More than 1,000 doctors, dentists, psychiatrists and veterinarians serving Los Angeles County-run hospitals, clinics and medical centers are preparing to strike on December 27. A strike authorization vote was held last month through the Union of American Physicians and Dentists (UAPD) after more than two years of failed negotiations. The UAPD is affiliated with the American Federation of State, County and Municipal Employees (AFSCME), part of the AFL-CIO.

The strike affects Los Angeles County’s departments of Health Services, Mental Health, Medical Examiner, Fire and Animal and Care and Control. The health care system has been plagued for years by an unprecedented exodus of medical staff as well as grossly inadequate and still deteriorating staffing levels.

The COVID-19 pandemic exacerbated what was an already dire situation. After four years of the COVID-19 pandemic and millions of dead worldwide, obscenely unsafe conditions prevail in the county’s clinics. Nothing significant has been done to implement basic safety measures such as the installation of HEPA filters and ventilation systems that would greatly reduce the risk of virus transmission.

According to a recent survey from Tebra, a third of healthcare workers plan to leave their current jobs by 2024. Burnout, anxiety, depression, and exhaustion are pushing these workers to the brink. It is estimated that 800,000 nurses in the US will leave their profession altogether by 2027.

UAPD’s president, Dr. Stuart Bussey, conveyed the depth of the crisis in a speech last month, stating, “We’ve lost many of the positions. They’re not coming here, they’re not staying here. We need better healthcare benefits so they will stay in Los Angeles County. They’re dedicated people but they need to be taken care of.”

In many departments in Los Angeles County, more than 50 percent of job openings remain vacant. It is even worse in the Los Angeles County Jails, where up to 70 percent of job offers cannot be filled. The burden also weighs particularly heavily on female doctors, who lack even the most basic family planning protections. They have been forced to work beyond the limits of safety during pregnancy, doing intensive overtime in order to extend their maternity leave.

Doctors and dentists have a long list of grievances: pension protection is inadequate, cost of living increases are taking a toll, health benefits are, ironically, extremely limited, workload is excessive and burnouts are common. Poor safety for both patients and medical staff poses dangers while the work environment is increasingly corporate and hostile, and contracting out threatens the viability of these jobs.

Despite this, the UAPD is pursuing the AFL-CIO’s treacherous script of Unfair Labor Practice (ULP) strike action. The calling of an ULP strike prevents workers from raising economic demands. It has thus become a favored tactic used by unions to facilitate the betrayal of workers struggles.

The UAPD stated this openly in a recent statement rejecting “claim(s) that the impending strike is an ‘economic strike’ aimed at getting leverage at the bargaining table before the two sides had reached an official impasse or exhausted the steps that follow impasse, making it ‘presumptively unlawful.’ However, the impending strike is an Unfair Labor Practice strike, not an ‘economic strike.’”

To make matters worse, the union is bending over backwards to meet the county’s demands that the strike be as toothless as possible. For example, responding to the County’s allegation that the strike poses an imminent threat to public health and safety, the UAPD responded that it “has assured the County that by following line pass procedures, no ‘essential employees’ will be on strike.”

The UAPD itself has no interest in actually pursuing an all-out strike, which will only expose it in front of its membership. In a recent tweet, it comments: “we’re hopeful that Los Angeles County will meet with us in mediation to prevent the strike from happening.” Nothing good can come out of this spineless attitude.

The policies being pursued by the UAPD are in line with those of the AFL-CIO, which for the past 40 years and more has suppressed the class struggle and overseen a huge reduction in workers’ living standards based on its nationalist, pro-capitalist program and its alliance with the big business Democratic Party.

Hand-in-hand with its betrayals of workers’ economic struggles, the unions have lined up behind the wars launched by every US administration aimed at securing the economic interests of big business.

In line with this, the AFL-CIO has issued not a single word about the Israeli genocide against the people of Gaza—absolutely nothing about the hundreds of doctors, nurses, and healthcare workers who have been slaughtered. On the contrary, the AFL-CIO has issued a pro-Israel statement, fully in line with the Biden administration’s genocidal policy.

Meanwhile, healthcare workers have been in the forefront of opposition to the genocide being carried out by the Netanyahu government against the people of Gaza with the full backing and military support of the Biden Administration.

Since October 7, Israel has killed thousands of civilians in Gaza, targeting hospitals and healthcare facilities, arresting or murdering those few medical professionals who courageously serve Palestinians.

While a substantial number of Los Angeles County doctors have taken a principled stance against the ongoing genocide in Gaza, the UAPD has made no public statement, nor has it come to the defense of Family Medicine residents who were recently targeted by Harbor-UCLA Medical Center (one of Los Angeles County’s main hospitals) and accused of misconduct for issuing a pro-Palestinian statement using the center’s logo.

The UADP’s complicit silence over this massacre is just another expression of its fundamentally hostile attitude to its own overstretched, exhausted workforce.

Los Angeles is an exceptionally wealthy city, in the wealthiest US state, plagued by extreme social inequality and run by a cabal of Democratic politicians who preside over staggering levels of poverty, homelessness, mental illness, substance abuse and the transmission of preventable diseases, to name a few.

Thus doctors face a struggle not only against the Democrats who control the city, but likewise who control the unions that claim to represent them.

The resolution of the grievances doctors raise is incompatible with the profit system the county officials defend. The doctors’ conditions mirror those of workers across the US and around the world, whose highest expression is the destruction of Gaza.

But to struggle against these conditions, to actually end the inhumane dilapidation of healthcare, an entirely new strategy is required.

First of all, it is necessary to forge strong alliances with other sections of the working class, from autoworkers to logistics workers to educators and postal workers. Workers across the country and the world are facing similar challenges, but are blocked by trade unions tied to the Democratic Party and hostile to any genuine united struggle.

Second, it is vital for health workers and professionals to build rank-and-file committees that actually reflect workers’ interests. Workers must control their own struggle democratically and break through the deceit and division imposed by the trade union apparatus.

Third and finally, health workers must understand that they face a political struggle, not just against the hospitals, but the Democratic and Republican parties, including the billionaires they represent. The only solution to the worsening conditions in healthcare is through abolishing the irrational and destructive system of for-profit healthcare and replacing with a high quality, free, socialist health care system democratically administered by the working class.