Posts Tagged ‘Obama’

‘Aloha’ Symbolizes Kaiser Permanente’s Entry into Post-war America

posted on July 27, 2010

By Tom Debley

Front and back covers of launch program for the S.S. Burbank Victory, July 28, 1945 (Courtesy of the National Park Service, Rosie the Riveter/WWII Home Front National Historical Park, Launching Program, RORI 3169)

Director of Heritage Resources

The world was changing dramatically 65 years ago this week. The war in Europe was over, and Japan would surrender within a few weeks. In Richmond, Calif., the last Victory ship built in the Kaiser Shipyards was readied for launch on July 28. Above the ship, the S.S. Burbank, the word ‘Aloha’ in giant letters was suspended between two cranes.

An orchestra played Hawaiian music, guests wore leis made from fragrant pikake blossoms, and Henry J. Kaiser’s wife, Bess, cracked the traditional flower-wreathed bottle of champagne across the bow.

“In launching the last of the Victory ships, we are not registering a finality,” said Kaiser, “but beginning the second phase in the achievements of our industrial family.”

Looking on were Kaiser’s two adult sons, Edgar and Henry Jr.

It was said 10,000 people were on hand, including shipbuilders who had worked on the very first Victory ship.  They sang “Aloha” to Mr. and Mrs. Kaiser and, as the S.S. Burbank slid down the way into San Francisco Bay, flowers tossed from the deck showered the crowd.

The symbolism of the “Aloha” theme has only grown over time. The Hawaiian word is used to say both goodbye and hello. America was saying farewell to World War II, and greeting the post-war world. Henry Kaiser was leaving shipbuilding and embarking on new ventures—including opening the Permanente Health Plan, later renamed Kaiser, to the public. And he was advocating for national reforms that would make health insurance available to all Americans.

Indeed, days before the launch of the S.S. Burbank, Kaiser announced he had drafted a legislative proposal that he presented to several U.S. Senators to create a national program of voluntary prepaid medical care.

“…The greatest service that can be done for the American people,” said the preamble to Kaiser’s 1945 proposal, “is to provide a nationwide prepaid health plan that will guard these people against the tragedy of unpredictable and disastrous hospital and medical bills, and that will, in consequence, emphasize preventive instead of curative medicine, thereby improving the state of the nation’s health.”

These events also were coupled with opening the Permanente Health Plan and Hospitals to the public under the leadership of physician co-founder Sidney R. Garfield. Thus, this week became the springboard for the 65 years—to date—of continually defining the future of health care with the growth and leadership of Kaiser Permanente . (See: Opening a Prepaid Health Plan to the Public 65 Years Ago this Month.)

This would be Kaiser’s ultimate legacy.

The Kaiser family at the launch of the last Kaiser Victory Ship, July 28, 1945.

As the preeminent California historian, Kevin Starr, has noted, “After all the things he did—the great dams he had built, the great waterways, the unprecedented work in the shipyards—Kaiser knew that this was the thing that would last.”

Or, as Kaiser, himself, said on several occasions in the last years of his life in Hawaii, “Of all the things I’ve done, I expect only to be remembered for…filling the people’s greatest need—good health.”

National health care legislation failed in 1945 and many times thereafter, but Kaiser, Dr. Garfield and their successors have persisted in advocating for heath care for all ever since and saw President Obama sign the Affordable Care Act last March 23. That came exactly 65 years and 20 days after the official date of Henry J. Kaiser’s original “Proposal for a Nationwide Prepaid Medical Plan Based on Experience of the Permanente Foundation Hospitals,” which had been prepared in consultation with Dr. Garfield.

Today, Kaiser and Garfield are honored for their contributions on the Home Front of World War II at the Rose the Riveter/World War II Home Front National Historical Park for making prepaid medical care “a legacy of the WWII Home Front.”

(Special thanks to Veronica Rodriguez, Museum Curator at the Rosie the Riveter/World War II Home Front National Historical Park, for locating and sharing use of the program images for the launch of the S.S. Burbank Victory, July 28, 1945.)

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Replacing ‘Sick Care’ with ‘Health Care:’ Dr. Sidney Garfield’s Ideas in the National Reform Dialogue

posted on April 5, 2010

By Tom Debley, Director, Heritage Resources

It was fascinating to me to research and write a book about the life of Kaiser Permanente’s founding physician, Sidney R. Garfield, but it has become even more so to observe how visionary he was in his time as discussion continues in the wake of President Obama’s signature on health care reform.

Dr. Sidney R. Garfield, a surgeon, co-founded prevention-focused Kaiser Permanente with industrialist Henry J. Kaiser.

A month ago, I wrote a blog about Harvard Business School Professor Clayton Christensen, who argued in the pages of Business Week that health care needs business models like Kaiser Permanente—health care systems in which doctors and insurers are on the same side of the ledger as the patient. I observed that this was an idea Dr. Garfield put forward as the model for Kaiser Permanente in a speech in Portland, Oregon 65 years ago Sunday (April 4).

This Monday (April 5), I was struck by a quote in an article by Robert Pear in the New York Times.

“We don’t have a health care system in America,” said Senator Tom Harkin, the Iowa Democrat who chairs the Senate health committee. “We have a sick care system. If you get sick, you get care. But precious little is spent to keep people healthy in the first place.”

First Lady Eleanor Roosevelt, visiting World War II Home Front patient, asked Dr. Sidney R. Garfield to tell her about prevention-focused medical care.

Harkin’s statement is an interesting juxtaposition with an event exactly 67 years earlier—April 5, 1943—when First Lady Eleanor Roosevelt visited a World War II Kaiser Industries shipyard worker, a woman with a seriously injured left leg, as shipyard manager Edgar F. Kaiser looked on in Vancouver, Washington.

Whatever Mrs. Roosevelt heard about Dr. Garfield’s focus on injury and illness prevention efforts as he built the largest civilian medical care program on the Home Front of World War II, she was immediately intrigued. Returning to the White House, she dictated a note to Dr. Garfield, “I am interested in getting medical care, both preventive and curative, at the least cost to the people. What is your program on the preventive side?”

“Your expression of interest in preventive medicine is rather closely allied with our thoughts for medical care,” Dr. Garfield responded in a letter detailing his ideas.

What Dr. Garfield did on the Home Front is, of course, one of the historical stories told at the Rosie the Riveter / World War II Home Front National Historical Park in Richmond, Calif.

Dr. Garfield spent his whole professional life on these ideas. It was not easy, but his vision was central to the evolution of Kaiser Permanente as—in Dr. Garfield’s words—a “total health” system of care.

In the first 15 years of toil after World War II, Dr. Garfield’s big frustration was how challenging it was to move from a “sick plan” to a “health plan,” but he never gave up. His big breakthrough came 50 years ago next month, and I will write about that story in a blog in May.

In the meantime, if you are interested in learning more about Dr. Garfield, my book, “The Story of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care,” is available from the publisher, The Permanente Press, as well as from in both book form and on Kindle.

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Garfield Biographer Speaks at the Commonwealth Club

posted on August 27, 2009
Photo by Joe Paolazzi

Photo by Joe Paolazzi

Dr. Sidney Garfield’s childhood dream of being an architect was shattered when his Jewish Russian immigrant parents insisted he become a doctor. Little did the young Garfield know that his destiny was not only to become a doctor but also to blaze trails few others had even dared to ponder.

Indeed, 25 years after Garfield’s death, President Barack Obama points to the medical care program Garfield founded as a model for 21st Century health care reform, author Tom Debley said in his talk to the Commonwealth Club in San Francisco Aug. 25.

Debley, author of a new Garfield biography, described the extraordinary life of the pioneering Kaiser Permanente doctor in the book, Dr. Sidney R Garfield: the Visionary Who Turned Sick Care into Health Care.  “Most people know very little of Sidney Garfield, and I try to remedy this with my book (written in collaboration with Jon Stewart),” Debley told the crowd.

Debley recounted Garfield’s 20th Century journey from his birth in 1906 in Elizabeth, New Jersey, through the Great Depression, World War II, the Cold War, and the 1950s and 1960s battles to gain acceptance for a different type of medical care.

Garfield’s formula for the best health care emphasized ways to keep people free of disease and thus not needing sick care. In 1933, Garfield found he could provide affordable care to the workers on the Colorado River aqueduct project by collecting weekly dues to cover all members whether they required care or not.

“After nearly going broke, Garfield linked two ideas from the debate of his era – prepayment and prevention – in a way that reversed medical economics,” Debley, director of Heritage Resources for Kaiser Permanente,  told the Commonwealth Club audience.

“In 1938, he joined forces with (industrialist Henry J) Kaiser and his son Edgar at the construction site of the Grand Coulee Dam. Here Garfield added the ideas of group medical practice, facilities under one roof, and a family plan,” Debley said.

In the War years, Garfield reunited with the Kaisers to provide medical care for workers in Kaiser’s Pacific Coast shipyards and the Kaiser Steel plant in Fontana, California. “In a mere 18 months, he and his colleagues opened four hospitals and built the largest civilian medical care program on the Home Front of World War II.”

When the War ended in 1945, Garfield and Kaiser were able to keep their health plan alive by opening up to the public and taking care of union members such as the longshoremen and the steel workers.  Soon enough, the University of California, public schools, other government and large employers picked up Kaiser Permanente care for their employees.

“Sidney Garfield was a doer – his is a classic American story – a man passionate about his calling and determined in his quest. Like his ideas or not, he and Henry Kaiser brought health care to millions of Americans – more than any two individuals I can think of in American history,” Debley told the group.

But, wait, the story isn’t over yet.  In the 1950s when Garfield’s run as medical director ended, he resurrected his youthful fantasy to be a builder. Garfield created designs for new Kaiser Permanente hospitals that won him national acclaim.

“Three hospitals opened in 1953 –in Walnut Creek, San Francisco, and Los Angeles – were labeled ‘dream hospitals.’ Dr. Walter C. Alvarez, perhaps America’s most famous physician of the era, told broadcaster Lowell Thomas:  ‘A new day has dawned, where more brains will go into the design and architecture of a hospital.’

“Newscaster Chet Huntley reported: “The use of labor-saving devices, the use of light (both natural and artificial), the gadgets, the décor, and the  personnel are all combined to make the new (Los Angeles) Kaiser Foundation Hospital something special,’ ”  Debley said.

Still, Garfield was not done.  In 1960, he insisted Kaiser Permanente embrace the computer whose development was in its infancy. “Garfield saw computers as a component of a ‘total health’ system of care,” Debley noted. Garfield’s early vision has allowed Kaiser Permanente to become an international leader in the field of electronic medical records and other IT systems.

All in a day’s work for Sidney Garfield.

 – Ginny McPartland


To order your copy of Debley’s book, Dr. Sidney R Garfield: the Visionary Who Turned Sick Care into Health Care, go to The Permanente Press.

To view the talk on, go to Commonwealth Club.

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