Posts Tagged ‘Permanente Health Plan’

National Hospital Day began in 1921 to honor pioneering nurse Florence Nightingale

posted on May 9, 2014

Special day meant to educate public
about medical trends and treatments

By Lincoln Cushing
Heritage writer

In 1921, U.S. President Warren G. Harding declared the first National Hospital Day. He picked May 12, Florence Nightingale’s birthday, to honor the famed nurse who set initial standards for hospital quality during the Crimean War of 1854.

"Complete prenatal and post-natal care is part of Permanente's family coverage," photo from Fore 'n' Aft, May 25, 1945.

“Complete prenatal and post-natal care is part of Permanente’s family coverage,” photo from Fore ‘n’ Aft, May 25, 1945.

President Harding declared the special day as an occasion to open hospitals across the United States and Canada to allow staff to educate visitors about medical examination and treatment and to distribute health care literature and information about nursing schools.

This publicity campaign was conceived by Matthew O. Foley, managing editor of the Chicago-based trade publication Hospital Management, in the wake of the 1918 Spanish flu pandemic.

The devastating epidemic killed an estimated 50 million people worldwide, including more than 675,000 Americans.  Foley sought to rebuild trust in the city’s hospitals as well as to draw attention to broader crises facing health care. A May 1921 Canadian Medical Association Journal editorial outlined those problems:

“The time is past when support for the care of the sick poor can be obtained through funds raised from private philanthropy.

“Modern hospital methods are expensive beyond anything formerly conceived of . . . [while at the same time] the increase of poverty and unemployment and the influx of a new and inexperienced immigrant population as yet unestablished in homes create a greatly increased number of indigent sick demanding care.”

War influenced day’s focus

National Hospital Day 1945 addressed a different set of challenges – a country still reeling from the Great Depression and still at war with Japan; victory in Europe was declared May 8, 1945.

Infographic, "Average length of patient's stay," Fore 'n' Aft, May 25, 1945

Infographic, “Average length of patient’s stay,” Fore ‘n’ Aft, May 25, 1945

San Francisco Mayor Roger Lapham proclaimed National Hospital Day as a date to honor volunteer and professional workers for what the mayor called “the splendid record for health in San Francisco during our fourth year of war”.

Among those health care providers honored were those serving workers and their families in the Kaiser shipyards in Richmond, Calif. The shipyard magazine Fore ‘n’ Aft published this editorial:

“Hospital Day has never been one of this nation’s major anniversaries, but – indisputably – health is, and will remain, one of this nation’s major problems for a long time to come.

“For most citizens as well, medical and hospital bills have been one of the major problems in their family budget. That neither of these problems need loom so large and insoluble has been proved at the Richmond shipyards.

“Richmond workers can count themselves among the select – and unfortunately, small – group of American citizens who needn’t worry about running up doctors’ bills, yet they have by their side every protection modern medicine can offer.

“To the service that makes this possible – the Permanente Health Plan – we dedicate this issue of Fore ‘n’ Aft.”

Hospital Day becomes Hospital Week

In 1953, National Hospital Day was expanded to National Hospital Week to give hospitals more time for public education about medical care.

Currently sponsored by the American Hospital Association, this year’s National Hospital Week is Sunday, May 11, through Saturday, May 17.

The week is a time to celebrate hospitals and the men and women who, day in and day out, support the health of their communities through compassionate care, constant innovation and unwavering dedication.

Writing at a time when nursing was generally a woman’s profession, a Canadian editorial writer touted the occupation:

“[On] National Hospital Day efforts will be made to bring the value of a modern hospital before every member of the community, and also to impress young women standing on life’s threshold with idealism still dominant, and aspiring to a vocation as well as seeking a means of livelihood with the view that nursing is a profession and not a business, and that in its honour sacrifices must be rendered as well as privileges won.”


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Labor unions offer early support for nascent Permanente Health Plan

posted on July 16, 2013
"Kaiser launches 747th - and last- wartime ship," article in the Oakland Tribune, August 13, 1945. Expanding the shipyard workers' health care plan to the public would be the birth of the Kaiser Permanente program.
“Kaiser launches 747th – and last- wartime ship,” article in the Oakland Tribune, August 13, 1945. Expanding the shipyard workers’ health care plan to the public sparked the birth of the Kaiser Permanente program.

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.

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Wartime shipyard child care centers set standards for future

posted on September 29, 2010

Naptime for Kaiser kids

By Ginny McPartland
Child care at the workplace was a brand new phenomenon in World War II. The government-subsidized Kaiser West Coast Shipyards nursery schools, which enrolled more than 7,000 offspring of women war workers, offered the perfect opportunity to test theories of the then-fledgling field of child development.

In 1943, Henry J. Kaiser invited key figures in child development studies to his shipyards to set up ideal facilities and programs so workers could build ships without worrying about the safety and health of their children. These model child care centers at the Kaiser shipyards in Richmond, California, and Portland, Oregon, yielded valuable research results that helped fuel the study of early childhood education for decades after the war.

Catherine Landreth, PhD, of the University of California, Berkeley, set up the Richmond schools program. Lois Meek Stolz, PhD, a child development researcher and author from Columbia University and UC Berkeley, set up the Portland centers. James L. Hymes, Jr., a student of Stolz at Columbia, served as manager of the Portland centers.

Stolz and Landreth continued to exert influence on the child development world until the end of their lives. But it was Hymes, just 30 at war’s end, who would become a prodigious contributor to the child development literature for the next five decades. His work is often quoted today. One such quote reflects lessons from the home front: “Every day-care center, whether it knows it or not, is a school. The choice is never between custodial care and education. The choice is between unplanned and planned education, between conscious and unconscious education, between bad education and good education.”

Early Hymes work discovered this summer

Recently, my colleagues and I unearthed the final report of the two Portland Kaiser wartime child development centers, along with a series of seven pamphlets written for postwar child care providers. We found these documents, mainly written by Hymes, in the Institute of Governmental Studies Library in the basement of UCB’s Moses Hall. They were originally filed in 1946 in the Library for Economic Research at Berkeley.

The series of pamphlets includes: 1) A Social Philosophy from Nursery School Teaching; 2) Must Nursery Teachers Plan? 3) Who Will Need a Post-War Nursery School? 4) Meeting Needs: The War Nursery Approach; 5) The Role of the Nutritionist; 6) Large Groups in Nursery School; 7) Should Children Under Two Be in the Nursery School? Two unnumbered pamphlets titled “Toys to Make” and “Recipes for Foods for Children” were also mentioned in the report but copies are not available in the library. Teachers bought a total of 2,582 pamphlets at 15 cents each, according to the report dated December 1945.

Pamphlets offer nuggets

The pamphlet titled “Should Children Under Two Be in Nursery School?” addressed an issue the child care centers were forced to face head-on during the war. Generally, nursery schools did not take children under 2 because experiments had shown the younger children did not thrive in group settings. But the demand for care for infants was too high in the shipyards to ignore. They agreed to accept children as young as 18 months, and in Oregon alone the centers enrolled 904 children 18 to 24 months of age.

“We therefore set out to plan a program which would include among other things: Provision for close and continuous relation of each child with one adult who would be responsible for him especially during eating, toileting and sleeping and during any time of emotional stress when he needed ‘mothering,’ ” wrote Stolz and Hymes.

Good food for good health

Another key wartime lesson: “Food influences behavior. Small children…have pounded into us in unforgettable ways that hungry people are irritable; that they fight more; that they cry easily; that they become destructive…Some children we have seen, hungrier still, have told us that hunger can make people placid, inactive, lethargic,” Hymes wrote. In pamphlet 5, Miriam Lowenberg, chief nutritionist, discussed the crucial link between food and good health: “The (nursery school) nutritionist (helps) teachers … bring the child who needs medical care to the attention of a visiting nurse or doctor.”

The final report discussed other crucial issues such as: the need for child care services after the war for low-income women, costs of the child care operation including nourishing meals, methods of recruiting and retaining qualified teachers, nurses and counselors, providing weekly onsite professional development, and offering opportunities for staff to participate in policy decisions. Attempts to maintain a 10:1 child-to-teacher ratio for the children over 2 and a 5:1 ratio for the infants 18 to 24 months were mostly successful, the authors reported.

Kaiser experts shine on after war

After the war ended, Hymes gained national recognition as an author. Among his earliest best-selling booklets was “A Pound of Prevention” in 1947, which advised first-grade teachers on how to handle difficult “war babies.” He wrote that the “crybabies, whiners and bullies” were still suffering from the disruption of war. Hymes also wrote “How to Tell Your Child About Sex” (1949), “Behavior and Misbehavior: A Teacher’s Guide to Discipline” (1957), “Teaching the Child Under Six” (1968), and “Twenty Years in Review: A Look at Early Childhood Education 1971-1990.”

Hymes served in the Lyndon Johnson administration on the National Planning Committee for Head Start. He and Catherine Landreth both were instrumental in the development of the educational program for low-income children. Landreth was also known for her groundbreaking research in social perception. One of her studies found that children learn racial prejudice from their parents as early as three years old. She wrote three books that were influential in shaping early childhood education: “Education of the Young Child” (with Katherine H. Read), 1942; “The Psychology of Early Childhood,” 1958; and “Preschool Learning and Teaching,” 1972.

After the war, Stolz published “Father Relations of War-Born Children,” a study of how father-child relationships were affected by a father’s absence for war duty (1954); “Our changing understanding of young children’s fears, 1920-1960” (1964), among other related works.

To learn more about the legacy of child care in the World War II Kaiser Shipyards, visit the Home Front festival Saturday, Oct.2, at the Craneway Pavilion on the Richmond waterfront. Kaiser Permanente Heritage Resources is collaborating with Rosie the Riveter/World War II Home Front National Historical Park to tell the story of the wartime child care centers.

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