Archive for the ‘Latest Blog posts’ Category

Historic Kaiser Permanente Artifact Donated to Smithsonian Institution

posted on December 14, 2017

Lincoln Cushing
Heritage writer

 

Multiphasic artifacts held by Diane Wendt; left, Dr. Sewell; right, Dr. Isaacs, and Dr. Ellison.

The clinking of glasses and din of conversation halted when the white-gloved archivists entered the room at the Smithsonian’s National Museum of American History.

Securely bedded on their cart was that evening’s crown jewel, a small, open-faced wooden box. Stuffed with the distinctive punch cards used in mainframe computers, this artifact represented the essence of Permanente Medicine – the sweat of laborers getting their first health examination, the fusion of physician practices with modern electronic systems, and the efficiencies of a medical plan that proudly served a nation in crisis during World War II.

Historians from each of the Permanente Medical Groups arrive at the National Museum of American History.

This box and questionnaire cards were key elements of the Kaiser Permanente Automated Multiphasic Examinations.

Diane Wendt, Deputy Chair and Associate Curator of the Division of Medicine and Science, described the donation as “A humble but important object” in the history of American medicine when it was officially turned over at a Permanente Executive Leadership Summit event on Oct. 9, 2017.

The questionnaire cards represented an evolution of a battery of tests originally developed to handle the large influx of longshore workers that came into the health plan in the 1950s. In 1961, the U.S. Public Health Service awarded the Kaiser Foundation Research Institute a grant to study the automation of the multiphasic health testing it had already been conducting manually for 10 years. Members would now go through the screening stations with computer cards that got marked along the way.  At the end of the session, which took a couple of hours, there would now be a computerized medical record of their current health status.

Francis J. (Jay) Crosson, MD (founding executive director of The Permanente Federation) and Richard G. Rajaratnam, MD, explain display items.

Pauline Fox, Esq. (Executive Vice President and Chief Legal Officer, The Permanente Federation, LLC; Interim General Counsel, Colorado Permanente) and Kaiser Permanente historian Lincoln Cushing hamming it up with founding physician Dr. Sidney Garfield.

Those records helped create fundamental medical information. A major medical news story splashed across the world in 2016: “Historic Kaiser Permanente Data to Aid in Long-Term Study to Determine Extent of Ethnic Disparities in Brain Health and Dementia; new $13 million study funded by National Institute on Aging will revisit patients who were first screened as long as 50 years ago.” Yes, that deep data was compiled as part of the Automated Multiphasic examinations, showing the persistent value of that program.

Representing The Permanente Federation at the formal signing of the deed of gift were Geoffrey S. Sewell, MD, FACP (President and Executive Medical Director, Hawaii Permanente Medical Group, Inc.; Chairman, National Permanente Executive Committee, The Permanente Federation, LLC), Richard S. Isaacs, MD (Executive Director and CEO, The Permanente Medical Group; President and CEO, Mid-Atlantic Permanente Medical Group; Co-CEO, The Permanente Federation, LLC), and Edward M. Ellison, MD (Executive Medical Director/Chairman of the Board, Southern California Permanente Medical Group; Chairman of the Board and CEO, The Southeast Permanente Medical Group; Co-CEO, The Permanente Federation, LLC).

 

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A Car by Any Other Name

posted on December 6, 2017

Lincoln Cushing
Heritage writer

 

Henry J. Kaiser with early model “Henry J” car before it was named – badge on hood says “Name The Car.” 2/29/1950.

What’s in a name? For Cordelia Maxwell Bell, that was a $5,200,000 question.

The Berkeley, Calif., widow, who held 200 shares in the automobile company started by Henry J. Kaiser after World War II, sued the company for that tidy sum in a complaint over how it named its entry-level car.

The hefty lawsuit contrasted with the low price of the controversial new car, dubbed the “Henry J,” which promised to be a first-time new automobile for millions of Americans hungry for wheels after World War II.

“The name is so ridiculous that it can be justified on no other ground than to satisfy a deep ingrained meglomanic [sic] desire for personal publicity,” read Mrs. Bell’s complaint, which went on to disparage the well-publicized naming contest that had resulted in the moniker.

The public first heard about the naming contest in early November 1949, when full-page ads appeared in newspapers across the country. With pointing-hand dingbats and boldface type befitting the result of a presidential election, the homely ads bellowed:

The Kaiser-Frazer $200,000 Walter Winchell “Name the Car” Contest! Just name the new low-priced car in the low price field!

Kaiser-Frazer “Name the car” newspaper contest ad 11/7/1949

The contest promised a first prize of $10,000, plus a matching donation to the Damon Runyon Memorial Cancer Fund, named after an American newspaperman and author who had died of throat cancer in 1946. A prototype of the car featured a name badge that said — what else? — “Name The Car.”

Jack Mulller, historian for the Kaiser-Frazer Owners Club, International, explains the business reason behind the contest:

The Kaiser-Frazer management fully and honestly expected 1950 would be a profitable one for the company.  The contest was aimed at showing the public Kaiser-Frazer was not a failure and that it had the product that Americans wanted (at least according to surveys). By getting contest entrants into Kaiser-Frazer dealer showrooms, the dealers had a shot at perhaps making a sale of the moribund 1949 and 1950 model year products.

The car was first shown to the public at the February 1950 Chicago Automobile Show, identified only as “The Red Car,” but not for long. The first American car to be christened by the public was announced May 13, 1950. The naming contest winner was Frances Atkinson, the wife of a Denver university student.

The top 29 winners all proposed the same “Henry J” name, but only 10 got $500 checks because their submitted explanations were so compelling. Mrs. Atkinson had written that, to America’s millions, the name symbolizes “vision, courage, democracy at work.”

More than 1,000 people shared cash prizes, and almost $80,000 went to the cancer fund. Newspaper accounts quoted Mrs. Atkinson’s response to receiving the check at the award ceremony:

“I didn’t believe it ’til I felt it. Look at the zeroes on it! Like the wheels on a train.”

But Mrs. Bell didn’t believe it either and proceeded to sue for lots of zeroes. A May 16, 1950, newspaper article further explained:

Mrs. Bell doesn’t care for the name. She says in her complaint the $200,000 spent to get the name was “stupidly squandered” and she wants the money returned to the corporation. The $5,000,000 is to reimburse the corporation for the damage caused by the selection of “the wholly unfitting, improper and ridiculous name.”

Henry J newspaper ad, 9/29/1950

The suit sought to restrain officers and directors of the Kaiser-Frazer Corporation from adopting the “Henry J” name. It complained further that “the said name is well calculated to make it the butt of many jokes; that it is to be expected that radio comedians, cartoonists, and columnists will forthwith begin lampooning the said automobile.”

The litany of gripes continued, including that “… said name is so ridiculous that its adoption leads to tremendous ill will among the other contestants who obviously submitted better names, and that its adoption necessarily leads to the inference among the other contestants and plaintiff that it was no contest at all; that the name had been decided on before the contest started.”

Naming hubris or not, such things happen. The Ford Motor Company’s new 1957 model was named “Edsel” in honor of the founder’s son, Edsel B. Ford.

There’s no record of what happened with the lawsuit, but despite its claims, the car came out of the gate as a marketing success, and around 82,000 were produced in its first year. When the Henry J rolled out to the public in the fall of 1950, it represented the fruition of Henry Kaiser’s dreams. A September 29 newspaper article reported:

…It is the car that Henry J. Kaiser, board chairman, envisioned when Kaiser-Frazer was formed in 1945. Developed on the basis of postwar engineering advances, the Henry J models profited from prior years of experimentation with 50 prototypes built under Mr. Kaiser’s personal direction.

Kaiser said: “We have achieved such an automobile with new standards of value, economy, performance and appearance. Presenting this car is the realization of the proudest ambition of my life.”

Chalk up a win for the American public.

Photo of driver Rocky Fisher leaping his Henry J over the “man-killing ramp” at the 87th Street Stadium in Chicago, from pictorial souvenir booklet “Aut Swenson Thrillcade: World Champion Auto Devils,” 1953.

The Henry J was the lowest-priced new car on the market. In 1946, Henry J. Kaiser had borrowed $44 million from the Reconstruction Finance Corporation; one of the terms of the loan was that Kaiser-Frazer would produce an affordable car with a price tag of less than $1,300.

Unexpectedly, the spartan Henry J would become a favorite of car customizers because of its low resale value, lightweight, rugged chassis, and relatively roomy engine compartment. In the end, the car was not competitive in the American market, and production slowed. Manufacturing stopped in 1954 after 1,000 cars had been sold, and total output was 124,871.

Even though ultimately unsuccessful in the automobile industry, Henry J. Kaiser had left his mark in producing a car for the people.


Henry Kaiser and his sons talk about the new Henry J in 1950 film clip. 

 

 

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Clearing the Smoke at Kaiser Permanente

posted on November 20, 2017

Lincoln Cushing
Heritage writer

 

“Once you made it inconvenient, I finally took steps to quit.”
– Former smoker, employee at Kaiser Permanente, 1980s.

Medical professional at Kaiser Permanente smoking a pipe and inspecting an X-ray, circa 1960

It wasn’t that long ago that cigarettes were an accepted part of the cultural landscape. It’s well-known that tobacco companies used to promote endorsements from physicians (although none from Permanente Medical Group doctors), and smoking in hospitals was typical, Kaiser Permanente facilities included.

A 1960s brochure from the Kaiser Permanente hospital in Fontana, Calif., cautioned patients that “Bedding can burn. Be careful with cigarettes and matches.” Staff housekeepers in many offices complained that one of their most common problems was fires in waste cans, because people would dump cigarette butts that weren’t completely put out. As medical evidence about tobacco’s harm piled up, however, it became clear that the smoking habit should not be part of the environment in health care facilities.

Kaiser Permanente first drove smoking out of its facilities in the 1980s. At first, the offices were smoke-free, then whole buildings. On January 1, 1987, a no-smoking policy went into effect in all Kaiser Permanente facilities throughout the Northwest Region. But people still went outside to smoke.

Anxious prospective fathers’ ashtray, “Dream Hospital” newsreel, 1953

California passed AB-13 prohibiting smoking in places of employment in 1997. On January 1, 2000, Southern California Kaiser Permanente banned smoking anywhere on campus property (including outdoor areas like parking lots, which were not included in prior local or state laws) making it the first major health care organization in the country to adopt such a sweeping policy.

There’s good evidence that the harder you make it for people to smoke, the more likely they are to quit.

One example comes from a Kaiser Permanente office building in the Portland area in the mid-1980s. A designated smoking shelter had been set up outside of an office building to keep smokers out the rain. But to make a point, a large crane was brought in and removed the structure for a photo opportunity. They unbolted it and lifted it off, a clear message that a haven for smokers was really gone, and they were not going to be able to light up there any longer.

Kaiser Permanente Fontana hospital patient caution regarding smoking in hospital room, circa 1960

Grudgingly, the smokers moved out to the curbs. One employee commented, “You know, I might have still been smoking, but once you made it inconvenient, I finally took steps to quit. What am I doing walking out in the rain to do this, this is ridiculous.”

Current practices to discourage smoking, beyond signage, include features at facilities that encourage healthy activities such as walking paths and outdoor exercise stations.

Now, smoking cessation has new targets – for example, dealing with e-cigarettes and vaping – but the goal remains the same.  E.W. Emanuel, MD, of Mid-Atlantic Permanente Medical Group, sums it up well in his March 2017 blog that these new vehicles for tobacco delivery are still considered harmful to adolescents’ health. E-cigarettes contain nicotine and other potentially toxic chemicals, and teens who use them may be more likely to start smoking tobacco. Kaiser Permanente offers advice and programs for those wishing to break the tobacco habit.

 

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Patriot in Pinstripes: Honoring Veterans, Homefront, and Peace

posted on November 7, 2017

Lincoln Cushing
Heritage writer

 

Henry J. Kaiser speaking at Navy ship dedication, Northwest shipyards, circa 1943.

During World War II, Henry J. Kaiser was a major producer of America’s “arsenal of democracy.” The Kaiser Richmond shipyards launched 747 ships; the yards in the Portland, Ore., area produced 743. Kaiser built cargo ships, tankers, fighting ships, and airplanes. Biographer Mark S. Foster dubbed him a “patriot in pinstripes.”

But Kaiser was no hawk. His eye was always on the human impact of the war, and his vision was focused on postwar reconstruction. He expressed these themes in a speech he gave in December, 1943:

Ironical as it must appear, the war has taught us to employ our vast resources and to multiply them a million-fold by power and the machine. The war has taught us how to train men and women quickly for new trades so that the labor, which is displaced by the machine can be quickly adapted to new techniques. In the dread circumstances of war, we have brought employment to the peak, and efficiency to an all-time high…[but] If we rebuild a world of monopoly and special privilege, we will taste a defeat as bitter as a victory for the Axis powers.

His employment record of 190,000 home front workers was unequalled, embracing the most diverse workforce to date in American history. While it’s true that as the war progressed, Kaiser had no choice but to hire workers beyond the standard industrial pool, he also did so without hesitation. He’d managed a diverse workforce in his construction business (such as while roadbuilding in Cuba in the 1920s) and learned how to adjust the work process to fit those who were doing it. His personal philosophy was to encourage the full development of all people.

Real Heroes comic, published by The Parents Magazine Press, 1943. Henry Kaiser is honored, along with Admiral William “Bull” Halsey and General Brehon Somervell.

He pushed back as much as he could against the unions that resisted change (most notoriously, the shipyard Boilermakers Union initially refused to hire women and blacks as equals to white workers), and went to great lengths to “accommodate” the needs of the new workforce – child care centers, special medical education programs, ability-based job placement, affordable health care – all things that he believed were of value to the postwar society as well.

He was the patron sponsor of the integrated service organization for merchant mariners, who operated his ships and suffered terribly during the war.

As Allied victory began to appear certain, he redoubled his plans for the next phase of history. His October 17, 1944, speech “Jobs for All” in New York eloquently described his views:

On this one fact, there is unanimous agreement: every man in the American Forces has the right to come home not only to a job, but to peace. Anything less would be a denial of the true American way of life. Peace means so much more than a cessation of hostilities! Peace is a state of mind. It is based on the sense of security…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.

Let us be inspired by Henry Kaiser and honor our veterans, honor our home front workers, honor peace.

 

Short link to this article: http://k-p.li/2j78zfH

 

 

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An Experiment Named Fabiola: Health Care Takes Root in Oakland

posted on October 12, 2017

 

Lincoln Cushing
Heritage writer

 

“Fabiola Ends Experiment in ‘Feminism’” -Oakland Tribune, October 16, 1932.

Original Fabiola Hospital and staff, circa 1924, from collection donated by nurse Helen Dahl Collier.

This was the provocative headline for a story about the closing of the Fabiola hospital, originally named for the Roman nurse and matron who founded the world’s first hospital in the fourth century. Henry J. Kaiser would assure funding for the purchase and refurbishing of this building in 1942 (but we’ll get to that later).

The author of the Oakland Tribune story was Nancy Barr Mavity, a well-known crime writer and journalist. She described how the institution was founded by eighteen women in 1876 with provisions that management “must always be in the hands of a woman” and that “every staff doctor must also be a woman“ — provisions which were revolutionary in their day and had been maintained unbroken for 56 years.

Mavity continued:

Photocollage of new Fabiola maternity hospital and Association women, Oakland Tribune, 1923.

“These pioneer women foresaw the need – now one of the most-discussed social problems of medical men and laity – of providing adequate hospital care for those of limited means who were yet not eligible in admittance to the county hospital. With this end in view, it has carried on its work of providing free and reduced-rate care for those who need it, supported by voluntary contributions and by those patients able to pay in full.”

The model of care crafted by the women of the Oakland Homeopathic Hospital and Dispensary Association forecast modern methods and theories long before they became generally accepted. They established the first training school for nurses in the East Bay in 1887; the first district nurse in Oakland, in 1895; the first children’s hospital, the first kitchen under the charge of a trained dietitian; the first ambulance service, contributed by Mrs. J. R. Folger; and the first health insurance program, founded in the 1890s by the mother of Mrs. J.P.H. Dunn (Fabiola Hospital Association’s president for 16 years) as the Fabiola Health Mutual.

Fabiola Hospital, before Permanente purchase and initial remodel, early 1942.

In 1886, Oakland water systems entrepreneur Anthony Chabot donated the broad field at Broadway and Moss Avenue for building the Fabiola Hospital. The expansive turreted facility burned down in 1900 and was replaced with a surgical building (1907) and a 50-bed maternity hospital (1923) at the corner of Moss Avenue and Broadway. Moss was renamed MacArthur Boulevard in 1950.

The hospital that would become the first Permanente (now called Kaiser Permanente) Hospital.

Vacant and unused, the facility had been donated to Merritt Hospital when Fabiola closed its doors in 1933. Henry J. Kaiser personally guaranteed the $350,000 bank loan needed to purchase and refurbish the hospital. While it was being remodeled, Dr. Sidney Garfield contracted for 20 beds at Merritt Hospital. The revived building was dedicated as the Permanente Hospital on August 21, 1942.

Architectural drawing of expansion at the Permanente Foundation Hospital, 1944

In 1961, the original Fabiola building and the adjacent two-story WWII expansion facilities were given a fresh exterior, and the building was demolished in 2005, replaced with a parking lot and patient drop-off and pickup site.

The Kaiser Permanente Fabiola Medical Office Building at 3801 Howe Street was built in 1993, continuing the proud name in Oakland’s health care. The “experiment” from 1876 that shone a light on the importance of providing affordable health care, by and for women, lives on.

Oakland hospital, 1961; Fabiola building and WWII expansion have been upgraded with new siding.

 

 

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Give Me Liberty – Wartime Ship Launch Honors Immigrants

posted on October 5, 2017

Lincoln Cushing
Heritage writer

 

During World War II, diversity was a media weapon against the Axis forces.

Small scale Statue of Liberty at Richmond shipyard #2, at launching of the last Liberty ship built on the Pacific coast, the SS Benjamin Warner

Our diversity – our “melting pot” of ethnicities, races, religions, and creeds – distinguished us positively from the purity and exceptionalism espoused by our foes. The Office of War Information promoted every instance in which our military and home front work force reflected the rich mosaic that is America, and the Kaiser shipyards offered fertile ground for content.

The Liberty ship Booker T. Washington, built at the California Shipbuilding Corp. at Terminal Island, Los Angeles, and launched in 1942, was the first major U.S. oceangoing vessel to be named after an African-American. Several cargo ships were named after what we now call historically black colleges or universities, but back then were “Negro colleges.” When the SS Tuskegee Victory was launched at Oregon Shipbuilding on May 8, 1945, her invocation (a traditional elements of a ship launching, also known as the Prayer of the Invocation) was offered by Father Thomas Tobin, pastor of All Saints church, “who has championed the interests of minority groups all his life.”

The second ship named after an African American was the SS George Washington Carver, built in the Kaiser Richmond shipyards.  She was the first Kaiser-built Liberty ship to be named for a famous African American, and many of the men and women who built her were African Americans.

The SS Pendleton was the 49th “T2” model tanker built at the Kaiser Swan Island shipyard, on the Willamette River in Portland, Ore.; her launching at the beginning of 1944 honored the role of Native Americans in the military and the home front.

Admiral Vickery (Vice-Chairman of the U.S, Maritime Commission) at launching of the SS Benjamin Warner, from Fore ‘n’ Aft, 7/14/1944.

Six Liberty ships were named for labor leaders, many of whom were European immigrants. And seven other Liberty ships launched in 1944 were named for Jewish American labor leaders, doubly sticking it to Hitler’s doomed Reich.

The launching of the SS Benjamin Warner on the 4th of July weekend, 1944, honored an immigrant, and the event was decorated with a giant replica Statue of Liberty. America’s film industry became a testament to the Allied moral high ground, as a place where even Polish Jewish immigrants could rise to fame and fortune.

The Warner was named after the father of Hollywood’s Warner brothers. Henry J. Kaiser, himself the child of immigrants, proclaimed “Benjamin Warner was a plain man, unknown and unsung until he entered the new world of hope and opportunity which he found in America.”

She was the 1,147th ship of this class built in the Kaiser shipyards and launched on the West Coast—and the last. A few Liberties are still being finished at East Coast yards. The Liberty class was being replaced by the larger and faster Victory class ships, and the Kaiser shipyards were already building them. A reporter for Time magazine described the event as “the melancholy end of a shipbuilding era.”

Benjamin Warner’s sons, Hollywood motion picture producers Harry M. and Colonel Jack Warner, were present at the ceremonies. The craft was sponsored at the launching by Miss Lita B. Warner, 19-year-old granddaughter, a Stanford University student.

Rabbi Rudolph I. Coffee conducted the Warner’s invocation. Between 1921 and 1933, Coffee had been the rabbi at the oldest Jewish congregation in the East Bay, Temple Sinai, at 28th and Webster streets in Oakland. After that he became the chaplain at San Quentin Prison until he retired in 1954. Rabbi Coffee had been selected for this honor because he’d performed wedding ceremonies for Harry Warner and his third brother, Albert.

A 13-foot-tall replica of the Statue of Liberty was unveiled as a gift from Warners to the builders. The fate of this replica is unknown.

Yes, send us your huddled masses yearning to be free. Modern diversity messaging favors the “salad bowl” concept rather than the “melting pot” (mixing together yet retaining individuality) but the concept is the same – In addition to making us stronger, diversity and inclusion enable us to achieve the vision our founders had when they started it all.

 

A short news film by Paramount Pictures of the launching can be seen here.

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Harbor City Hospital – Beachhead for Labor Health Care

posted on September 29, 2017

Lincoln Cushing
Heritage writer

 

Painting of proposed Harbor City hospital, circa 1955

When the Permanente Health Plan was made available to West Coast members of the International Longshore and Warehouse Union in 1950, it was a classic example of “be careful what you wish for.”

The Permanente plan, robustly serving workers and families for Henry J. Kaiser’s home front industries, expanded to the public on July 21, 1945, less than a month before the end of World War II. It was a heady and challenging period, and labor unions were to become major group members of the postwar Permanente. Why? Because, for the first time, unions could negotiate health coverage.

The key legal ruling was the 1948 decision by the Seventh Circuit United States Court of Appeals in the case of Inland Steel Company vs the National Labor Relations Board. This precedent affirmed the legal obligation of employers in unionized companies to include health and welfare benefits as part of labor negotiations.

Harbor City Hospital under construction, 1959

In 1950 The International Longshoremen and Warehouse Union and the Pacific Maritime Association requested the Permanente Health Plan provide care for all 22,500 of their workers up and down the West Coast; The ILWU became the first major group enrolled in the Health Plan.

At the insistence of ILWU leader Harry Bridges, Permanente was the only choice for the union members. This exclusivity violated Permanente policy that membership should be voluntary, which understandably caused some dissatisfaction with ILWU members. It wasn’t until 1954 that ILWU members were offered a choice of a second plan after Permanente consultant and economist Avram Yedidia convinced Bridges of the importance of dual choice; only 10 percent would leave Permanente.

But there was a problem with capacity. Bridges brought in thousands of new members to a plan that was recovering from a postwar slump and had limited facilities.

For the major ports of Oakland and San Francisco, where the Permanente hospital and clinics were already established, that wasn’t a problem. Looking north, ILWU members in Seattle got care through an agreement with the Group Health Cooperative of Puget Sound and other providers while Portland-Vancouver union members were served by Northern Permanente. Southern California would involve an estimated membership of more than 11,000 longshoremen, but the only Permanente hospital was at the Fontana Steel Mill, 60 miles from the ocean. Not exactly longshore territory.

First LA South Bay clinic, 599 W. Ninth St. (and Grand Ave.).

Bridges wanted a Permanente facility in the San Pedro harbor area where there was a high concentration of members. His promise convinced Permanente that this is the time and the place to expand. Enter the Harbor City Hospital, proud pioneer of the Los Angeles South Bay service area.

Temporary facilities began immediately. A history compiled for the 60th anniversary of the South Bay area described the first San Pedro clinic:

Dr. Ray Kay (founder of the Southern California Permanente Medical Group) and Medical Director Dr. Ira “Buck” Wallin found a working clinic at 599 W. Ninth St. (and Grand Avenue) already occupied by doctors who were, at first, willing to share space. They even agreed to help take care of the longshoremen after hours. That arrangement was short-lived, however. Spooked by the economic threat posed by group practice, the doctors in the community gave the cold shoulder to Wallin’s staff and anyone who associated with them professionally or socially. The three fee-for-service doctors with offices in the shared clinic buckled under the pressure and vacated the premises.

Permanente promised the ILWU that they would build a new hospital in the Wilmington-San Pedro area, but progress was slow. The new Kaiser Foundation Hospital in downtown Los Angeles broke ground in late 1951, and drew institutional resources away from the Harbor City facility.

Aerial photo with lot boundary marked, Harbor City Medical Center, 1100 West Pacific Coast Highway, circa 1957

Things came to a head when 5,000 cannery workers in the San Pedro area signed up with the Permanente plan at the end of 1953. The workers’ employers had wanted them to sign up with the California Physicians’ Service, a competing prepaid plan offered through the California Medical Association. This was during the period where the medical establishment disapproved of Permanente physicians, who were barred from facilities such as San Pedro Community Hospital. The ILWU had been waiting more than two years for their promised hospital, and were getting cranky.

1953 was also the year the scrappy Permanente clinic in Pittsburg, Calif., opened to serve the labor unions and local community.

By early 1955 a site had been purchased, a complex deal involving three parcels, each held by different owners. Clarence Mayhew, the most prominent architect of Kaiser Foundation hospitals, drew up plans for a bold and innovative 66-bed hospital. It featured “vast amounts of glass,” separate corridors for staff and the public, and the famous “baby-in-a-drawer.” The groundbreaking ceremony November 4, 1955, included elected officials, leaders of the ILWU, and the PMA.

On January 14, 1957, the Kaiser Foundation Hospital in Harbor City at 1100 West Pacific Coast Highway, opened. It was hectic. At a 30-year celebration, Medical Administrator Pat Crowe reminisced “The day before we opened, carpenters were still making last-minute changes and final clean-up was not yet complete. Eighteen patients were admitted that afternoon and evening.” One of them was about to deliver her second child. At 1:54 a.m. on January 15 she gave birth to a healthy baby girl.

Aerial photo, Harbor City Medical Center, 1100 West Pacific Coast Highway, expansion construction, circa 1975

The ILWU Dispatcher newspaper of February 15 added this under “Local 13 Man Launches New Harbor Hospital”: First patient in the new $1,000,000 Kaiser Foundation Harbor Hospital was ILWU Local 13 member Oscar Roberts, covered through the ILWU-PMA Welfare Program.

As with all the Permanente facilities, demand always pushed capacity. Sixteen beds were added in late 1958, and a two-story clinic at 1050 West Pacific Coast Highway was built in 1959. Additional expansion happened in 1964, bringing bed capacity up to 121. 1969 saw further clinic expansion. A serious fire destroyed a section of the adjacent Parkview Medical Office Building in 1973.

Harbor City Hospital, ER nurses’s station, 1966

Harry Shragg, MD, served at Harbor City from 1957 until 1968 as a surgeon, chief of the Department of Surgery, administrator of a community health care program for indigents, and medical director. In his oral history he recounted an epiphanic moment about Permanente medicine:

I was on call in the hospital one evening, and a black girl from Compton ─ which is a lower socio-economic level area ─ came into the emergency room with abdominal pain. I think she was sixteen years old. And she was seen by a board-certified pediatrician, examined by a board-certified gynecologist, and examined by me, a board-certified surgeon. We took her to the operating room ─ she had appendicitis ─ and we operated on her. And the whole sequence of that one episode, to my mind, crystalized the merits, and the value, and the philosophy of this kind of practice, where the issue of whether one could afford it or not never arose… She was just a sick person who came in and needed help, and we just gave her what I thought was outstanding quality care… That was, to me, a very dramatic and very memorable occurrence, and I think that’s what it’s all about.

 

Service to working communities. Yes, that’s what it’s all about.

 

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Upstart Health Plans Vs. the Medical Establishment in the 1950s

posted on September 14, 2017

Lincoln Cushing
Heritage writer

 

Part 2 of 2: The Permanente Health Plan responds to legal charges by the medical establishment and the similar experiences of Group Health (originally called Group Health Cooperative of Puget Sound) in Washington state. In 2017, Kaiser Permanente acquired Group Health, making Kaiser Permanente Washington our newest region, the first in over 30 years.

During the late 1940s the medical establishment tried mightily to eliminate health plans that it saw as competition. As we saw in part 1 of this article, two of the biggest targets were the Permanente Health Plan (Kaiser Permanente) and Group Health.

Henry Kaiser speaking in New Orleans, 1957.

 

Henry J. Kaiser takes the high road

During these challenges with the medical establishment, Henry J. Kaiser consistently took the high road. When he spoke to a group of physicians in San Francisco on June 9, 1948, he let them know he was “… astounded and horrified to be informed by our attorneys that a group of Alameda County doctors have declared war on the Permanente health program.” He outlined his many legal options, but then offered a more cooperative path because “… we must be sobered at thinking what an all-out fight on the issue of more medical care for more people could mean.” He sought an amicable solution:

I want to believe that tonight is the beginning of a real conscientious effort on the part of everyone here to strive to fulfill the common objectives not only for group medicine, if it be lower in cost, but for that type of medicine which so many want, called private medicine, although it is higher in cost … until the earning power of the nation is greater, all the people cannot participate in private medicine.

His appeal to civility fell on deaf ears. Rather than accept the olive branch, fee-for-service practitioners rolled up their sleeves to knock out the competition.

A legendary event etched into Kaiser Permanente history was the 1953 competition for plan sign-up by 4,000 United Steel Workers of America members in Pittsburg, Calif. Local private practice physicians mounted an all-out campaign, which included provocative leaflets, newspaper ads, billboards, and even a sound truck. On September 3, 1953, the union members voted overwhelmingly for the Kaiser Foundation Health Plan.

Henry J. Kaiser defends Dr. Sidney Garfield, 10/26/1947.

That December, delegates at the annual California Medical Association meeting tried the carrot rather than the stick approach by announcing a pilot prepaid plan to compete with Kaiser Foundation Health Plan. They offered the 9,000 members of the International Association of Machinists at Santa Monica’s Douglas Aircraft plant “free choice of physician and hospital to its subscribers” through the California Physician’s Service. The CMA had established the CPS in 1939 as statewide prepaid medical care organization.

The proposed plan would cover hospitalization and surgical care for all workers earning below a certain salary threshold, charging more for those earning above it. (Newspaper coverage noted that the Kaiser plan had no income ceiling provision.)

Private practice physicians were on the ropes. Dr. Francis Rochex of San Francisco was quoted as saying “Organized medicine has lacked vision in anticipating the extent of penetration of political and socialized pressure groups.” But measures to develop a comprehensive alternative stumbled; CMA delegates were unable to agree on a plan which would cover both prepaid medical care and still observe “the doctors’ traditional independence and maintain professional standards.”

By 1960 the “Long Beach Physicians Health Plan” through CPS had been adopted for all Douglas aircraft workers throughout the world, and Long Beach city employees and school district employees came under the plan in 1959. On its own terms it was successful; the Long Beach Independent bragged that it was “the only plan that has had wide acceptance by so large a number of the people who are seeking a workable medical insurance plan under the free enterprise system.”

 

Group Health Cooperative wins ruling against local medical establishment, 11/16/1951.

The experiences of Group Health

A letter to editor in the Port Angeles Evening News April 16, 1965, presented the story from a proud member’s perspective:

As a member of the Group Health Cooperative of Puget Sound during the Forties, I well remember the efforts of the AMA to put Group Health out of business. Methods used included, denial of membership in local medical societies to Group Health doctors, denial of hospital privileges to Group Health doctors and their patients, and plenty of good old fashioned slander. Needless to say, as a true cooperative, the services of Group Health physicians were not being ‘sold at a substantial profit by a third party.’ Convicted of criminal conspiracy under the antitrust laws, the AMA fought the case to the U. S. Supreme Court — and lost.

The landmark legal decision in this fight was Washington Supreme Court case of Group Health Cooperative of Puget Sound et al., Appellants, v. King County Medical Society et al., November 15, 1951. Group Health fought back after it experienced “unfair and illegal fetters placed upon its service and growth.” In November 1949, it brought this suit asking for an injunction and damages.

An Associated Press news item in the Walla Walla (Washington) Union-Bulletin, November 16, 1951, “Court Ruling Hailed”:

Group Health Cooperative of Puget Sound Friday hailed as a “victory for free enterprise” a state Supreme Court ruling that King County Medical society policies toward the co-op violated the anti-monopoly law.

The Washington Supreme Court ordered the King County Medical Society to stop boycotting Group Health Cooperative. Organized medicine was indicted for violating the Sherman Antitrust Act in its efforts to suppress Group Health. Eventually, both plans established a more collegial relationship with their private practice peers. One of the founding Permanente physicians, Dr. Cecil Cutting, explained:

… the American Medical Association set up a committee to study provision of medicine in the country. They came out and examined us and gave a report that we were providing as good or better medical care as in the community. That sort of set them back a ways and now, we are fully accepted and I think in many times envied because of the practice, the coherence, the fundamentals of our group practice pre-payment that has tested the time and I think proved an excellent way of practicing medicine.

Dialogue about the “best” form of health care remains a vibrant topic of national conversation. Physicians, staff, and resources of the now-joined pioneering health care organizations Kaiser Permanente and Group Health are leading the conversation.

 

Part 1 of this article
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Lights, Camera, Action: Kaiser Shipyards Play a Starring Role

posted on September 6, 2017

Lincoln Cushing
Heritage writer

 

“Man from Frisco” movie poster, 11×14″, 1944.

“Action!”

When Hollywood descended on the sprawling, bustling Kaiser Richmond shipyards during World War II it was sure to cause a buzz. Beside the standard patriotic Home Front promotion films of shipbuilding, such as the classic documentary “We Build Tankers,” the entertainment industry also tapped into the natural energy of the yards for two major motion pictures.

The first was “Man from Frisco.” It was based on the script “Man from Brooklyn,” written by George Carleton Brown and directed by Robert Florey (1900-1979). Brown would later write screenplays for the 1960s TV comedy series McHale’s Navy.

The second major wartime film shot in the Kaiser shipyards was “Since You Went Away,” released June 1944. It was written and directed by David O. Selznick and starred Jennifer Jones, Claudette Colbert, Joseph Cotton, Shirley Temple, and Lionel Barrymore.

Stills from “Man from Frisco” in Fore ‘n’ Aft, 5/19/1944.

“Man from Frisco” was a fictional story based on the iconic industrialist Henry J. Kaiser, named Matt Braddock in the film and played by actor Michael O’Shea. Other leading roles were played by Gene Lockhart, Dan Duryea, and Anne Shirley.

The plot involved upstart Kaiser and his innovative shipbuilding practices locking horns with a veteran local competitor. The first clues of the film surfaced December 7, 1942, when Republic Studios announced their most ambitious motion picture, initially titled “Victory Fleet.” News accounts noted that “It is with ships, and more ships, that Uncle Sam will avenge the Japanese sneak on our fleet at Pearl Harbor. Certainly, no man stands out in our defense effort more colorfully than Kaiser, who believes in getting ships out first and talking about it later.”

Alas, the film did not do well with many critics. The New York Times reviewer Bosley Crowther sniffed “…Some of the shipyard scenes are vibrant, and the documentation of building is good. But you can’t expect much from a picture that is so obviously propped up on clichés.” The Hollywood Reporter reviewer termed the picture “disappointing” due to its “melodramatic Hollywood treatment,” despite it containing “numerous absorbing shots of the great shipyards at Richmond, Calif., and along the line a fund of extremely interesting information is given concerning the high-speed operation and how they evolved.”

Photos of filming of “Man from Frisco” in Fore’n’Aft, 11/19/1943.

Some reviews were more positive, focusing on the patriotic message of home front workers:

There are thousands of “extras” in Republic’s dramatic new picture who receive no screen credit. These “extras” are the Americans who are employees of a shipyard in Richmond, where much of the background material for the screen plays was filmed. Those men and women are the people about whom the story is concerned. Working twenty-four hours each day, they keep American ships sliding down the ways to the sea to take food, men, and equipment to the battlefronts of the war.

Filming in the Richmond shipyards (and nearby Point Richmond) caused quite a buzz. The weekly Kaiser shipyard newspaper Fore ‘n’ Aft wrote about it November 19, 1943, with photos [above, right]:

Republic’s Director Robert Florey points the camera at a bit of Yard One. The film -“Man from Frisco” – is about the guy who brings prefabrication to shipbuilding. Naturally, you’ll want to see it. Paramount gets Yard One’s main drag and home-bound workers. So, you’re in pictures!

When it opened May 18, 1944, in Oakland, Richmond, and San Francisco, Fore ‘n’ Aft carried this commentary:

If this is the way we look to Hollywood – and it apparently is, since Stephanie Bachelor ploys a woman shipbuilder in Republic Pictures’ “Man from Frisco” – then all we can say is, “Gosh!” Background shots for this movie of the life and loves of a shipbuilding executive were obtained in our own yards. That dazed look in Stephanie’s eyes is the result of not wearing flash goggles.

“Man from Frisco” got a rousing revival in the summer of 2010 when it was shown at the recently refurbished S.S. Red Oak Victory ship at Kaiser Richmond shipyard #3 with historical context provided by Kaiser Permanente Heritage Resources consultant Steve Gilford.

Film stars Jennifer Jones and Anita Colby in the Kaiser Richmond shipyard, in Fore ‘n’ Aft, 8/9/1944

In ”Since You Went Away,” the shipyards were merely a backdrop to the poignant home front story about a housewife who struggles to care for their two daughters and a pair of lodgers while her husband is off in the war. NYT’s critic Crowther bemoaned its almost 3-hour length and thin plot. But at the 1945 Oscars it won Best Music, Scoring of a Dramatic or Comedy Picture.

Again, Hollywood stars in the shipyards were a welcome bonus during the grueling frenzy of war production. Fore ‘n’ Aft, September 8, 1944, published a photo [right] with the caption:

Wearing a becoming backdrop of 5,000 Yard Three workers, movie star Jennifer Jones visited Richmond last week. Inset, Anita Colby of Selznick Studios, who caused the Big Wind of 1944 hereabouts when she appeared with Jennifer. You know, whistles.

Whistles, indeed!

 

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A More Perfect Union: How Labor Paved Way for Employer-Sponsored Health Care

posted on August 30, 2017

Lincoln Cushing
Heritage writer

 

The factory’s got a good medical plan
And, cousin, I’m a union man.
-Warren Zevon, “The Factory,” 1987

 

“Permanente’s First and Largest Coastwise Group,” Planning for Health, Fall 1951.

For more than 60 years, millions of Americans have gotten health care insurance through their work. Despite employment changes in the American economy, that sort of coverage is still enjoyed by more than half of the non-elderly population. But it wasn’t always that way. The hard work of organized labor was instrumental in making employer-sponsored health coverage a cornerstone of the human services safety net.

Henry J. Kaiser’s workers at the Grand Coulee Dam (1938-1941) enjoyed a well-run prepaid health plan as part of the job, and after the unions insisted, their families were able to join. The same benefits later applied to Kaiser’s 190,000 defense workers during World War II.

But this was an anomaly. Most American workers had nothing remotely close to a nonindustrial health care plan, even in the booming years after the war. That would change in 1948 and 1949 with two key labor law rulings, W. W. Cross & Company, Inc. v. United Steelworkers of America, CIO and Inland Steel Co. v. National Labor Relations Board, which established a precedent for union contracts regarding hospital and surgical benefits for employees and their dependents.

The first case involved the union at Pacific Coast Steel Co., Local 1069, in the San Francisco Bay Area, which selected the Permanente Health Plan (now called Kaiser Permanente) for its members and requested that employers provide payroll deductions for health care. Bethlehem Steel Company (which acquired Pacific Coast Steel in 1930) disputed their right to make such a decision. The union brought the issue to court, and won.

Permanente pediatric clinic at 515 Market St, San Francisco – nurse giving Patricia Nisby, daughter of ILWU Local 10 member Wiley Nisby, a shot. ILWU Dispatcher, 10/13/1950.

With the Inland Steel case, trial examiners from the National Labor Relations Board ruled that the employers were guilty of unfair labor practices in not consulting the Steelworkers Union when they put insurance and pension plans into effect. The examiners in both cases directed the companies to bargain with the union on the type and extent of these plans.

Inland Steel appealed, but on September 23, 1948, a higher court affirmed the NLRB position and ordered Inland Steel to bargain with the CIO union concerning retirement pension plans. This ruling applied to all unionized companies engaged in interstate commerce.

The door to employer-sponsored health care plans had been opened, and hundreds of thousands of working people benefitted. This was a major step forward in building public expectations that medical care be affordable and accessible. The two rulings fundamentally shifted organized labor’s role in defending and expanding workers’ rights.

In a key example of the ruling’s impact, the International Longshore and Warehouse Union approached the Permanente Health Plan in 1949 about covering their membership. Permanente was attractive to the ILWU for its racially integrated facilities and labor-friendly record during the war. The January 6, 1950, ILWU newspaper The Dispatcher announced the new health plan, and by year’s end, 90 percent of eligible members had signed up.

Thank you, organized labor — you not only brought the weekend to our regular work week, you brought us the employer-sponsored health plan. And on this particular Labor Day weekend, let’s remember and honor the gains made by unions.

 

Special thanks to ILWU archivist Robin Walker, who has put their newspapers from 1932 to present online.

A longer version of this article appears in The Stansbury Forum.

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