By Laura Thomas
Throughout its history, Kaiser Permanente has relied on the “can-do spirit” of its dedicated workers and on the support of organized labor to keep the prepaid health plan strong.
Coming out of World War II, the medical plan had proven its viability in caring for a large shipyard workforce, but with the end of shipbuilding contracts, Henry Kaiser and Permanente founder and medical director Dr. Sidney Garfield had a big problem. Where were the large numbers of new members going to come from?
Kaiser, a friend of labor, attracted workers’ unions whose leaders understood the power of prepaid health care and wanted it for the welfare of their workers. Bay Area workers – from Oakland city employees, who were the first to sign up, to union typographers, street car drivers and carpenters – embraced the Permanente Health Plan with its emphasis on preventive medicine.
In 1950, Harry Bridges brought the 6,000-member International Longshoremen and Warehousemen Union (ILWU) into Kaiser Permanente, bringing the total West Coast membership, including Los Angeles, to almost 160,000. In 1951, the Retail Clerks union added 30,000 to the membership rolls in Los Angeles.
Opposition tries to squelch KP
Despite this success, Kaiser and Garfield often faced rear guard actions from private practice doctors who felt threatened by group practice medicine. In 1953 when KP opened a new hospital in Walnut Creek and sought the health plan contract with workers in the U.S. Steel plant in Pittsburg, California, all hell broke loose in that small town along the Carquinez Strait.
Before Kaiser Permanente came along, the steelworkers union had both a national hospitalization plan and a local supplementary health plan with local private practice doctors. The workers were not satisfied with the current health plan and were complaining that providers charged too much and were lackadaisical about responding to emergencies and requests for house calls.
For their part, the Pittsburg area doctors argued that inflation required rates to rise and disputed the idea that service to members was lax.
Kaiser Permanente already provided care to steelworkers at the South San Francisco Bethlehem Steel plant and was prepared to expand services to the Pittsburg area. The beginning of KP’s negotiations with the Steelworkers Local 1440 in Pittsburg raised the hackles of the 41 private practice doctors already established in the area.
These doctors, all members of the East Contra Costa branch of the Alameda-Contra Costa Medical Association, quickly devised a new and better plan to offer the union, including 24-hour emergency service and a cap on fees.
Offer steelworkers couldn’t refuse
Joseph Garbarino, in his 1960 study of the Pittsburg conflict for the University of California, reported that the union bargainers welcomed Kaiser Permanente because of its offer to provide comprehensive care for a specific price for a specified period of time. This arrangement was attractive to the local union whose leadership had never before been able to negotiate such a favorable deal with their private practice providers.
The Pittsburg area doctors were furious and immediately mounted a campaign to discredit the Kaiser Permanente agreement. The doctors appealed to the steelworkers to reject the decision of their insurance committee and place the KP plan and the private doctors’ revised offer side by side for a vote of the full membership.
Fred Pellegrin, a Kaiser Permanente physician in the new Walnut Creek facility, remembers a rally where the local doctors “begged us not to go to Pittsburg … People stood up, yelling at us, called us Communists. It was a real shouting match.”
Using full-page newspaper ads, handbills and direct mail, the fee-for-service doctors bombarded the community with arguments supporting their plan and implied that the national Steelworker union officials were investigating the local’s decision.
The union answered the doctors’ charges in its newsletter and then agreed to a Sept. 3 (1953) election. Both sides agreed to a break in hostilities for the month of August. The agreement called for the doctors to stop their campaign and for the union leaders to remain neutral on the election.
The truce ended just days before the election when the union distributed voting packets with both health plan proposals, and included a leaflet encouraging members to favor the Kaiser Permanente plan. Enraged private practice doctors took to the battlements again, issuing a more detailed plan explanation and blasting the union in a full-page newspaper ad.
The doctors hired a truck with a loud speaker that cruised through workers’ neighborhoods broadcasting their opposition to Kaiser Permanente. They enlisted supporters, including Pittsburg doctors’ wives, to distribute literature in the steel company parking lot. Plan B was to drop leaflets from the air if solicitors were barred from the plant. According to news reports, tensions rose and the sheriff’s department was called, but no clashes occurred.
Victory of KP health plan
The Pittsburg medical establishment’s effort failed as steelworkers voted 2,182 to 440 to retain the Kaiser Permanente plan. For KP, this was a victory, but more struggles related to organized labor were yet to come.
Financial troubles in the 1980s and 1990s resulted in labor issues that threatened to stunt the health plan’s progress. Happily, those years of turmoil spawned Kaiser Permanente’s landmark Labor Management Partnership (LMP), which forged a cooperative relationship between KP’s 26 unions and the health plan leadership. The partnership fosters a respectful collaboration to improve health care for members and to create a positive work environment.
Kaiser Permanente unions had a big role in bringing about that partnership. In the midst of hostile bargaining in 1995, union leaders realized the labor disputes could damage the future of the health plan. Kathy Schmidt, a member of the bargaining team from Oregon, recalled, “We realized: here is the most unionized system in the country. Why don’t we try to help them? We learned more about trying to have a Partnership.”
Then-Kaiser Permanente CEO David Lawrence reached back across the abyss and agreed. “What I remember thinking about at that meeting was: We’ve got nothing to lose by being forthcoming about what I believed needed to happen …about the kind of collaboration that I think is required to deliver modern medical care in all of its complexity,” he told Harvard University researchers in 2002.
Today, scholars at both Harvard’s School of Government and Stanford University’s School of Business are following the progress of the LMP and consider it a prime example of labor and management cooperation. Its continued success will contribute to the realization of KP’s goal of being the model for health care delivery in the United States.
Read more about the Labor Management Partnership.
By Ginny McPartland
When I first heard Kaiser Permanente was offering its employees a $50-to-charity incentive to take the THA, I wasn’t that impressed. I didn’t think the donation would convince people to participate in KP’s initiative to build a healthier workforce. I also didn’t think $50 would go that far. I have to admit I was WRONG!
By mid-December, more than 22,000 (14.5%) KP employees nationwide had taken the THA and by that small action collectively raised an impressive $1.1 million. Now that will go a long way. How far? For starters, each $50 could buy 700 pounds of fruits and vegetables or 77 dozen eggs for the hungry. Or it could provide 10 pediatric flu shots for needy kids. Multiply those items by 22,000 donors and you get the picture.
The money raised by the 2010 THA incentive program will go to community healthy eating initiatives and to support health care for disadvantaged people and families, especially the homeless, the disabled and those living with HIV/AIDS. The KP region whose employees raise the most money will receive an extra $50,000 for charities in their communities. The winner will be announced in January; the money will be awarded in March.*
I think it says something about the KP culture that so many employees were motivated to raise money for others less fortunate than themselves. If they hadn’t felt compelled to take the assessment for their own sake, they were motivated to help others. Of course, Kaiser Permanente has given millions to good causes over the years through its Community Benefit programs.†
Total health assessment by any other name
Given our history as a preventive care organization, it shouldn’t come as a big surprise that Kaiser Permanente has been a champion of the total health assessment for over 60 years. In 1950, such an assessment was called the “multiphasic examination,” and it was initiated when labor leader Harry Bridges of the International Longshore and Warehouse Union (ILWU) demanded it for all members of the union.
These records, still accessible today, have supported long-term health research related to heart disease and other chronic diseases. One such study, “Characteristics of Longshoremen Related to Fatal Coronary Heart Disease and Stroke” by Paffenbarger et al., was published in the “American Journal of Public Health,” in 1971.
In the late 1960s, Permanente founding physician Sidney Garfield launched a program called “The Total Health Care Project” to expand the multiphasic programs in Oakland and San Francisco. Garfield and Robert Feldman, MD, hired and trained KP’s first nurse practitioners to run the program that included the use of computerized lab machines that yielded results while the patient was still at the clinic. Their goal was to collect baseline health data that could be used to identify health risks and to prevent disease.
Today’s iteration of the multiphasic exam is a system of chronic disease screening programs designed to detect symptoms early and identify risk factors. The total health assessment questionnaire challenges participants to scrutinize their lifestyles and work with their doctors to figure ways to head off diseases such as diabetes, heart disease and cancer.
For me, the THA results are a reminder of what I need to do to stay healthy. I’m also hoping I can improve my sleep by following through with the online insomnia program. But most of all, I feel glad that my co-workers saw fit to get involved for themselves and to raise money to improve the health of others less fortunate.
*Benefit-eligible Kaiser Permanente employees and physicians may earn the $50 charitable donation by taking the THA by Dec. 31. Go to the Healthy Workforce site to participate.
†Click here for more information about Kaiser Permanente’s Community Benefit Program.
By Ginny McPartland
Christmas 1956, and the family of Henry J. Kaiser, Jr., was reveling in the beauty of the season and reflecting on its own good fortune and faith. As they had done the two previous years, the trio – Henry Jr., his wife, Bobbie, and son Henry III, then 4, recorded a holiday album to share their happiness with their friends and the employees of Kaiser Industries.
The album eavesdrops on the young family as they recount stories and sing in anticipation of Santa’s arrival on Christmas Eve. The child, nicknamed Henry Three (aka Henri Trois), vows to stay up to see St. Nick up close. Can he do it? His parents are skeptical.
Just about seven minutes long, the 1956 recording celebrated San Francisco Bay Area’s newest bay crossing, the Richmond – San Rafael Bridge, the release of a musical classic from “My Fair Lady,” and the talent of young Henry Three who showed his precociousness by reciting a poem in French and then translating it for “Papa” Kaiser.
For me, “Mama” Bobbie Kaiser’s reference to Santa coming from the north to Oakland over the “new Richmond Bridge” rang a bell. As a native of Richmond, I remember taking my last ride on the auto ferry that connected the East Bay with Marin. My parents had a ritual of cramming all eight of us in to our 1950 Ford and driving onto the ferry as a special Sunday outing. That ended in September of 1956 when the bridge opened.
Henry J. Kaiser, Jr., son of industrialist and visionary Henry J. Kaiser, showcased his singing talent by launching into “I Could Have Danced All Night” as Henry Three reiterated his determination to greet Santa whenever the jolly soul showed up at the Kaiser home during the night. The song, which was well known later, had just been published and performed on Broadway in 1956. Audrey Hepburn as Eliza Doolittle (actually sung by Marni Nixon) popularized the tune in the 1964 screen version of “My Fair Lady.”
Precocious child grows up
Henry Three’s Christmas album performance foreshadowed his success as a brilliant student who enrolled at Harvard University at 16 and as an innovative and eclectic musician, research diver, videographer and film producer.
In 2007, Henry Three produced a documentary film about scientists working in Antarctica with famed documentarian Werner Herzog. The movie, “Encounters at the End of the World,” was nominated in 2009 for an Academy Award for Documentary Feature. Kaiser appears briefly in the film and his underwater camera work is showcased in the DVD’s special features.
The Baby Boomer Henry Kaiser has an impressive discography and is well known as a gifted musician and composer. Wikipedia has this to say about him: “Recording and performing prolifically in many styles of music, Kaiser is a fixture on the San Francisco music scene. He is considered a member of the ‘first generation’ of American free improvisers.”
Happy holidays, and enjoy this excerpt of the Kaiser 1956 album. Kaiser_Christmas_1956
By Laura Thomas
(Second of two articles)
As the holiday season of 1945 approached, Kaiser shipyard workers faced an uncertain future on the West Coast. Interviews with workers in the “Fore ‘n’ Aft,” the Richmond shipyard newsletter, reflected some anxiety: “What do I think about the end of the war?” said laborer Lon Van Brunt. “Let’s study about that: I look for it to be hard times.”
The local press reports, often tinged with sentimental hope, insisted that the Dust Bowl migrants were tossing mattresses back on their cars, packing up pots and pans and leaving wartime housing in droves.
Bernice Rarick, a Portland worker reflected that ambivalence when she told the “Bosn’s Whistle,” the northwest Kaiser shipyard newsletter, she was going right back to her ranch in Idaho yet wondered, “It doesn’t seem possible that everyone can go back to normal living again.”
Transplants try to find their place
The women were the first to go despite the fact that some 70 percent in a December 1944 Yard Two survey said they wanted to work. Black migrant workers also struggled to find new employment with the unemployment rate for black men in 1948 about 15 percent, three times the state average.
“News came over that the contracts were cancelled, and that was it,” recalled Margaret Cathey who came from Iowa and worked as a welder. “You didn’t get two weeks notice or anything like that, no. You were just finished.” She was lucky because she found a job with the telephone company, anxious to hire women operators.
A welder at the Kaiser shipyards, Willie Stokes earned $10 a day but, after the war, was only able to find unskilled labor at $6 and was unemployed by 1947. “One day you are an essential worker in a vital industry and the next you were a surplus unskilled laborer essential to no one,” he said in an article, “Willie Stokes at the Golden Gate,” by Cy W. Record published in “The Crisis Magazine,” June 1949.
It took a while for many ex-shipyard workers to find their footing. In an article in “Salute Magazine” in June 1946, writer William Hogan called Richmond, “hangover town” because so many were still living there or had returned in hopes of finding work.
Mostly from rural areas with ways that seemed backward, these workers and their families had been lifted out of poverty working for Henry Kaiser and were destined to prove themselves, especially to long-time Richmond residents.
“I said, ‘Well, here these people are. They’re not going to leave here. This is Mecca,’ ” recalled Clifford Metz, a former Richmond school official who had insisted the notion that the migrants would go back was an illusion.
“I think we went down maybe ten or fifteen thousand people in a short time. Most of them, well, they had learned that they liked it here. Some of them, with the money they had, they could invest. They were not unintelligent people.”
Selena Foster, who came from Fort Worth, Texas, in early 1944, and her husband, Marvin, were among those with that precise idea. “My husband said to me, ‘We have no home to go back to.’ We had a little money and we found property was fairly reasonable if you could find something to buy,” she said in 1992.
The Fosters did make a trip back to East Texas in a shiny new car that made quite an impression on their family, but they returned to Richmond and within months had bought a home on Hoffman Boulevard and 29th Street, one of the first African-American families to do so after the war.
The uncertainty of that holiday period 65 years ago was soon eased by a postwar economic boom in both the Bay Area and the Northwest. The upturn raised the fortunes of many who arrived back then with little but hope. Over the decades they have become woven inextricably into the cultural fabric of both regions.
*Marguerite Clausen, “A World War II Journey: From Clarkesdale, Mississippi, to Richmond, California, 1942,” an oral history conducted in 1985 by Judith K. Dunning, Regional Oral History Office, The Bancroft Library, University of California, Berkeley, 1992.
By Laura Thomas
(First of two articles)
Christmas 1945 was undoubtedly the happiest Americans had known since 1940, the year before the bombing of Pearl Harbor. The Japanese surrender in August closed the final chapter of World War II and meant the return of loved ones serving overseas and the hope that normal life would resume.
But it was not entirely clear what that would mean for tens of thousands of shipyard workers in California, Oregon and Washington whose lives were irreversibly changed by their trek westward to work for Henry Kaiser. Would their lives ever be normal again?
From a height of 93,000 employees in the Richmond shipyards in 1943, the total spiraled downward in 1945 as the contracts were cancelled, with 40,000 workers in March dropping to 16,000 by the end of September.
In the Northwest, where Kaiser had yards in Portland and Vancouver, Wash., the cutbacks were sudden. From January to December, employment fell from 90,000 to just above 10,000.
After three years of hard-driving work fueled by a strong sense of mission and new experiences, many, especially the women and black workers, were once again jobless and possibly a little disoriented.
Vancouver worker Chauncey Del French describes the last day on the job in November for the paint crews who “took off like so many flushed quail to their locker room…a half-hour later, the ‘painters’ parade’ started up the dock.
“Men and women, arm in arm, sang Auld Lang Syne in the rain. They had their honorable discharge papers and were going to collect their ‘rocking chair money’ and live the life of Riley,” French wrote in his book “Waging War on the Homefront.”
Workers in the Northwest were told to grab farm labor work with 9,000 jobs available picking pole beans. “Highest wages ever received in Oregon by farm workers are being paid out this year,” stated an article in the “Bosn’s Whistle,” the shipyard newsletter, which noted they would be displacing Mexican workers who had been brought in to do the picking during the war.
Henry Kaiser relentless in pursuing postwar contracts
Meanwhile Kaiser said he “was determined to keep the job level at Richmond shipyards at the highest possible point” as he anticipated rail car and dry dock contracts. He also labored to get repair contracts and to attract work building ships for the Merchant Marine. Despite the major lobbying by Kaiser’s top officials motivated by concern for the workers, the U.S. Maritime Commission closed Richmond’s and Portland’s yards in 1946 and 1947.
No doubt what had Kaiser worried was news in his own press. “Fore ‘n’ Aft,” the newsletter for the Richmond yards, reported a survey of Yard Two workers in December 1944 that showed 63 percent of the out-of-state workers wanted to stay in California.
Yet, in 1945, many started to move to better jobs or – as contracts disappeared and layoffs began amidst some predictions of mass unemployment – started to head home. They also faced loss of the medical care provided by the Permanente Health Plan and the much-touted child care program that Kaiser had helped to start with the Richmond schools.
As the number of health plan enrollees in the shipyards dropped, Kaiser Permanente was invited to provide care for Vallejo residents of eight large wartime public housing dormitories and, in July, its first attempt to extend prepaid medical care to the general public was under way.
But other services that eased the burden of these dislocated workers disappeared rather quickly. Richmond hesitated to step into the breach, with some hoping that cutting back on services and beginning to tear out wartime housing would prompt the workers to leave. And many did leave, but, as it turns out, not for long.
Next time: Laid-off shipyard worker dilemma: Should I stay or should I go?
By Tom Debley
Director of Heritage Resources
It’s time for me to say farewell after 15 years with Kaiser Permanente. The last seven years have been as founding director of Heritage Resources, our history program. But at the end of the day on Dec. 17, I will head off to new adventures in retirement.
Do not fear, my able colleagues Bryan Culp and Ginny McPartland will carry on the history work in Heritage Resources!
So what does one say to many friends, colleagues and Kaiser Permanente history buffs other than good-bye?
For me, I quote the literary great, Robert Penn Warren: “History cannot give us a program for the future, but it can give us a fuller understanding of ourselves, and of our common humanity, so that we can better face the future.”
Recently, I was reminded of the importance of this – and a key reason why we maintain a historic archive at Kaiser Permanente. It came as an inquiry on our History of Total Health Blog from John Herron, a history professor at the University of Missouri, who had read a blog about Rachel Carson and Kaiser Permanente’s environmental history by our intern, Jac Brown.
Carson’s last public lecture prior to her death was delivered at an October 1963 Kaiser Permanente symposium attended by 1,500 doctors, scientists, medical students and journalists at the Fairmont Hotel in San Francisco.
This was a year after publication of Carson’s then very controversial book “Silent Spring,” critiqued in 1962 in Time Magazine, which concluded: “Many scientists sympathize with Miss Carson’s love of wildlife, and even with her mystical attachment to the balance of nature. But they fear that her emotional and inaccurate outburst in Silent Spring may do harm by alarming the non-technical public, while doing no good for the things that she loves.”
Today, of course, Carson’s “Silent Spring” is a classic of the 20th century and she is considered the catalyst for the modern environmental movement.
Quite naturally, Professor Herron wanted to know why the then vice president, and later president, of Kaiser Foundation Health Plan and Hospitals, Dr. Clifford Keene, invited such a controversial figure to lead off a public service symposium, the theme of which was “Man Against Himself.” We sent him materials for writings he and other scholars are preparing for the 50th anniversary of the publication of “Silent Spring.”
And that’s one of two reasons why we have a history program. One is to share stories of our history with our physicians, staff and communities. The other is to be here for scholars, museums and others who seek historical insights.
I started our Heritage Resources program in 2003. Professor Herron’s recent question reminded me of the day in 2003 that I first read a one-paragraph item about Rachel Carson’s lecture in a list of “highlights of the year 1963” in an old annual report.
Immediately, I flagged this event as something around which to begin collecting documents for archival purposes. Why? This was a high-water mark that helps illustrate why Kaiser Permanente is a recognized leader in sustainability, because sustainability is important to building healthy communities.
Today, we have Ms. Carson’s lecture text, copies of the correspondence between her and KP planning for her presentation, and other documentation.
As a result, we have collected and archived a wide array of historical materials. A mere handful of these documents illustrate how we stand on the shoulders of other leaders like Rachel Carson:
- Founding physician Sidney Garfield was looking for sustainable practices and was recycling in the Great Depression and during and after World War II;
- It was a Kaiser Industries executive who was among those who founded The League to Save Lake Tahoe in 1957, and coined the phrase seen on bumper stickers and elsewhere to this day: “Keep Tahoe Blue”;
- Kaiser Steel was pioneering pollution control equipment in the 1950s and 60s – before the modern environmental movement and before the first Earth Day in 1970;
- In the early 1970s, employees at the Kaiser Permanente Medical Center in Santa Clara, California, formed an Ecology Committee with an objective of teaching employees “ecological common sense”;
- In the 1980s, employees in Vallejo, California, were honored for reducing energy consumption by half in five years;
- Today, the efforts continue with Kaiser Permanente adding solar power generation to 15 of our facilities by next summer. These groundbreaking projects will eliminate purchase and disposal of 40 tons of harmful chemicals and dramatically reduce KP’s use of fossil fuels.
Our commitment to sustainability is but one example of Kaiser Permanente’s mission to improve the health of its members and of the communities in which they live.
History reminds us, as Robert Penn Warren said, of who we have been, why we are who we are, and where we are headed if we remain true to our values and mission – as individuals and as institutions.
By Tom Debley
Director of Heritage Resources
Sad news has reached us at Kaiser Permanente Heritage Resources that Jim McCloud, a longtime employee and executive in Henry J. Kaiser’s industrial empire died on Dec. 2 at the age of 92 in La Verne, Calif.
I remember meeting Mr. McCloud for the first time about a decade ago when I had the privilege to assist him and a number of other former Kaiser executives who raised the money and supported the “Henry J. Kaiser: Think Big” special exhibition at the Oakland Museum, a tribute to Mr. Kaiser, in 2004.
During World War II, Mr. McCloud, right out of Stanford University with a degree in mechanical engineering, went to work at the famous Kaiser Shipyards in Richmond, Calif., in 1941. He became outfitting superintendent in Yard No. 3 – today a key site of the Rosie the Riveter / World War II Home Front National Historical Park.
I will never forget one meeting when he was asked to describe just how frenetic things were when Kaiser workers were building a ship a day during World War II. “Well,” he replied, “if you dropped a quarter on the deck of one of those ships when it was being outfitted, that quarter would be welded to the deck before you could bend over to pick it up.”
Mr. McCloud was proud of the wartime shipbuilding effort in which tens of thousands of workers smashed all production records in the history of shipbuilding.
“None of these accomplishments would have been possible without the native ingenuity and patriotism of the American workers and the strong support of the City of Richmond, which absorbed the greatest percentage growth in population of any wartime center in the nation,” he said at the 1992 dedication of Kaiser Shipyard No. 2 as a historic landmark.
This year marks the 10th anniversary of the National Historical Park that honors that important chapter in American history.
To learn more about Mr. McCloud’s experiences on the Home Front, read his Oral History in the collection of the Rosie the Riveter World War II American Home Front Oral History Project, a collaborative program of the Regional Oral History Office at The Bancroft Library at the University of California at Berkeley, the National Park Service, and the City of Richmond.
James F. McCloud was born in West Oakland, Calif., on July 2, 1918. He attended Cole Grammar School, Lowell Junior High School and McClymond’s and St. Mary’s high schools.
It was in the shipyards building Liberty and Victory Ships that he met his wife of 54 years, Geneva Edgar, who died in 1999.
Except for a brief stint with Pacific Bridge Co. in San Francisco he spent his entire working career with Kaiser Industries. Following his work in the shipyards, he moved to the Kaiser-Frazer Willow Run automobile plant in Michigan. In the mid 1950s, he went to Argentina for the formation of Industrias Kaiser Argentina, the automobile plant in Latin America of which he became president.
Mr. McCloud returned to the Kaiser world headquarters at Kaiser Center in Oakland in 1972 and became president of Kaiser Engineers. He retired in 1983.
Mr. McCloud volunteered much of his time on behalf of many Oakland nonprofit organizations such as Mercy Care, the Catholic Diocese of Oakland, St. Mary’s College, the University of Santa Clara, Providence Hospital, the Oakland Coliseum and the U.S.S. Potomac Association.
He received a Papal Honor in 1964 and was made a Knight of St. Gregory by Pope Paul VI. He was also a Knight and his wife, Geneva, a Dame of the Order of Malta.
Mr. McCloud is survived by his four sons, Kimball, Kelly, Mark and James; two daughters-in-law, Claire and Marcela; eight grandchildren and two great-grandchildren.
Services will be held Saturday, Dec. 11. For information on the services and more about the family of Mr. McCloud, see his obituary at InsideBayArea.com.