The Power of One – Kaiser Permanente’s First Individual Plan

posted on October 22, 2018

Lincoln Cushing, Heritage writer

 

Brochure for Northwest Kaiser Permanente’s Personal Advantage plan, November 1998

For many years, Kaiser Permanente members signed up through “groups” — organizations such as unions or employers who provide health plan benefits to their employees. However, when the Affordable Care Act became law in 2010 and the first open enrollment began 2014, Kaiser Permanente saw a large demand for “individual member plans” — plans families and individuals purchase themselves — and created options accordingly.

That wasn’t the first time. In 1995, an exciting new Kaiser Permanente individual plan was opened to the public.

When founding physician Sidney Garfield, MD, started his practice for the workers on the Colorado River Aqueduct project in 1933, they were covered under an industrial health plan. Non-work-related health care was paid as fee-for-service, but Garfield soon covered that under a low-cost prepaid plan. Dr. Garfield next cared for the workers at the Grand Coulee Dam project in Washington, where there was a community of wives and children. When the unions insisted, a prepaid health plan was extended to families. During World War II, Dr. Garfield’s medical coverage of the workers in the West Coast shipyards added families, first in the Northwest in September of 1943 and then in California in April 1945.

Brochure for family health plan, 1945

After the war ended, the Permanente health plans faced a serious challenge with the loss of almost 200,000 Kaiser workers. But because of Henry J. Kaiser’s positive relations with organized labor, unions became the first group members of the public plan. Soon, corporations, government agencies and nonprofit organizations were signing up their employees, and for many years, group membership was the primary point of entry for health plan members. Group membership in 1959 was 80 percent; within 20 years that would grow to approximately 90 percent. The few individuals were “conversion members” who were no longer covered under a group.

In late 1995, Kaiser Permanente in Northern California sought to increase membership by launching its first non-group health plan for individuals and families who weren’t covered by their employers or a family member. It was called Personal Advantage. In 1996, the employee magazine Contact described the development:

Rates for this plan are based on age and are highly competitive, with special rates available for people living in certain geographic areas. … Personal Advantage members have access to the same comprehensive quality care provided by Kaiser Permanente’s [“conversion member”] individual plan, including a prescription plan and optional dental coverage.

Personal Advantage brochure cover, Georgia region, 2008

Personal Advantage was marketed through television and newspaper advertising, and was promoted at events that attracted young adults, such as sports events and concerts.

“Growth has been nearly 100 percent higher than expected,” said Jill Feldon, advertising manager. “Consumers like the low price, and they appreciate the value of receiving comprehensive health care coverage, access to specialists, and the high-quality care that Kaiser Permanente provides.”

In 2002, Personal Advantage Plan members were able to take advantage of the then-new phenomenon of online enrollment. The initiative marked one of the first examples of an insurer offering online enrollment through its own website, and it reduced processing time by eliminating paperwork. By 2005, the Kaiser Permanente Personal Advantage Plan was joined with a similar effort called the Kaiser Permanente Individual Plan and became Kaiser Permanente for Individuals and Families.

Group or individual, Kaiser Permanente strives to accommodate the health care needs of all.

 

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The Picture of Health

posted on October 16, 2018

Lincoln Cushing, Heritage writer

 

Masthead for Planning for Health, Kaiser Permanente Southern California member newsletter, 1958

Quick — what’s the symbol commonly used to depict medical practice?

If you said two serpents wrapped around a winged staff, you would be right — and wrong.

The story of the symbol representing medical care is one of mistaken identity. In the United States, we usually think of the caduceus, two snakes twisted around a winged staff. Its origins go back to antiquity, where it was carried by the Greek god Hermes and represented commerce and negotiation. It was later appropriated by the Roman god Mercury. The caduceus never referred to medicine (or at least the essence of healing), but it looks very much like the Greek Rod of Asclepius (composed of a single snake and staff, no wings), which does. What happened?

It appears that when the U.S. Army Medical Corps developed their branch logo in 1902 they picked the wrong symbol, and it has permeated American medical graphics ever since.

Here are examples of these images from the Kaiser Permanente archives. Some are from our own organization, some are external, and some display various combinations of the two logos. Click on one to engage slideshow.

Also see article on the Kaiser Permanente logo
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Hungry for Health: The Evolution of Hospital Food

posted on October 5, 2018

Lincoln Cushing, Heritage writer

 

Joyce Nishimura using Radarange model 1161 at a Kaiser Foundation hospital, circa 1958

Did you know that Kaiser Permanente’s founding physician, Sidney Garfield, MD, was an innovator in prepaid health care, hospital design and … hospital food service?

In 1955, along with E. R. Park, coordinator of the Kaiser Permanente Dietary Departments, Dr. Garfield worked out the plans for introducing microwave ovens into Kaiser Foundation hospitals. Dr. Garfield was extremely proud of this experiment, claiming they would bring more flexibility to serving patients warm meals. In 1956, he wrote an unpublished article titled “Just a Second! Becomes a Truism With Microwave Ovens.”

In this age where “fresh and local” is synonymous with good, healthy food, it’s easy to smirk at the benefits of microwave ovens in food preparation. But, like the advent of refrigeration, this technological advance had its advantages in the preparation of hospital food. The microwave’s primary purpose was warming previously cooked meals when the patient was ready to eat.

Kaiser Foundation hospital nurse using Radarange microwave oven circa 1961. The dome cover on top of the dish was designed by Marie Marinkovich of the Kaiser Dietary Department to ensure even heating.

The earliest microwave ovens were the size of a refrigerator, required water for cooling, and consumed massive amounts of electricity, thus limiting their usefulness. The Raytheon Corporation’s first commercial model, the 1161 “Radarange,” was introduced in 1954. It would be another 10 years before Raytheon produced a microwave model that was user-friendly and inexpensive enough to become a universal kitchen accessory. Between 1965 and 1997, Raytheon’s consumer products were produced under the Amana name.

Dr. Garfield was an early adopter, bringing 1161s into Permanente’s new California hospitals at Harbor City, San Francisco, and Walnut Creek.

By the mid-1960s, the ovens had gotten small enough that they could be moved out of the kitchen and placed in nursing stations, closer to patient rooms. These were accompanied by refrigerators and hot water/coffee dispensers, creating kitchenettes throughout the facility.

Kaiser Permanente nurse with food tray and happy patient, 1972

In 1965, Kaiser Permanente’s Santa Clara Medical Center became the first in the organization to provide built-in microwave ovens on the nursing floors. The Bellflower Medical Center followed suit when it opened in 1965.

An article in the June 1967 issue of the trade publication “The Modern Hospital” examined how the Kaiser Foundation hospitals were embracing microwave ovens, a key part of what was called the “total convenience food system.” At that point, most of the 18 Kaiser Foundation hospitals in the Western states and Honolulu had converted or built into their new facilities a food service system using microwave ovens and prepared foods.

Caution sign for early hospital microwave oven, 1971

Kaiser Permanente food service consultant Marie Marinkovich said: “The difference between other hospitals’ failure … and our success lies in the quality of the food being served … [our suppliers] cooperated with us fully in developing entrees, both for regular and special diets, that met our needs.”

Microwave ovens continue to serve as part of the toolkit for providing healthy and appetizing hospital food. Jan Villarante, director of Kaiser Permanente’s National Nutrition Services, calls microwave ovens “workhorses“ and notes that every food service operation within the organization uses microwaves today.


National Healthcare Food Service Week is October 8-14, 2018. Honor food service workers.
Pacemaker hazard warning graphic by Delmar Snider, MD, 1934-2017

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Be an Upstanding Citizen!

posted on September 19, 2018

Lincoln Cushing, Heritage writer

 

Fore ‘n’ Aft, 1/29/1942

Falls Prevention Awareness Week starts September 22. This 1942 cartoon from the Kaiser Richmond shipyard newspaper Fore ’n’ Aft illustrated remarks from Secretary of the Navy Frank Knox about industrial accidents on the World War II home front. “We have no time to train replacement workers… We cannot afford to permit accidents to encroach upon that bare minimum of time.”

Falls were among the largest contributors to shipyard accidents, which overall accounted for approximately 5 percent of employee absenteeism. But campaigns around safety education and rule enforcement made a difference – the frequency and severity of accidental injuries dropped 50% from 1941 to 1942, an improvement unsurpassed by any major industry in the United States.

These days, Kaiser Permanente still seeks to reduce fall-related injuries, for both employees and patients.

An injury-free workplace is an essential ingredient of high-quality, affordable patient care. Kaiser Permanente has set the goal of eliminating all causes of work-related injuries and illnesses. “Slip, trip, and fall” prevention is part of a comprehensive workplace safety strategy, designed to keep employees safe and create a workplace free from harm.

A focus on patient safety comes from the “No One Walks Alone” program – pioneered at the San Diego Medical Center and adopted at the Moanalua Medical Center in Hawaii – where the number of patient falls was reduced by more than half. And last year, the Kaiser Permanente Washington Health Research Institute contributed an editorial accompanying the latest JAMA study about preventing falls among seniors.

For 10 tips on preventing falls, see this infographic.

 

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