More than 7,200 healthcare workers at Oregon Health & Science University (OHSU), members of AFSCME Local 328, are poised to strike on December 12, which marks the end of a mandatory 30-day “cooling-off” period following their overwhelming vote to strike last month.

The workers include those involved in patient care, food services, administrative staff, hospital research and more. They are demanding an 18 percent increase in pay over three years to $27 per hour for all workers, better staffing ratios and improved benefits. OHSU management claims the university posted an adjusted operating loss of $133 million in its 2025 fiscal year and is thus unable to provide higher levels of compensation for its staff.

The university was, however, able to pay its former president, Dr. Danny Jacobs, an annual salary of $1.64 million, and $350,000 a year to his retirement account.

The strike authorization at OHSU is part of a broader wave of labor struggles across the US and internationally. At Legacy Health, also in Portland, 135 advanced practice providers began an open-ended strike on December 2. Some 800 nurses at Henry Ford Health Genesys hospital in Grand Blanc, Michigan, are facing ramped up strikebreaking by the multibillion-dollar health conglomerate. And workers across Italy conducted a general strike on November 28, followed by a day of mass protests on November 29, the third such nationwide strike in a three-month period.

These struggles come amid an ongoing jobs massacre being carried out by US corporations. An estimated 32,000 private sector jobs were cut in November alone. More than 3 in 10 companies are planning to carry out layoffs before the end of the year, and 42 percent will not give severances to those being dismissed. Some 69 percent of employers are leveraging AI tools to help determine whom to fire.

And these figures do not include the hundreds of thousands of public sector workers that have been cut this year by the Trump administration. Nor do they include the full scope of the impact of the government shutdown in October and November, as the Trump administration has refused to release unemployment data for October.

Heading into the holiday season, workers are finding it increasingly more difficult to pay for basic necessities, leaving little, if anything, to celebrate. However, healthcare workers, as every section of the working class, face a critical question: How can a genuine struggle be waged?

The determination of OHSU workers to fight for real improvements stands in contrast to the lack of serious preparation by the union leaderships. Instead of mobilizing to wage a powerful, unified struggle to win workers’ demands, AFSCME is seeking to divide and undermine the fight. After dragging out negotiations for months past the June 30 contract deadline, AFSCME scheduled a strike vote right before the holidays, when financial and family pressures on workers are the greatest.

Moreover, only a fraction of the AFSCME members at OHSU, as well as members of the Oregon Nurses Association (ONA), are set to strike, undermining a united fight.

The ONA recently announced that a separate group of 700 advanced practice providers at OHSU represented by ONA reached a tentative agreement and would not strike, weakening the position of those under Local 328, and suppressed the possibility of a joint struggle.

ONA also represents more than 3,000 registered nurses at OHSU, while other AFSCME locals represent thousands of medical interns, residents, fellows, postdocs, graduate students and other researchers, who are all under separate contracts.

AFSCME and the Oregon Nurses Association have worked to keep the contract expiration dates offset from each other. A collective strike across the entirety of OHSU, Legacy and Providence, for example, would place the initiative squarely with healthcare workers and provide a powerful basis for actually achieving workers’ demands.

When nearly 5,000 nurses at Providence Health & Services went on strike in January and February, the ONA forced through an agreement that did achieve parity with nurses at other facilities and included only 75 percent of retroactive pay, paid out in three installments, contingent on nurses remaining at Providence.

Nurses’ chief demand, improved staffing ratios, was not seriously addressed. Instead, the ratios remain governed under Oregon’s so-called safe staffing laws, which were crafted in collaboration with the ONA, state hospital networks including Providence, the pseudo-left Democratic Socialists of America (DSA) and the Democratic Party. The actual impact of the law has been that in many units, Providence has actually been able to reduce the number of nurses.

Moreover, the agreement, which the ONA claimed passed in a 75-25 percent margin, was essentially the same as what had been rejected by the rank and file in an earlier 84 percent “no” vote. The response of the ONA, and its parent union, the American Federation of Teachers, to the initial rejection was to further isolate the strike in order to ram through a virtually identical sellout deal.

OHSU workers cannot afford to leave their find in the hands of the union apparatuses. They must set up their own organizations of struggle, rank-and-file committees democratically elected from the hospital floors to enforce the demands of workers themselves. OHSU rank-and-file committees will be able to collaborate with other workers in healthcare, public education and other workplaces in the US and around the world under the umbrella of the International Workers Alliance of Rank-and-File Committees (IWA-RFC).

Healthcare workers must also connect their struggles with the broader social crisis. The Trump administration has sharply escalated its attacks on immigrants nationally, with the complicity of the Democratic Party. Since October, ICE arrested at least 329 people in Oregon, a 550 percent increase over previous months, conducting armed raids in unmarked vehicles. Nurses have noted in particular the collaboration of the Legacy Emmanuel Medical Center with ICE.

Further, any serious mobilization of workers faces the possibility of a confrontation with the National Guard currently deployed in Portland. The city was one of Trump’s first targets for domestic troop deployment, based on the lie that the city was “war-ravaged” and describing those protesting ICE as “domestic terrorists.”

In opposing such police state measures, workers cannot rely on the courts or the Democratic Party. Throughout Trump’s entire second term the Democrats have actively collaborated with the fascist, would-be dictator, voting to end the budget stand off on Trump’s terms and offering no serious opposition to ICE terror. This was epitomized in the friendly meeting between New York Democratic Mayor-elect Zohran Mamdani and Trump last month.

OHSU workers must go into action now to ensure the broadest possible mobilization to win their contract demands. At the same time they need to recognize they are engaged in a political, not merely a contract fight, against the entire capitalist, for-profit health system. Despite the vast advances in medical science, life expectancy is falling, and infant mortality is on the rise.

Only through a network of rank-and-file committees, which is being built around the world by the International Workers Alliance of Rank-and-File Committees (IWA-RFC), can the enormous power of working class be brought to bear. Healthcare workers, who want to build a rank-and-file committee and connect workplace struggles to the broader fight of the working class, should contact the World Socialist Web Site.