“Often I am classified as a dreamer, particularly when I talk about health insurance. To live abundantly and take part in a productive economy, our people must have health. This is not only a matter of medical science, but facilities. Health service can be rendered on a self-sustaining insurance basis, at a price well within the reach of all.”
—Henry J. Kaiser, “Jobs for All,” Waldorf Astoria Hotel, New York City, October 17, 1944
“The Kaiser Foundation health plan did not start out with preconceived ideas … but instead developed by evolution over a spread of 20 years. It evolved out of a great human need … the health needs of workers on remote construction projects … the needs of war workers, and then, the demands of the general public.”
—Henry J. Kaiser, testimony in the Wolverton Committee, U.S. Congress, 1954
By Ginny McPartland, Heritage writer
Shipyard physician achieves brilliant postwar career as international reproductive biology expert
Before 1943, nobody knew how well women shipyard workers would adapt to the grit and physicality of a man’s world of heavy industry. In the midst of World War II, physician Hannah Peters tackled the job of unraveling that mystery without a play book.
She cared for female workers that poured into the Kaiser Richmond Shipyards. These women were pioneers, recruited to industry for the first time due to the war emergency.
Peters, German-born and trained in New York, had migrated to California in 1940 and set up an office in East Oakland. She found herself struggling to make ends meet and realized she needed to find a way to connect with patients who needed her.
When the United States entered the war in late 1941, Peters heard about Sidney Garfield, MD, who was developing a medical care program for Henry Kaiser’s shipyard workers in Richmond, Calif. She decided to leave private practice and join the staff of the Permanente Health Plan.
Shipyard women craved special attention
She quickly learned that the needs of women workers were abundant. They came from the South, the Midwest and the East Coast, and many had never seen a physician.
“I joined the medical department but it soon became clear to me that a gynecological department was necessary to take care of the special problems of the 23,000 women working in the yards,” Peters wrote in her memoir years later.
“A trained gynecologist was added to the staff and we established special programs to deal with the question of abnormal menstruation, pregnancy, venereal disease, sexual problems and to provide contraceptive services,” Peters wrote.
In seeing her patients, Peters noted many complaints about excessive menstrual bleeding that began when they started doing heavy work. Peters deduced that with a change in diet, to incorporate more carbohydrates for work energy, the women were worsening an already existing Vitamin B deficiency. She found shots of Vitamin B-complex solved the problem in most cases.
Peters also noticed that women lacked the stamina and strength to comfortably do their jobs. She arranged an activity program that had the Rosies (the term used to describe women war workers) climbing ladders and performing other tasks meant to strengthen their bodies to better handle their jobs.
Female workers screened for cancer
A believer in prenatal care and cancer prevention screening, Peters encouraged women to seek care often. She also urged women to come to the clinic to have pelvic and breast examinations every six months to screen for cancer of the ovaries, cervix, uterus and breast.
“In this way (conducting frequent physical examinations) we have demonstrated that extremely early cancer of the cervix can be consistently detected and not stumbled upon accidentally,” Peters and colleague Wilson Footer, MD, wrote in their article “Gynecology in Industry,” published in the Permanente Foundation Medical Bulletin and elsewhere in 1945.
The physicians also distributed materials to educate workers on how to avoid venereal disease and unwanted pregnancy. In their study, Peters and Footer also looked at the question of whether women should continue to work after they become pregnant.
In reviewing many cases of miscarriage among yard workers over a two-year period, they concluded that none of the terminations could be blamed on the work.
Shipyard experience opens up opportunities
“(Later in the war) another obstetrician (Dr. Robert W. King, a prince of a fellow) joined our group. He taught me obstetrics and gynecological surgery. . . I learned a great deal during the three years I was at Permanente . . . the years working with the shipyard women gave me experiences I could not have gotten in a life-time of private practice.
“The work with so many women of different backgrounds and coming from different cultures opened a new field for me: office gynecology,” she wrote.
After the war, Peters continued her work in women’s health, including family planning in India and elsewhere. She distinguished herself over the decades as a prolific publisher of research about reproductive biology and cancer.
She founded the Laboratory of Reproductive Health in Copenhagen, Denmark, in 1959 and headed the lab until her retirement in 1980. Hannah Peters passed away in 2009 at the age of 97.
by Lincoln Cushing, Heritage Writer
During the mid-1980s poisonings were the top public health hazard to children five and younger, so Kaiser Permanente in the Northwest decided to teach by showing at their new Rockwood Clinic and built a 15-by-18 foot “Sinister Garden” with 30 common poisonous plants. Each plant was labeled with botanical and common name as well as which parts were toxic; the clinic also offered guided tours and educational literature.
By Lincoln Cushing, Heritage writer
Photo exhibits honor workers who built the original Bay Bridge and modern-day eastern span replacement
The San Francisco-Oakland Bay Bridge was one of the engineering marvels born during the depths of the Great Depression in the mid-1930s.
Thousands of people were put to work building the infrastructure we still benefit from today.
Henry J. Kaiser and his industries were significant players in at least four key aspects of building that bridge:
- helping secure U.S. government support and funding for the project
- constructing footings on the East Bay side
- initial painting of the bridge, and
- providing concrete for the other bridge components beyond the East Bay footings.
Kaiser Permanente has roots in ironworker history as well, going back to the first president and CEO of the Health Plan and Hospitals, Clifford Keene.
Photographic record of bridge building expands
Noted Bay Area labor photographer Joe Blum has documented the entire construction of the new eastern span of the Bay Bridge, which is scheduled to be dedicated this fall. Blum’s exhibit of these photos, “The Bridge Builders,” features 80 large-format color images that highlight and honor the workers who’ve brought the huge project to fruition.
The show is hosted by the San Francisco Arts Commission Galleries Art at City Hall Program and can be seen on the ground floor of San Francisco City Hall. The free exhibition runs through September 27 and is open to the public.
A second Blum exhibition, “A View from the Bridge: Black and White Photography by Joseph A. Blum,” will be on display August 3 through October 3 at the Harvey Milk Photo Center in San Francisco.
Another exhibition, “Peter Stackpole: Bridging the Bay,” features 20 photographs documenting the original Bay Bridge construction in 1935. Stackpole was a pioneer in the use of the then-new imaging technology – the compact 35mm camera. The show runs at the Oakland Museum of California through January 2014.
Short link to this story: http://ow.ly/n5ROs
by Lincoln Cushing, Heritage writer
As World War II neared an end, the Permanente Health Plan was looking at a dramatic shift in its member base. Wartime shipyard closures loomed, and the future of the plan during peacetime would hinge on attracting new members in the community.
Given Henry J. Kaiser’s support for labor, it was not surprising that labor unions were among the early member groups. Bay Area workers – Oakland city employees, union typographers, street car drivers and carpenters – embraced the Permanente Health Plan and its emphasis on preventive medicine.
One of the first and largest unions to endorse the plan was The International Longshoremen and Warehousemen Union.
On June 7, 1945, the Stewards and Executive Council of the ILWU’s Oakland unit voted unanimously to make coverage in the health insurance plan of the Permanente Foundation a part of its future negotiations with employers. The executive council also requested that employers pay for the plan’s premiums.
We want our Permanente!
An article in the ILWU’s The Dispatcher explained:
“. . . Permanente operates on three principles: prepayment . . . group practice of medicine (the hospital has 84 doctors on its staff, many of them specialists . . . and adequate facilities.)”
Related to adequate facilities, the article noted that a group practice health plan like Permanente could afford the latest medical equipment, which individual, fee-for-service physicians did not have.
Preventive care takes center stage
“The most important provision of the plan . . . is that the first two visits to the hospital are included in the insurance.”
“A spokesman for (Permanente) explained that the hospital was interested in really affording the worker medical security. If the patient had to pay for the first two visits, he would be deterred from using the plan until an ailment became necessarily serious.”
“The hospital’s facilities are open to all groups with no segregation of patients because of creed or color,” the article reported.
Within five years, by 1950, ILWU president Harry Bridges had brought all 6,000 union members working up and down the West Coast into the Permanente Health Plan.
The union’s agreement with Permanente leader Sidney Garfield, MD, included opening a medical facility in San Pedro near Long Beach. Up to that point, the health plan had only one Southern California hospital, which provided care for the workers at the Kaiser Steel Plant in Fontana.
Because Mary has been told that the injection “is going to hurt a little” she is not frightened or surprised.
Rosy cheeks and carefree smiles of health usually can be traced back to timely inoculations, where Permanente babies and youngsters are concerned. As a routine part of the child care program in the Pediatrics Department, inoculations and vaccination are used on regular schedule to produce immunity to a number of common diseases including diphtheria, whooping cough, and tetanus. Shots, as they are familiarly called, are also used in certain cases to modify the effects of mumps, chicken pox, and German measles, while still other, rarer diseases can be guarded against by the simple inoculation method.
from Kaiser Permanente’s member newsletter, Planning for Health, 1948
By Lincoln Cushing, Heritage writer
First website for health plan members launched in the 1990s
Today, Kaiser Permanente boasts a robust, member-friendly and sophisticated Web presence. But like all tech-based communication, the health plan’s website started out small and inauspicious.
You don’t have to go very far back to find the kernel of this medium, the first “Home Page” for the provider’s regional operations across the country. In stages, Kaiser Permanente’s online interaction with members has matured and become integral to patient care.
The first Kaiser Permanente website debuted only 17 years ago, in February 1996.
www.kponline.org was the health plan’s program-wide presence on the World Wide Web, providing a URL for Kaiser Permanente staff to link to and communicate with its members.
The site featured health information and self-care tips, media information, resources on occupational health and injury prevention, answers to frequently asked questions, and Kaiser Permanente facility locations and contact information.
Technology predictions ring true
In its early iteration, KPonline featured articles that were exuberant about the potential for this new medium. An Interactive Technology Task Force final report from November 1995 noted:
“The ATM-based revolution in banking is a hint of the changes to come . . . perhaps the most profound changes will take place when the ‘information superhighway’ reaches into millions of homes throughout the country, giving people access to information in the form of text, voice, graphics, and video on virtually any subject imaginable.”
The Web was not the first investment Kaiser Permanente had made in networked information technology. The health plan anticipated the ability to electronically transfer medical data and speed up internal communications.
Microwave stations pave the way
In the early 1980s, Kaiser Permanente began building a powerful infrastructure of microwave stations in the San Francisco Bay Area.
Known as the Kaiser Permanente Digital Transmission System, the network sought to free the health plan from dependence on the private utility companies that had heretofore supplied its telephone and computer lines.
By 1988 Kaiser Permanente had completed a private regional telecommunications network, ranging from Santa Teresa in the southern Bay Area to Santa Rosa north of the bay and extending to Roseville, east of Sacramento.
The system was managed from a control center at 1950 Franklin Street in Oakland. Cost was a driving force in the project; analysts projected a savings of $15 million over the first 10 years of operation.
This network prepared the health plan for the enormous potential uses of high-bandwidth communications. Jim Harvey, manager of the system, explained in a 1988 internal newsletter:
“Despite the distance between facilities and personnel in our Northern California Region, this system will enable us to come together quickly to discuss issues and answer questions that used to take months of time and miles of travel to resolve.”
Health plan earns honors for tech advances
The commitment to technology has continued at Kaiser Permanente, which today is a global model for medical communications technology.
Examples abound: Just last year Kaiser Permanente received six eHealthcare Leadership Awards for its commitment to using online and mobile technologies to support its mission of total health through patient engagement.
Today, more than 4.2 million members use My Health Manager on kp.org, Kaiser Permanente’s personal health record program.
The feature allows mobile device users to access most test results, email their doctors, make appointments, and order prescription refills for delivery by mail.
Enhanced patient-provider communication, facilitated by My Health Manager, has helped Kaiser Permanente to improve its quality of care ratings, research shows. Secure email in particular has resulted in better management of chronic diseases.
The results of the Kaiser Permanente 2010 study were published in Health Affairs, July 2010.