July 21, 2015

Kaiser Permanente's early support from labor

Experiencing the Kaiser Permanente health plan led labor unions to support and promote the health plan after World War II for accessible and preventive care.

Nurses Guild Local 699 (CIO), signing first Permanente Foundation hospital nurses contract. Labor Herald, August 23, 1946.

From providing health care to workers and their families at Grand Coulee Dam to the massive medical program in the World War II shipyards, Henry J. Kaiser believed that cooperating with labor was more productive than fighting it. This institutional philosophy had profound positive implications for the nascent public postwar health plan. As the war was drawing to a victorious close — Victory in Europe had been announced on May 8, 1945 — Henry J. Kaiser’s health plan began to prepare for a peacetime economy by expanding beyond its own employees. The plan would be opened to the public by late July.

Given Henry J. Kaiser’s support for labor, it was not surprising that labor unions would be among the early member groups. Bay Area workers — Oakland city employees, union typographers, streetcar drivers, and carpenters — embraced the Permanente Health Plan and its emphasis on preventive medicine.

On June 7, 1945, the Stewards and Executive Council of the International Longshoremen and Warehousemen Union’s Oakland unit voted unanimously to make coverage in Permanente a part of its future negotiations with employers. The executive council also requested that employers pay for the plan’s premiums.

Founding physician Sidney Garfield, MD., reflected on that support:

"So [the postwar health plan] gathered momentum… [In 1949] the longshoremen's union came to us and said, "We would like you to take over all our members." They had about thirty thousand here and the [San Francisco] Bay area. They said, "We won't give them to you unless you do it up in Portland, Seattle, Los Angeles, and San Diego. We want to give you the whole thing.

"Then Joe DeSilva of the Retail Clerks' union called up and wanted to see me. He came up here and said, "I want you to set up a health plan for our workers in Los Angeles." I guess he had about thirty thousand workers plus families of I don't know how many. I told him that we would need facilities because we couldn't depend on using other hospitals because someday they would boycott us probably. So he said, "I'll pay you several month's dues in advance if that will help you build a hospital."1

Years later, Kaiser Permanente CEO David Lawrence would express that relationship succinctly:

“If not for organized labor’s active marketing support immediately following World War II, it is unlikely that Kaiser Permanente would exist today.”2

Permanente physician examines a longshoreman in San Francisco, 1951.

Permanente physician examines a longshoreman in San Francisco, 1951.

But labor did not just mean health plan members, labor employees were also a key part of delivering health care. A year after opening up to the public, the Permanente Health Plan signed its first nurses' contract with the hospital in Oakland and the field hospital in Richmond, making it the first nurses’ union in the U.S. to do so.

On July 26, 1946, the Nurses Guild Local 699, affiliated with the Congress of Industrial Organizations, announced that they approved a contract covering wages and working conditions with Permanente Hospital of Oakland and Richmond (as well as medical staff at Kaiser Steel in Fontana). Lora Lee Swan, nurse consultant for the Guild, declared:

"This is the first Alameda County hospital in which nurses have been allowed their democratic rights to a free election in choosing their bargaining agent. The precedent set here is truly a great victory for working nurses everywhere." 3

In 1997, after years of labor turmoil within Kaiser Permanente and competitive pressures within the health care industry, Kaiser Permanente and the Coalition of Kaiser Permanente Unions formed their groundbreaking Labor Management Partnership. Today, the partnership covers more than 100,000 union-represented employees in 28 local unions as well as 14,000 managers and 17,000 physicians in California, Washington, Oregon, Colorado, Georgia, Hawaii, Virginia, Maryland, and Washington, D.C.

1 “Pre-paid Medicine: Kaiser Hospital in Oakland is Opened to the Public,” S.F. Chronicle, July 21, 1945.

2 “Leaders Tell How — and Why — Health Plan Grew,” KP Reporter, May 1962.