Kaiser Permanente's early support from Labor
Lincoln Cushing, 3/5/2025 (Originally published in the Kaiser Permanente History of Total Health blog July 2015)

From providing health care to workers and their families at Grand Coulee Dam to the massive medical program in the WWII shipyards, Henry J. Kaiser believed that cooperating with labor was more productive than fighting it. This institutional philosophy had profound positive implications on 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.



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, street car 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 longshoremens' 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 some day they would boycott us probably. So he said, "I'll pay you several months dues in advance if that will help you build a hospital."

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.”

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 – which also is likely the first such labor agreement in California.

On July 26, 1946 the Nurses Guild 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.

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.

Images:
Signing first Permanente Foundation hospital nurses contract, Labor Herald, August 23, 1946.
Permanente physician examines longshoreman, 1951.

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