below.