Last week, I stood alongside fellow nurses and other healthcare colleagues, social workers, physical therapists, chaplains, dietitians, rehab specialists, lab scientists, and more, in a 5-day labor solidarity strike at UCSF Benioff Children’s Hospital Oakland. While I’ve returned to work due to financial necessity, my courageous NUHW colleagues remain on open-ended strike, defending safe staffing, fair contracts, dignified care, the right to remain in their unions, and access affordable benefits and healthcare. Isn’t it ironic, that healthcare workers do not have access to affordable and quality healthcare? I've seen a crucial reality firsthand as a nurse case manager: commercial insurance plans, usually employee/employer paid, often throw up more roadblocks to essential care and community resources than government programs like Medi-Cal. Sure, commercial plans might look good on paper, sometimes with lower employee premiums or bigger networks, but they frequently deny vital outpatient and community-based services, especially for kids. That means less access to the crucial therapies, long-term support, and holistic care that Medi-Cal, as a safety-net program, is more likely to cover.
And the truth is, the big business system we have now is killing people, both patients and providers.
Our small but mighty inpatient Nurse Clinician team recently went into the bargaining session with California Nurses Association (our union) and the UCSF hospital team, to read statements of the current UCSF “Integration” and it’s impact on us and patient care.
UCSF Is Laying Off Healthcare Workers. Yes, Really.
Just as this strike was happening, UCSF Health laid off 200 workers: lab scientists, rehab therapists, patient care staff and about 50% management. Many of these people’s work is essential to healing and recovery. Middle management, or PMC (professional managerial class) on the other-hand, I still question the value they bring to the working class, they are usually c-suite puppets with no power to make any real change, but that topic deserves it’s own post entirely. And we will absolutely be discussing this soon!
These layoffs come while the system cries about financial challenges. But let’s be real, UCSF is a multi-billion-dollar health system, Executive salaries and management layers continue to grow, Frontline care, the heart of healing, keeps getting cut
Here’s the news.
And here’s more.
This isn’t just poor decision-making. It’s the trickle-down logic of corporate healthcare, where efficiency metrics and budget lines matter more than relationships, trust, and safety. The disconnect from the UCSF CEO and other “leadership” during the recent town hall was jarring. To robotically address 200 lay offs, while touting a “recovery plan" without an ounce of accountability for the financial mess UC created, is simply disgusting.
We Need to Talk About Private Equity
The layoffs at UCSF feel familiar because they follow the same pattern we’re seeing everywhere private equity (PE) touches healthcare. Cut staff. Overwork who’s left. Extract profits fast. Leave communities worse off. PE's influence in healthcare often prioritizes profit over people, leading to severe consequences for patients and communities. Here is what the data shows us:
Worsened Patient Outcomes & Safety: PE ownership is linked to higher patient deaths, increased infections, and more complications in hospitals and nursing homes.
Staffing Cuts & Workforce Strain: PE cost-cutting drives reduced staffing, increased workload, high turnover, and burnout among healthcare professionals.
Community Devastation & Access Issues: PE's debt-heavy model often leads to hospital closures, especially in underserved areas, and can reduce access for government-insured patients.
Increased Healthcare Costs: PE acquisitions are associated with higher prices for both payers and patients through increased charges and upcoding.
If that doesn’t sound like a red flag, I don’t know what does. Here is an eye-opening and horrific example of PE’s impact on vulnerable communities, like mine:
Buurtzorg: A Model That Puts People First
Meanwhile, in the Netherlands, there’s a model that gives me hope: Buurtzorg.
It’s a nurse-led, home-based care system made up of small, self-managing teams. They work locally, with trust and flexibility. No bloated middle management. No investors breathing down their necks.
And guess what?
It saves up to 40% in healthcare costs
Staff rate their experience 8.7 out of 10
Patients get better care, and nurses don’t burn out
That’s what happens when you build a system around relationships, not profit.
Learn more: buurtzorg.com
We CAN Do This Differently
Here in my Bay Area small town, we’re planting the seeds of a different kind of healthcare model, a cooperative that centers community, worker ownership, and care for the people most often left behind. It’s small. It’s slow. But it’s rooted in something real.
This moment we’re in, the strike, the layoffs, the national PE takeover, is calling us to imagine something better. And now to build it.
I Want to Hear From You
Have you worked in a system that felt like it cared about people?
What would it look like to build a Buurtzorg-style model in your neighborhood?
How do we move away from big business and back to care that’s actually… caring?
Drop a comment. Share a story. Let’s talk about what comes next. I’ll be featuring community responses in an upcoming Reimagining Healthcare podcast episode.
In solidarity and deep love for all people doing the work,
D
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