AMNA NAWAZ: Welcome to the "NewsHour."

The largest health care strike in U.S. history is under way, after the nonprofit health care giant Kaiser Permanente and its unionized workers failed to reach a new contract agreement.

GEOFF BENNETT: More than 75,000 health care workers walked off the job today at Kaiser facilities in five states and Washington, D.C. JACQUELYN DULEY, Radiologic Technologist: So what's happening is, Kaiser has not been bargaining with us in good faith.

And so it's pushing us to come out here and strike.

We don't want to.

We want to just be inside taking care of our patients.

But, unfortunately, Kaiser's not bargaining in good faith.

GEOFF BENNETT: The strike is set to last three days as contract negotiations continue focusing on wage increases and solutions to staffing shortages.

Caroline Lucas is the executive director of the Coalition of Kaiser Permanente Unions.

And she joins us now to talk more about this.

Thank you for being with us.

Health care workers taking to the picket lines, they're fighting for better pay, better benefits.

That's certainly true in California, which has a high cost of living.

It's also where most of the 75,000 striking Kaiser Permanente workers have walked off the job.

What specifically are you asking for?

CAROLINE LUCAS, Executive Director, Coalition of Kaiser Permanente Unions: Hi.

I think that you have captured it.

We are really looking for Kaiser executives to listen to the voices of front-line health care workers as they raise to the forefront the short-staffing crisis that is impacting patient care within Kaiser Permanente.

GEOFF BENNETT: Kaiser Permanente staff, they say that they're exhausted.

They say that the staffing levels at the Kaiser facilities are unsafe.

Patient wait times, they say, are dangerous.

Paint a picture for us of what an average day at a Kaiser office or hospital looks like right now.

CAROLINE LUCAS: Such a good question.

I was just talking to folks in Colorado, and the receptionist in the audiology department was saying that people are often on hold for 60 minutes just to reach him.

And then, once they do get through to him, he's offering them appointments two to three months out.

And that same story is true across California in Portland, in Washington, D.C., area, where patients are waiting for a long time just to speak to someone to be told your next appointment isn't for months and months out.

GEOFF BENNETT: On this matter of staffing shortages, the health care industry nationwide is facing labor shortages.

And here's what a Kaiser executive had to say about that.

MICHELLE GASKILL-HAMES, Executive, Kaiser Permanente: I think, coming out of the pandemic, health care workers have been completely burned out.

The trauma that was felt caring for so many COVID patients and patients that died was just difficult.

And so people have left the industry as a whole.

GEOFF BENNETT: So, practically, what more could Kaiser Permanente be doing in terms of recruiting and hiring staff that it's not already doing?

CAROLINE LUCAS: Kaiser Permanente has a huge advantage, in that it has front-line health care workers who want to step up and work on long-term solutions to the staffing crisis, comprehensive solutions.

Those look like infrastructure investment in the work force, growing our own in terms of education and training, developing a pipeline for new health care workers to join Kaiser Permanente, and developing a robust wage and benefit package that not just attracts new people into the Kaiser Permanente, but retains existing staff.

GEOFF BENNETT: As we mentioned, this is a multiday, multistate strike.

What do you see as the impact on patients who need immediate care?

How will those folks get the health care that they might need right now?

CAROLINE LUCAS: I think that's a question a lot of people ask.

And what we would say is, front-line health care workers have been seeing patient care suffer now.

Before they went out on strike, there were long waits in the emergency department, and patients were using long waits to access care prior.

And all of the wait times, all the delayed care compounds in a situation that creates a real patient care crisis.

So we know Kaiser Permanente received 10 days notice from us, which is both a legal obligation and an ethical obligation to provide notice to strike.

That's an opportunity for Kaiser to fix the staffing crisis by negotiating good solutions.

Having failed to do that, Kaiser executives will be spending lots of money on outside, expensive companies to come in and staff facilities that could be staffed by Kaiser Permanente employees.

GEOFF BENNETT: So, specifically, what does Kaiser need to do to meet the union's demands?

CAROLINE LUCAS: Kaiser needs to listen to the voices of front-line health care workers as they come up with long term staffing solutions.

Some of those solutions look like incentives to attract new staff into the health care field.

It looks like providing training so that the right staff have the right skill set to deliver care.

It looks like incentivizing off-shifts, night shift, weekend shifts that are really hard to staff right now, partly because differentials haven't changed in 30 years.

And most concerning, we have just heard from Kaiser Permanente an issue that rose up in the last 24 hours, that Kaiser Permanente is interested in outsourcing the jobs of health care workers that, a year ago, they were calling heroes.

GEOFF BENNETT: And we should explain for the unfamiliar, what are differentials?

CAROLINE LUCAS: Oh, thank you.

Absolutely.

So, shifts like night shift weekend shifts are harder to staff, they're harder to attract people to, and they're added costs for workers of taking those shifts.

And so they're an incentive to work an off-shift.

GEOFF BENNETT: Caroline Lucas, the executive director of the Coalition of Kaiser Permanente Unions, thanks so much for your time and for your insights.

We appreciate it.

CAROLINE LUCAS: Thank you for your time.