The following is a rushed transcript and may contain errors. It will be updated.

Maximillian Alvarez:

Alright. Welcome everyone to Working People, a podcast about the lives, jobs, dreams, and struggles of the working class today. My name is Maximillian Alvarez, and today we are speaking with union nurses who are speaking out against big tech and big brother, sneaking more of their tentacles into our healthcare system and into our lives. They and their union, National Nurses United, participated in a National Day of Action on August 27th, which brought together hundreds of registered nurses, patients, and community allies in cities around the country to demand that hospitals and elected officials cut all ties with artificial intelligence giant Palantir. As a press release from NNU lays out, “The nurses who are members of National Nurses United, the nation’s largest union of registered nurses, stop traffic in an act of civil disobedience in eight cities, Palo Alto, California, Los Angeles, California, Chicago, Illinois, Washington DC, Portland, Maine, Asheville, North Carolina, Austin, Texas, and New Orleans, Louisiana.

Union nurses cannot be silent when our most vulnerable people, babies and children are being detained by federal immigration agents,” said NNU President Jamie Brown. “While our patients and neighbors are living in fear of immigration raids enabled by Palantir, our hospitals are facing huge cuts and our patients are facing mounting healthcare costs because of H.R.1. Nurses aren’t just saying no to Palantir, but we’re calling for our public resources to go toward the benefit of working people, not billionaires and their corporations. “The press release continues. From 2009 to 2025, Palantir received $2.5 billion in federal government funding, but this number has grown tremendously in just the past year. Last July, the Department of Defense announced a $10 billion agreement with Palantir to use its technology to share data across federal agencies, enabling unprecedented surveillance power. This followed a $30 million contract awarded to Palantir by the Department of Homeland Security to build an AI-powered system that would identify immigrants for deportation.

In February of 2026, the Department of Homeland Security and Palantir signed a $1 billion contract. In the hospital industry already, Palantir manages more than one fifth of US hospital beds. For nurses, this marks a dangerous threat to their nursing profession, which is seeing a glut of untested and unregulated technology introduced into patient care settings.” All right, so we got a lot to talk about here, and to talk about all of this, I am really grateful to be joined on the show today by three guests who are all registered nurses, all members of National Nurses United. Thank you all so much for joining me today. I really appreciate it. Please introduce yourselves to our listeners.

Kiera Arbour, RN:

My name’s Kiera Arbour. I’m a registered nurse from Chicago, Illinois.

Kelli Brennan, RN:

My name’s Kelli Brennan . I’m a registered nurse from Portland, Maine.

Lee Barker, RN:

I’m Lee Barker. I’m a registered nurse in Kansas City, Missouri.

Maximillian Alvarez:

Well, again, thank you all so much for joining me today. I really, really appreciate having you all three here to talk about this because there’s so much here that I didn’t even know before I saw the day of action and started digging into this. So before we really get into Palantir and all this AI stuff, I want to start at the shop floor worker’s eye level, and I want listeners to get to know more about you all and to have y’all give us more of a lay of the land here. So could you start by telling us more about the jobs that you do, the hospitals that you work at, the kind of patients that you care for? And I guess could we talk a bit about all the non-AI workplace issues that you and your coworkers are already dealing with on a daily basis?

Kiera Arbour, RN:

This is Kira. I am a nurse in the neurosurgical ICU at Stroger Hospital of Cook County. We are one of the largest safety net hospitals in the United States. So I am just finishing up my first year as a nurse. Just graduated from my nurse residency program last week, came to nursing late in life. I took my licensing exam the day after I turned 50. For me, I think the thing that has really been the most challenging part of my first year of practice as a nurse is the patient population that we serve at Stroger Hospital as a safety net hospital in the third largest city in the country is just all of the poverty related, social determinants of health related illnesses. So in the neurosurg ICU, anybody who’s a gunshot wound to the head comes to us, blunt force trauma to the head, two gunshots to the head on the unit last night, one blunt force trauma, and then a whole bunch of people who have had strokes because they live in food deserts, they don’t have access to healthy things to eat or they don’t know how to manage chronic conditions like diabetes and high blood pressure.

And as somebody who grew up pretty privileged and whose parents are heading into their 80s over the next year and a half or so, I see my amount of death play golf every day. They go swimming with their grandkids every day because they grew up middle class, they grew up with money. And then I see people 20 years younger than them who are looking at end of life type of illnesses in our hospital. And it has really kind of overwhelmed me emotionally just because we live in a system that doesn’t do a very good job of allocating resources to folks. And so I’m watching people be very sick and eventually die from very preventable diseases and things that are associated with poverty. Violence is associated with poverty.

Kelli Brennan, RN:

I’m Kelly. I’m at Portland, Maine. Similar to Kara, I also work in neurosurgery, neurotrauma. My background is in stroke. I’ve been a nurse for a little over 17 years from Boston and then I moved to Georgia. I was a director of neurosciences in Georgia, so I was in management, left management to come back to the bedside and be a union nurse and use everything I learned as a manager now for the good of the union. So happy to be here. I’ve been at MaineMed for about five years. I was a member of the original facility bargaining committee when we were organizing for our union. And when I got here, I was coming from Georgia right after COVID and COVID in Georgia was awful, made me realize I needed to go back to New England. So I left the South, came back to New England, wanted to be near family.

So I came to Maine and just wanted to work at the bedside, work my three 12s, get my shifts done and go home and not have twenty four seven responsibility. Now I’m in the union and I have a different kind of twenty four seven responsibility, but I love it. So I started and when I got to the hospital in Maine, I was almost like, well, this is compared to where I came from in Georgia, I was like, “Well, this is pretty nice.What are you guys all upset about?” And started talking to the staff and learning things. And then I shifted my thinking and I was like, “I just came from a really bad situation. Things aren’t that bad up here in Maine, but I know that the way healthcare works, because what I saw in Georgia was consolidation of healthcare systems, lots of financial issues, lots of layoffs and closures and all that kind of stuff.

I didn’t want any of that bad healthcare to come up to this hospital.” So I was like, “You know what? The best thing is to start a union and to lock it in what we have now so that it can’t get taken away because we know the turnover in the C-suite is every five years. These people are not dedicated to the communities. They’re not dedicated to the hospital. They are there for five years just to make a resume, just to go on to the next place.” So I got all in with the union. I’m a charge nurse, I’m a steward, I’m chair of our professional practice committee, and I’m co-president of the Maine State Nurses Association. Yeah, I’m all in. And the things that we’re working on now outside of AI is staffing. There’s this huge misconception or this though process that there’s a nursing shortage.

And we’ve been saying for years there’s not a nursing shortage. There’s a shortage of nurses willing to work in unsafe conditions at the bedside. And that’s why I went into management when I did because the working conditions at the bedside suck and nobody wants to work every weekend. Nobody wants to work every holidays. You can go to management and have your weekends off, have your holidays off, get paid more. So you see the shift of people leaving the bedside because the work is just unmanageable. The working conditions aren’t safe. The patients are sicker, more complex. Our nursing turnover is super high. The years of experience on the floor are low. When I work, there’s a lot of times I’m the most experienced nurse on my unit by 15 years. So it’s a lot of challenges in that, and there’s no focus on nurse retention. They just let one go and then just hire a traveler or temporary staff and we try to make the best of it.

I was at my professional practice committee meeting this morning and it was all about staffing. The hospital has budgets and staffing grids and plans, but they fall through. They don’t hold themselves accountable.

Lee Barker, RN:

Just wanting to build off of what Kelly said, staffing is also an issue at the hospital that I work at research in Kansas City, Missouri. I work specifically in our inpatient psychiatric population. Our staffing grids call for one nurse to every eight patients. That’s already an unsafe ratio and our management likes to push us to one to nine, one to 10. I’ve seen 11 and 12 as well. And like Kelly said, it’s not that there’s a nursing shortage in this country. There’s a shortage of nurses that are willing to work in the unsafe conditions that the hospitals push on us. At research, I mean, we used to have, I think, 800 nurses when we were fully staffed up. Currently we have like 550 and we just can’t. The hospital doesn’t care to retain nurses. Somebody leaves and, oh, we can hire in a new grad and they’ll stay for their two years, get their experience and leave and well, we’ll just hire another new grad.

Maximillian Alvarez:

Well, and it’s like, I hate to make light of all the incredibly serious and important stuff that y’all just laid out, but in 2026, hearing all this, my mind is imagining the Pawn Stars meme of like, “Hey, hospitals, can you fix any of these problems?” And the response is, “No, the best I can do is nothing, and I’m going to add Palantir to your list of things to be worried about now.” So that’s the kind of upside down, topsy-turvy nightmare reality that we’re living in right now, but it is what it is and we got to deal with it.

I’m so grateful to all of you for laying that out for folks because it’s such important context for everyone to understand even though we’re all focused on AI and Palantir right now, let’s not lose sight of the forest from the trees here. There’s so many other systemic issues that are running workers into the ground and screwing over patients and all of us for the benefit of a few. Those sorts of dynamics are already at work in the stories you’ve been hearing on this show about the working conditions for healthcare workers around the country. We’ve been covering it for years, but now we got to worry about ICE coming into hospitals. We got to worry about these truly super villain-esque big tech oligarchs putting their AI into our most sensitive and private systems and information. So let’s talk about this gang, because I need your help unpacking this for myself and for our listeners.

So I want to stay in the world of healthcare right now, and I want to ask if you could sort of lay out for us how is AI in general and Palantir specifically seeping into your workplaces and your work lives?What are nurses seeing here that perhaps the average patient is not?

Lee Barker, RN:

So the hospital that I work at is owned by HCA or the Healthcare Corporation of America, and what HCA has done in their partnering with Palantir is to build an AI scheduler called Timpani. We don’t really know how it works. It’s like a black box. We put our preferred days of working in. Timpani spits out a schedule that’s allegedly balanced, so we have enough nurses working throughout the week. They’re supposed to also balance our level of experience so we don’t have a unit full of new grads and then all of the experienced nurses are working different shifts. These were the promises that we were made. And unfortunately, at the end of the day, Palantir is giving us a shitty product. Aside from all of the moral reasons that Palantir sucks, they can’t even provide us again with the product that meets the promises that they told us, which is that it would take the burden of scheduling off of our managers.

And now our managers in the building don’t have any way to adjust our schedules. So when the AI inevitably screws up, puts out a bad schedule, nobody in the building has any way to fix the schedule unless it’s, I think, within 24 or 48 hours of the shift beginning, which is ridiculous. Part of what Timpani does as well is HCA is using it to push short staffing. Allegedly, our understanding of how Timpani works is that it somehow looks at the average daily census on the unit and decides, “Oh, for 16 patients on this psych unit, we need two nurses every shift.” What Timpani doesn’t see is that that unit can hold up to 24 patients, and frequently we are trying to fill it up to 24. Timpani will schedule only two nurses and management will say, “Well, really, we could admit a couple more patients.

We’ll push you guys up to one nurse can take 10 patients instead of one to eight.” And so they’ll sneak in and just ask us to do more and more with less and less.

Kelli Brennan, RN:

So at MainMed or Maine Health, we have Palantir in our hospitals through their application called Foundry. When we first heard about the potential, we asked the hospital or MaineHealth to let us know what they were using it for. And at first they told us it wasn’t really any of our business. We further pushed, sent letters to the board asking what’s going on, what’s it for? And their response was that they’re using it for insurance denials. So they’re using it. So say a patient comes in and they have pneumonia and the doctor doesn’t write the details of the pneumonia clearly. The insurance company will deny the claim and say that there’s lacking documentation for payments or whatever. So the hospital or MaineHealth’s idea is that Palantir’s AI software will look at these denials and claims and figure out what the letter or what the documentation needs to be in order for the claim to get approved.

So this requires us, Maine Health, sharing information with Palantir of our patient’s information.

Maximillian Alvarez:

I’m sorry. So was our whole system of already not approving so many prescriptions and surgeries in our American healthcare system, was that all not bad enough that now we need a fucking AI bot denying us as well? I can’t believe that that is actually happening.

Kelli Brennan, RN:

It’s very much crazy. The argument is that the return on investment is already better than projected, so the hospital will be gaining so much money, but they’re claiming that they’re losing money because the insurance company is denying it because the insurance company changes the rules 15,000 times a year. It has no obligation to tell the hospitals, so that’s why they’re getting denied. So instead of holding the insurance companies accountable, now we’re introducing Palantir to help solve it. That’s the solution. It doesn’t make any sense, and it just makes us complicit in this whole thing.

Kiera Arbour, RN:

Thankfully, in Chicago, we don’t have Palantir software anywhere near our patient’s information. Our action was based on the fact that our pension fund has $28 million invested in Palantir. That includes all county employees, not just nurses. So everybody who works for Cook County, which is where Chicago is, including all the people who work at the hospital, the doctors, the administrators, the nurses, the PCTs, the environmental service people, the folks who work in the cafeteria, the people who work in the forest preserves of Cook County, where I like to ride my mountain bike. All these people unknowingly have their pension funds, A, invested in a company that’s heavily aligned with the current administration and could potentially go, if Democrats screw his spine, could go belly up in a couple years. And then B, is doing some pretty nefarious stuff, is collaborating with ICE and making it so.

Kellyann mentioned that the patients are getting sicker and sicker. One of the reasons the patients are getting sicker and sicker is because they know that they have the potential to get arrested if they come seek healthcare. So they delay and defer care and then they come to us and they’re a lot of times near death. I took care of somebody last night who intubated completely unconscious body full of ammonia because their liver had failed and they had deferred care. And I couldn’t get this person’s story because obviously they were intubated and in a coma, but judging from this person’s last name, they very easily could have been somebody who was undocumented. But for us, for me, for the nurses at Cook County, we became nurses because it sounds cheesy, but it is a calling. I walked away from a six-figure career in supply chain and logistics management to come do this with the rest of my life because I felt a calling to do so because in 2020, I was at the George Floyd protest.

I said, “Wow, I’m actually the baddie and I need to get my life right.” And so I was feeling really good about what I was doing every day, taking care of some of the sickest people, the poorest people, the least fortunate people in my community and serving my community. And then I find out the thing that I’m relying on for my retirement is heavily invested in a company that’s collaborating with ICE, that is writing software for the IDF, that is tracking kids home from school in Gaza so that the Israeli Defense Force can send a bomb to this person’s house because there’s a one in two million chance that this kid’s dad is part of Hamas. And so that doesn’t align in any way with my values. And so we felt the need to step up and demand that our pension board divest itself from Palantir, and we were kind of blown off.

So I am looking to put together a run to be part of the pension board in the next few months. So that’s where our involvement with Palantir is.

Maximillian Alvarez:

Hell yeah. Well, I want to keep going in the direction that y’all are leading us to. I want to keep zooming out here and take this discussion beyond the world of healthcare, but I think it bears repeating or reminding all of us who and what we’re talking about here. I mean, if you’re still asking yourself or you listen to this and you’re saying, “Well, why is Palantir so bad? Who are they?” They’re telling us who they are. They published a whole batshit manifesto about their evil vision of and for the world. Their CEO, Alex Karp is constantly saying super villain type stuff about the kind of future he imagines with AI. And there’s a piece that we’ll link to in the show notes from The Guardian that is literally titled Palantir Manifesto described as Ramblings of a Super Villain Amid UK Contract Fears. And in that article, here’s a quote that says, “Palantir’s manifesto, which embraces AI state surveillance of citizens along with national service in the USA is either a parody of a Robocop film or a disturbing narcissistic rant from an arrogant organization.” And that was actually from a liberal Democrat MP in the UK.

But read that, read the manifesto. They are telling us who they are and we should believe them. I don’t want this creep carp near my healthcare or my information or any of my government data. I don’t want them near anything having to do with the administration of our society or what remains of it these days. And yet they are getting in there in our government. The data centers that are popping up everywhere. They’re tied up in all of that too. So I wanted to ask y’all to sort of zoom out and keep talking about that bigger picture. And I wanted to ask why you and your union are demanding that not only hospitals, but elected officials cut ties with Palantir. Why is it important for you to speak out against this kind of larger onslaught of big tech and to speak out as union nurses to stop it?

Kiera Arbour, RN:

I would say first of all, we have our own manifesto. It’s called Vision for a Healthy Society, and it’s not super villainy. We want people to live happy, healthy, self-fulfilled, self-actualized lives where they have the resources they need to not just survive day-to-day, but to thrive as human beings in the way that human beings were meant to exist and to flourish, not to be beholden to these giant unelected powers, whether it’s Palantir, whether it’s Anthropic, who was just in the news yesterday because they have their own AI building dossiers on folks like us who are opposed to what they do, and nobody elected these people. They became billionaires because venture capitalists invested money in them, and now they call the shots. They own pretty much both parties. Shout out to Rokana for giving that money back from Palantir, but for the most part, they’re heavily invested in both Democrats and Republicans.

As far as union nurses, because we can’t, because our union has our backs, because they’re going to protect our free speech rights, they’re going to protect our right to go out there and say, “This is wrong. We don’t agree with it.” And they allow me, because they are themselves, my union is itself anti-colonial, anti-imperial. They stand up for these values that I try to model myself, and so I need to stand in solidarity with my working class siblings, and I need to work for the society that I think is going to allow human beings the best chance to live the lives they deserve.

Kelli Brennan, RN:

In Maine, in January, we had operation Catch of the Day, which Maine is one of the whitest states in the country. We have a Somali population. So for us to be targeted with this operation, it was devastating. It affected our community, it affected the hospital, our housekeeping workers, our transporters, our ancillary services, and all staff felt this. You could feel the emotions throughout the hospital as this was going on. About 30% of our housekeeping were calling out because they were afraid. We were picking up food because we had a food bank, but people were afraid to go to the food bank. So our C-suite was storing groceries, so we were bringing our immigrant vulnerable community members to get food. And then one of my coworkers, who’s of the vulnerable community, I offered to give her a ride into work because everything was so escalating. So I picked her up one morning and we were driving to the hospital to go to work, and it was about six o’clock in the morning.

It was dark out. We were driving down the street, and as we were driving, pulled up to what seemed to be ice activity. There was a bunch of unmarked cars, out-of-state license plates, just seemed suspicious. So I couldn’t just drive by. So I pulled into a parking lot across the street and started filming on my phone what these officers were doing, just trying to see if they had anybody, if anybody was in trouble. But I also had my friend in the car, so I didn’t want to draw too much attention, so I didn’t honk my horn. I didn’t get out. I didn’t yell. I just sat there with my phone on recording, and the officers saw me. They flashed their flashlight at me as to say, “Hey, we see you.” And then I saw them heading to their car. So at that point, I decided that this was not a safe situation and we should leave.

So we pulled out of the parking lot, carried on down the street, and realized that they were following us. So got to a red light, and they pulled up in the lane next to me, and I could feel them staring at me through the window. So I rolled my window down because I could see that they were wanting that, and they rolled down their window and they looked at me. It was a male and a female officer, and they said, “Can we help you?” I said, “Yeah.” I said, “You can get the fuck out of Maine.” To which they replied, “Oh, looks like we have another Karen here.” At this point, the light is still red, and I’m like, “Okay, this is going to escalate.” I was worried My friend. And so when the light turned green, they looked at me and they said, “I’m going to arrest three more people today just for you.

Ha ha ha ha ha.” And pulled out in front of me, did a U-turn and carried on down back to where they came from. I don’t think anybody was abducted that morning, but my friend and I continued to drive to work and it was just like I felt so awful. It was traumatizing. And so that right there for me was like, this isn’t okay. And so we went to work and then this was happening across our town and the hospital went through so much to help and support people. They changed where they were picking up employees so that the parking lot was gated so that there couldn’t be agents in there. And they did all these things. And then we find out that they have a contract with Palantir and it’s like, wait a minute, we just went through this in January. We felt the effects of this in the hospital.

So that’s where we all kind of started to get involved. And then fast forward through the summer, we get to July and we have the murder of Johan Sebastian Guerrero in Biddeford, which is three miles down the street from a Maine health facility. And at this point we are aware about the app called Elite that Palantir is using to target immigrants in our communities. So at this point, we’re concerned that this is really ramping up in our community. And then fast forward to August when our own nurse was abducted by ICE at an airport in Portland. And then to still find out that MaineHealth is still doubling down on their contract and Susan Collins is still holding onto her money, it’s just infuriating. And I think for us up here in Maine, you’re going to see us out and doing everything we can to try to tell the community that Palantir has no place in our hospitals, no place in our community.

And that if patients can’t trust the hospital, if they can’t trust where they’re going is safe, they’re not going to come and get care. And that’s not what we’re here for. Nurses are advocates first. We’re trained to advocate and to speak up when something is wrong and that’s what we’re doing.

Lee Barker, RN:

I mean, exactly. I think the biggest reason that union nurses are speaking out against Palantir is simply because we can. It’s the right thing to do. And like Kelly said, we’re advocates for our patients, we’re advocates for our communities.

Maximillian Alvarez:

Well, my God, thank you all so much for that. That was really, I think, important, really powerful. And I’m really grateful to y’all again for speaking out the way that you are and letting our listeners know why this is important. And I want to end on that and bring us back to where we started in the beginning where I learned about this Purge Palantir campaign from NNU because of the day of action in August. So I wanted to ask if you could tell folks more about now that we’ve thoroughly covered why we should all be invested in this and horrified that these tyrants and oligarchs and freaks and villains who want to control everything and everyone, why we should not just go quietly into that dark night and why people should stand up and fight back and that we can choose a different path. We don’t have to go down this path.

And that’s what I see all around me and in every kind of story we cover at The Real News. People around the country are pissed, they are fighting back, they are doing so wherever they can, however they can, whether it’s speaking out as union workers in mobilizations or it’s people in deep red, rural areas where there are data centers popping up or people here in quote unquote deep blue cities like Baltimore where data centers are also threatening to pop up. This is kind of forcing us all together and we’re going to need to work together to figure this out. And so in that spirit, I wanted to end by asking y’all if you could tell folks more about what NNU is doing to fight back and what people listening, what your message is to them about why they should get involved and what they could do to get involved.

And if you have any final words about what will happen to all of us if people don’t fight back against this now.

Kiera Arbour, RN:

So I would say that, and probably understanding that the demographic of your podcast are what we like to call fellow travelers. They’re socialist, anarchists, anti-capitalists, what have you. We need to get people off the sidelines. We’ll take care of our own business here in Chicago with this pension fund. What I would suggest that your listeners do is reach out to somebody who they would probably consider a liberal or a conservative and do something simple like, I don’t know, go take them to see the movie American Doctor. I don’t know if you’ve heard about that. It’s the story, it’s a documentary of people trying to go provide aid in Gaza in the midst of a genocide because I really feel like there is a large percentage of the population out there who just doesn’t really understand. It’s not that they don’t care, it’s just that A, they don’t understand what’s happening and B, they don’t know or don’t feel like they have any sort of political agency to change it.

And there are a lot of people who probably identify as neither any sort of political affiliation, and those are the people that we need to reach out to to let them know what’s happening around us. So go see something like American Doctor, which is really going to get you right here. Understand that Palantir and all these big tech companies played a very large part in all the horrible things that you’re going to see in that movie. And then wherever you live, I guarantee you there are people that there’s an anti-war committee. There are mutual aid groups who are going out every day and collecting donations and trying to feed the less fortunate in our community, the people who are undocumented, who are afraid to go to work. There’s so many opportunities to go out there and connect with the people in your community and that’s what’s going to make you feel safe and that’s what’s going to make you feel like you have power over this and that’s what’s going to make you feel like you have agency over this.

And that’s how we defeat this in solidarity together as working class human beings.

Kelli Brennan, RN:

I think it’s going to be really important that people get out and vote in November. I think it’s really going to be, we don’t know what the outcomes of the elections will be, but if they go the way we want them to go, there’s a chance that those results aren’t going to be accepted. So I think we have to prepare and organize and make sure that we’re getting everyone out to vote, making sure people are registered. I think there’s no hesitation on my mind about that we need a huge voter turnout this midterm. And I think if people aren’t involved, be a poll watcher, drive people to the polls, make sure your community members know if they’re registered, how to register, where the voting locations are, and notify your elected officials that you don’t approve of Palantir. Whenever I do stuff lobbying, one things that representatives in Congress or locally or wherever, they say that I don’t hear from my constituents.

No one’s called me to tell me about this. And that really matters. So I think it’s important for people to get out and vote. I think it’s important for people to join an organization, unionize. If you’re not in a union, join one, make one, connect with one because there’s so many resources. And if we’re all doing different things, we need to all do the same thing together at the same time. And we need to sustain organizing, sustain networking, talk to people that you don’t normally talk to. What I love is our candidate for Senate, Troy Jackson, one of his sayings I love is we’re not from the left, we’re not from the right, we’re from the bottom and we’re rising. This is a working class issue. They’re sayings that unions save the middle class, unions built the middle class. We’re going to have to do that again.

And even if you’re not in a union, you’ve got to link up with somebody because it’s going to take all of us to get through this. And nurses are first and foremost humanitarians, right? We’re the trusted profession over and over again. So we know what’s needed in healthcare. And as a nurse for 17 years, I’m so sick and tired of apologizing to my patients and their families on behalf of health insurance executives and hospital CEOs. So everyone get out and do something.

Lee Barker, RN:

Absolutely. Just to echo that, getting out to vote, reaching out to your elected representatives, telling them to purge Palantir. I’m going to put a couple links in the chat also. There’s a purgepalantir.com. You can get on there and find out what’s going on with the Purge Palantir campaign, Actions Near You. The other link I put in there is there’s a letter that people can fill out that will go to HCA specifically telling them to cut ties with Palantir. Anyone can sign that. Anyone can sign that. Anyone can find that.

Maximillian Alvarez:

All right gang, that’s going to wrap things up for us today. I want to thank our guests, Kelly Brennan, Lee Barker and Kira Arbour, all three registered nurses, all three members of National Nurses United, all participating in NNU’s Purge Palantir campaign. And you can learn more about that campaign in the links that we provided in the show notes for this episode. And of course, I want to thank you all for listening and I want to thank you for caring about this. We do this work for you, but we cannot do it without you. Working People is brought to you in partnership with In These Times Magazine and the Real News Network. This show is produced by the great Jules Taylor and is a proud member of the Labor Radio Podcast Network. We’ll see y’all back here next time for another episode of Working People. And in the meantime, go explore all the great work that we’re doing at the Real News Network, where we do grassroots reporting that lifts up the voices and stories from the front lines of struggle around the US and across the world.

Subscribe to our YouTube channel. Check out our great podcasts like Under the Shadow and the Mark Steiner Show and connect with us on social media and get updates on our reporting there and help us do more work like this by going to therealnews.com/donate and becoming a supporter today. I promise you guys, it really does make a difference. I’m Maximillian Alvarez. Take care of yourselves. Take care of each other. Solidarity forever.

Maximillian Alvarez:

Alright. Welcome everyone to Working People, a podcast about the lives, jobs, dreams, and struggles of the working class today. Working People is a proud member of the Labor Radio Podcast Network and is brought to you in partnership with In These Times Magazine and The Real News Network. This show is produced by Jules Taylor and made possible by the support of listeners just like you. My name is Maximillian Alvarez, and today we are headed north to the state of Vermont, where frontline healthcare workers and the patients they serve are facing a major crisis at the University of Vermont Health Network, the state’s leading healthcare provider. In an article published in the Rake Vermont, which is an independent worker-owned news outlet based in Vermont, writer Matt Moore breaks down the situation like this. “In June, UVM Health eliminated over 140 positions across its network, a third of which were union positions, according to AFT Vermont, which represents workers there.

The cuts which the hospital estimated will save $9.5 million comes as the network faces a $300 million budget shortfall. Rules set by the Green Mountain Care Board, which regulates Vermont hospitals, will require UVM Health to cut expenses by that amount over the next three years. Later that month, UVM Health handed down a speed up order to its medical group, which includes outpatient clinics and more than a thousand physicians, which practitioners say will result in briefer appointments with patients. Owen Foster, the former chair of the Green Mountain Care Board, took aim at what he saw as the excesses of UVM Health in a board meeting last September. “It’s essentially an expensive and ineffective layer of overpriced and unnecessary corporate bureaucracy that has proven itself both physically and spiritually distant and unconnected from the mission of our flagship academic medical center and the needs of Vermonters,” Foster said.

Foster found that the surplus revenue earned by UVM Medical Center was being siphoned off by UVM Health to subsidize its hospitals in New York State that the network has been unable to manage profitably to the tune of over a hundred million dollars over the last several years. He noted that at the same time that UVM Health was shutting down kidney dialysis services in St. Alban’s, Rutland, and Newport, it was moving $10 million from UVMMC to its New York hospitals. Multiple executives, many of whom had received a combined $3 million in bonuses in 2024, were laid off in October of 2025 as part of a restructuring process. However, the most recent round of cuts and likely future cuts are aimed directly at the caregiver and support levels, leading to reductions in the quality of care for a majority of Vermonters.” To talk about all of this, I am really grateful to be joined on the show today by two guests.

Melissa Lavalle is secretary of UVMMC Support Staff United and VP of Healthcare for AFT Vermont. And Teagan Cook is lead outpatient chemotherapy scheduler at her hospital and a chief steward in UVMMC Support Staff United. Melissa Teagan, thank you both so much for joining me today. I really appreciate it. And I know we got a lot to dig into here, and I want to talk to you about everything that’s happening now at the UVM system with these devastating cuts or restructurings or whatever we’re calling them and the events that led to this point. But before we do that, I’d really love to start by getting to know more about you all and the work that you do. Every week we strive to remind listeners that there are flesh and blood human beings and fellow workers behind every name tag, every job title, and every one of us has a story worth telling.

So please tell us more about yourselves and how you got into this work and the kind of jobs that you do.

Melissa Lavalle:

Thank you so much for having us. I’m Melissa and I’ve lived in Vermont my whole life. I was born here. My family lives here. I was the kid that moved furthest away because I was 45 minutes from mom and dad. I’ve worked retail. I’ve been a grocery store clerk. I was a photographer inside a Kmart for Holy Mills. And when they were going to cut my health insurance, I decided it was time to get into a job line that would give me health insurance. And that’s what brought me to working in medical. I’ve been a medical assistant and I am currently the finance and admin assistant for the psychiatry and mental health departments. There’s a lot of backend bureaucratic needs, paperwork, vacation time, continuing education stuff. And so I am the department Santa. I love my job and love serving the folks that are giving wonderful and such needed mental health care to our community.

Teagan Cook:

Thank you so much for having us. I’m Teagan. Like you said, I’m the lead outpatient chemotherapy scheduler here at UVMMC. And I got into my job after previously working in law, which is where I have a degree. Not the one you can actually do something with, but still a degree in law. And the industry of law has just so many miserable soul-sucking problems without a lot of real emotional reward, at least that I was feeling. So I ended up moving into healthcare, which is a place where you can actually make a real difference to real people. And not all of it is couched in a bunch of pseudo-Latin nonsense. A lot of it is just making real connections with your patients, understanding what their daily lives look like. A lot of what my day-to-day looks like, if you came behind my computer, it would look like I was playing Tetris a lot of the day because I’ve got the blocks of each person’s treatment that we’re trying to all stack together to make fit to get as many people as possible safely treated in the amount of time and the amount of space that we have.

It’s very rewarding. I get to make contact with a lot of different people from across the state. I’ve got patients in New York, I’ve got patients in New Hampshire, I’ve got some patients in Canada. And working here has been really incredibly rewarding. But unfortunately, as time has gone on over just the past three years that I’ve been here, sometimes the stress and the weight has started to outweigh that reward in some ways that are really specifically related to the way that our labor as workers here is treated.

Maximillian Alvarez:

And I want to really talk to y’all about that at the shop floor day-to-day level. But I guess I need your help here because I want to talk about the crisis that is happening right now in the UVM Health Network. And first we need to help our listeners understand what is this crisis exactly? What do folks need to understand? Is it a budget crisis? Are you facing draconian cuts? Is it a shortfall? I guess we don’t have to get too far into the weeds that we lose sight of the whole plot, but help us understand what exactly the nature of the crisis that y’all are facing there at UVM is right now.

Melissa Lavalle:

It is incredibly complex, and I can kind of scratch the surface. For years, for decades, management at the top was kind of left alone to do what they want. And what they wanted to do was give incredible salaries to the folks at the very top. We went from being Fletcher Allen to University of Vermont Medical Center, and then the Health Network was formed. So now the network encompasses five hospitals in Vermont, and I think two or maybe three in Northern New York as well. So that necessitated an extra level of administrative folks at the top, and they’re not the ones making $20 an hour by any stretch of the imagination. Vermont’s really unique that we have what’s called the Green Mountain Care Board. It came out of the work of activists in 2011 in the passing of Act 48, which ostensibly created universal healthcare in Vermont.

We never had a governor that was able or willing to find funding for that. So instead this advisory board was created and yearly Green Mountain Care Board reviews and either approves or denies budgets for hospitals in the state. About three years ago, Green Mountain Care Board really put their foot down. Vermont is the most expensive state in the country to buy or get healthcare. And they said, “This is insane. UVM Health has an obvious monopoly on the state. You folks have been making way too much profit for too long, and now it’s going to be a cut.” So the budget, instead of having any growth to it, actually had a reduced amount of profit that was allowable. So now that they’re not able to charge the most exorbitant prices for literally everything, they are saying, “We’re losing money every day. Austerity measures need to go into place.” And what that looks like is those 140 cuts and staff just being overworked in almost all locations.

Teagan Cook:

Yeah, Melissa has a much more of a bird’s-eye view of it than I do because Melissa is much deeper into the daily goings on of the union. So she’s much more well-briefed than I am. But as far as how I’ve seen this in my day-to-day work, it’s been, for example, in my clinic, which is the outpatient cancer clinic at the flagship hospital in the network, the scheduling team is about three weeks behind at any given moment, which doesn’t necessarily sound like a big deal if what you’re generally familiar with as far as healthcare scheduling is just a primary care physician’s office. If you’re three weeks behind looking at that, generally it’s not going to be a huge deal for scheduling. But here in the outpatient cancer clinic, these are patients who are coming in twice a week or every single day, five days long once a month, or they’re coming in every other week, which means that if we get three weeks behind, we are operating so far behind the patient’s actual reality that it functionally doesn’t even make sense for us to be doing our jobs because we are working with outdated information that we then have to crosscheck with the more up-to-date information that we’re seeing in the chart.

Everything takes longer because we have to do that. We get further and further behind. Patient care falls further and further behind. And we’re all very concerned about the safety of the care that we’re able to deliver because of this. And this could be solved with safer, better staffing by increasing our numbers by just two or three more people. And we’ve been refused for months and months and months. Even while going through an official grievance process to try to address the issue, we have continued to be denied.

Maximillian Alvarez:

Well, I want to ask one more kind of clarifying question here because it seems like in all the kind of research I was able to do before we started recording this episode, there’s some competing narratives going on here, and that’s sort of muddling the picture and making it hard for folks to understand what’s going on here and why it’s so egregious. So I wanted to ask who is behind the narrative that this is a $300 million budget shortfall that requires squeezing people at the bedside level, people in the office level, and cutting back the most essential labor and piling more work onto the most essential workers?

Melissa Lavalle:

So there’s always yours, mine and theirs, but Green Mountain Care Boards saying, “You folks have made way too much money off of Vermonters for way too long. You need to lower your prices.” UVM Health is saying, “Oh my God, we used to make this much money, but now we’re only allowed to make this much money.” So normally in my mind, folks would lower the prices of things. What they’ve done instead is lower the number of available inpatient beds. So they’re seeing fewer patients, so therefore less money is getting made. And there was a law that went in that said they had to drop their prices on cancer infusion drugs because those were just astronomical through the roof. So care board says you’re making too much. Hospitals says we’re not making enough any longer. And from the union’s perspective, we’re saying this was poor management over decades and you’re now asking your lowest paid workers to bear that burden.

Maximillian Alvarez:

Well, let’s talk about that sort of how we got here question. Because sadly, this is a story that I have heard from healthcare workers across the country in different contexts. I’ve talked to workers on the picket line at a private Catholic hospital here in Baltimore saying very similar things. I’ve interviewed workers on strike at Kaiser Permanente in the Pacific Northwest saying similar things. Workers in Chicago at a university healthcare system there, very similar story. But the devil is also in the details and not every story’s the same. But it feels like the effects that people are feeling are very similar, which is that workers are being burnt out because they’re being asked to do more with less for less while either hedge fund type corporations are buying up their hospitals and forcing them to speed up production for the sake of more profits. Or you got a system like your guys’ system where you’re being forced to claw back your operations to sustain an unreasonably poorly managed from the top down system.

Again, those are different situations, but the effect is very similar on the workers and the patients. But as you said, Melissa, that didn’t happen overnight. And so I wanted to ask how the hell did it happen? And how did you all as rank and file workers experience this over that time?

Melissa Lavalle:

A fact I heard once that really blew my mind was most hospitals used to be owned by the doctors. They were kind of co-ops that the doctors owned. And so if something terrible happened, you know whose door to knock on to complain. But letting hedge fund managers, letting private equity into healthcare. And even in Vermont, UVM Health is a nonprofit network, but letting business managers run health decisions does not work. And every other industrialized country in the world has figured it out that it’s most effective not to be paying these insurance middlemen to do nothing but mostly deny folks. Are governments capable of administering Medicare, which folks are generally happy with. With Medicaid, folks are generally happy with. And this introduction of the business element into health is where things went wrong, to be totally honest. Folks are making money off of something that should not be a money-making enterprise.

Teagan Cook:

I mean, I think what it boils down to, to your point, Melissa, is the fact that hedge fund managers, extremely well-paid executives in the healthcare industry, it’s kind of like the final frontier of late stage capitalism. This is the last way that you can profit off of not only your workforce, but the physical bodies of your workforce and the people around you. UVM Health has a monopoly on healthcare in Vermont, which means that all of their workers are here receiving care from them for the vast, vast majority, which means that not only are we struggling to get them to pay us wages that are meaningful in the economy of Vermont, which is total trash garbage right now, but there’s also the fact that we are functionally handcuffed to whatever decisions they’re making about what our healthcare is going to be like. I know, and I’m not alone in this, my fiance and I have been having to have really serious talks about when we get married, what’s going to happen to his healthcare?

Is it going to be worth it? Are we going to have to delay our wedding? I don’t know when I’m going to be getting married until we get a new contract for our union because I don’t know what my healthcare is going to look like. I don’t know what guarantees I’m going to have, and I’m not going to be able to get married if I have to pay $800 a month for me and my fiance to both have care as chronically ill people.

Maximillian Alvarez:

Jesus, man. I don’t know how people can hear stories like that from everybody everywhere all over the place. And we all just accept it as like, well, I guess that’s just the way things got to be, but that’s not the way things got to be. And I do want to talk about in the end, what can be done? What can folks listening do? But by way of getting there, I wanted to bring things back down to that worker and patient eye level. Can you tell us how, since those initial cuts, what this is translating to for frontline workers providing healthcare and for patients seeking healthcare?

Melissa Lavalle:

Patients seeking healthcare are definitely experiencing waits. They know it. They know why. When my husband goes to his primary care that’s part of the network, there’s one person to check in and check out folks in an office with 25 providers. You’re waiting longer when you call in to try to talk to a nurse to get a prescription refilled from your primary care. It’s just more work, more stress. You know that the cuts happened. And it’s so weird how they always seem to happen a couple of months before bargaining. So we have been in bargaining. And when we did our pre-bargaining survey, we’re doing combined bargaining between our support staff unit and the technical professionals unit of the VFNHP nurses union. So your radiologists, your respiratory therapists, those sort of folks.

But the layoffs really also energized our members to see that this is why we’re bargaining. And when we did our pre-bargaining survey, 3,300 members across the board, the priority was safe staffing. And our folks are not in great economic shape. We know wages are a thing, but we work in healthcare because we care about our patients and because we know we are the patients as well. And that was far and away what folks cared about, that when community members are coming to us, that we are safely staffed and they’re not going to get worse because they came to UVMC for care.

Teagan Cook:

Yeah, I think that the staffing is really the critical issue. And some of those layoffs did affect union members and some of them were non-unionized staff. For example, folks in IT, folks who were in MGET, which is medical group education and training. Those are the folks who train newly oncoming doctors how to use our health record system, which is byzantine and complex. So you know how it is. The money that the people at the top are getting is never going to trickle down, but the consequences that the people at the top impose trickles down. So it takes longer for these doctors to get appropriately onboarded. It takes longer for them to get the hang of how things are supposed to be done in these systems so that things are going through workflows correctly so that people like me are making sure that you are getting scheduled out for your treatments appropriately and safely.

People in IT getting laid off. I have had a ticket out for a fax machine that my unit uses to get looked at since April, and nothing has happened about it. And that doesn’t sound like a big deal except for the fact that not all outside facilities will accept electronic faxes. And that means that we are not able to, until that gets addressed, send imaging orders to those other hospitals because they won’t accept them because they’re only e-faxable right now because we don’t have a fax machine, which can result in patients getting delayed care in something as important as getting imaging done to figure out if their chemotherapy is working or not.

It’s difficult. The layoffs and the threat of more layoffs has created such an environment of paranoia and distrust, which is the exact opposite thing that anyone needs. We’re already all struggling enough, but it’s just created an incredibly difficult work environment from the things that are tangible, like the stupid fax machine, to wondering every day when you come into work, is this the day where I find out that I don’t have a job anymore and that my patients are going to call in and just end up waiting on the line for three hours to get a simple answer.

Maximillian Alvarez:

So where do things stand now and what can be done about this? And what can anyone who is listening to this conversation right now do to help?

Melissa Lavalle:

The base of the problem is the for-profit healthcare system. That just has to be the foundation that we’re working from. In our bargaining, like I said, priority safe staffing, we’re fighting for safe staffing committees. The hospital came proposing takebacks from our first contract. So that is one of the places where we’re kind of far apart. But one of the things we’re also doing on top of joint bargaining is a common good platform. We’re asking for protections for our immigrant coworkers. If they get detained, they don’t lose their jobs position, they don’t lose their health insurance. They get time off to go to these appointments when they need to, even if it’s short notice, like we know is happening more and more often. We’re asking the hospital to join our local community group as Migrant Justice, and they have a Milk with Dignity program to only source milk from farms in Vermont that treat their workers appropriately, give them safe housing, give them safe work conditions, pay them fairly.

And we are also saying that the hospital, in all its poverty, stop using its very high paid lobbyists and publicity folks to fight us in our plate for universal healthcare. Act 48 is on the books. We intend to get it funded and enforced. And every time we’ve tried in the past, the hospital, which is a huge economic driver in the state, has had their people at the state house pushing back, pushing back. And the time has come to stop. We cannot cut our way out of this. And I would encourage everybody listening, if they don’t have a union that they can get involved in and push them to fight for universal healthcare, get involved with a grassroots organization. They are just literally everywhere. Folks see this problem, and we know what the solution is. It’s a single-payer healthcare system.

Teagan Cook:

Yeah. I mean, what Melissa said, what it comes down to is that the for-profit healthcare system is functionally a vampire that is sucking us out of money without any real significant payoff. I don’t know anyone who has gone from being on Medicaid or Medicare to being on private health insurance and gone, wow, this is so much better.

Maximillian Alvarez:

All right, gang, that’s going to wrap things up for us today. I want to thank our guests, Melissa Lavalle, Secretary of UVMMC Support Staff United and VP of Healthcare for AFT Vermont, and Teagan Cook, lead outpatient chemotherapy scheduled at her hospital, and a chief steward in UVMMC Support Staff United. And of course, I want to thank you all for listening, and I want to thank you for caring. We’ll see y’all back here for another episode of Working People. And in the meantime, go explore all the great work that we’re doing at the Real News Network, where we do grassroots reporting that lifts up the voices and stories from the front lines of struggle. Check us out across our YouTube channel, our podcast feeds, our website, and our different social media pages, and help us do more work like this by going to therealnews.com/donate and becoming a supporter today.

I promise you guys, it really makes a difference. I’m Maximillian Alvarez. Take care of yourselves. Take care of each other. Solidarity forever.