More than 2,000 Johns Hopkins Hospital union workers picketed in East Baltimore after rejecting an offer from the hospital. (Barbara haddock Taylor/Baltimore Sun video)

As striking service workers rallied Wednesday on Orleans Street in front of John Hopkins Hospital, a hospital official said that the East Baltimore medical institution can't raise wages too much without eliminating other jobs.

"A key concern is making sure we can offer competitive wages and be fair to all of our employees while we continue to preserve jobs," said Bonnie Windsor, the hospital's vice president of human resources. "You can only give so much if you want to preserve jobs. There is a finite amount of money."

The hospital's first public comments about the contract dispute came the same day that the workers, members of labor union 1199 SEIU United Healthcare Workers East, began a three-day strike.

The strike comes amid a national push for more equitable wages by workers and some politicians, including in Maryland, where the General Assembly just approved increasing the minimum wage to $10.10 an hour.

But it all also comes as the state's hospitals face economic uncertainty as they adapt to a new system that overhauls the way they make money.

"What happens is a big institution like Hopkins is going to be a target because they look rich," said Paul Harrington, an economist with the Center for Labor Markets and Policy at Drexel University. "But Hopkins probably doesn't feel rich. They are facing a lot of pressure for cost containment. They are facing a lot of uncertainty, and the clarity of how hospitals are going to get paid is up in the air."

Hopkins officials said the strike is not affecting patient care. Managers, nonunion workers and hired temporary staff are performing the duties of the striking workers, Windsor said.

The union represents 2,000 housekeepers, cooks, surgical technicians and other workers, and nearly 950 had signed up to participate in the strike by lunchtime.

Some of the unionized workers chose not to strike and reported to work, Windsor said, although she could not provide a number.

Hopkins officials have not publicly discussed their contract proposals but have said they are trying to reach a settlement that's fair to everyone and reflects financial responsibility on the part of the hospital, which employs 20,000 workers in total.

Such reassurances mean little to Hopkins hospital workers who say they live in poverty.

Tyrenka Dorsey said she doesn't make enough money as a housekeeper to cover all of her living expenses. The 22-year-old, who makes $11.19 an hour, tries to make ends meet by paying a part of her utility or telephone bill and trying to cover the rest the next month. But she is always behind on something.

On Wednesday, she hoisted a protest sign and joined hundreds of other Hopkins workers to rally for a fair wage.

The workers marched in a circle from the hospital entrance on Orleans Street to the corner of North Wolfe and McElderry streets.

The strike began after months of failed negotiations with the hospital after the union's bargaining committee rejected Tuesday night what they called an inadequate "last, best, final wage offer presented by Hopkins.

"Nobody wanted to go on strike, but we had to do this to get what we need," Dorsey said. "I'm tired of living paycheck to paycheck. I'm tired of struggling."

The union has been pushing for a $15 minimum wage for workers with at least 15 years of experience in the first year of a proposed four-year contract, with every Hopkins worker earning at least $14 an hour by the end of the four-year contract. Workers now make between $10.71 to $27.88 per hour, depending on their job.

Members of the union's bargaining committee said Hopkins offered them a five-year contract with annual raises no higher than 2 percent and a minimum wage of $12.25.

Workers called Hopkins' offer inadequate, and many said they struggle financially. Some have to take on side jobs and get food stamps. Others can't afford to put their children on their insurance plans, so they turn to Medicaid instead.

"People are really getting fed up with pay inequality and have reached a tipping point," said Bill Barry, who was the director of labor studies at the Community College of Baltimore County before retiring nearly two years ago.