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History
Sidney R. Garfield, MD, and industrialist Henry J. Kaiser were the visionaries behind Kaiser Permanente.
Between 1933 and 1938, Dr. Garfield introduced prepayment and prevention in his Southern California practice caring for the workers building the Colorado River Aqueduct to Los Angeles. He turned medical economics on its head. Instead of being paid by the insurance companies when workers were injured or sick, he was prepaid a nickel a day per worker. Guaranteed stable income, he realized that if he promoted wellness, money he saved could be devoted to illness. Workers were healthier. The employer lost fewer days of work to injuries. Everyone was better off.
In 1938, Henry Kaiser was working on the Grand Coulee Dam in Washington State, the largest construction project in world history. Frustrated on three earlier jobs by the challenge of providing medical care at remote construction sites, he turned to Garfield. Garfield created a multi-specialty group practice, organized a coordinated delivery system, and added dependents to the prepayment plan. With entire families covered, he witnessed an almost immediate drop in serious illnesses. Because cost no longer was a barrier, people were coming in early for care.
With U.S. entry into World War II, Henry Kaiser’s shipyards, along with his steel mill in Fontana, California, exploded into action on the home front. Hundreds of thousands of men and women suddenly needed medical care. President Franklin D. Roosevelt exempted Dr. Garfield from the Army to provide this service.
Other important concepts emerged during the war years. Dr. Garfield urged Henry Kaiser and his wife, Bess, to create a nonprofit foundation to be a central financial structure. Now they could maximize the dollars available for medical care, including reserving money for future construction of medical facilities, for clinical research, for support of medical education, and for public health work in the community-at-large.
When the war ended, the Permanente Foundation Health Plan opened its doors to the general public and grew into Kaiser Permanente. |
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