Sidney R. Garfield (17 April 1906-1984). A medical doctor (University of Iowa College of Medicine, 1928; now called the Roy J. and Lucille A. Carver College of Medicine ) who co-founded the Kaiser Permanente healthcare system with businessman Henry J. Kaiser, thus a pioneer of health maintenance organizations.
In 1933, Garfield opened his "Contractor's General Hospital" in the Mojave Desert, east of Los Angeles. This hospital was set up to provide medical care for the 5,000 workers on the Metropolitan Water District of Southern California's aqueduct, which was designed to bring Colorado river water to Los Angeles.
The hospital started as fee-for-service, but insurance companies were slow to pay, and non-payment was also a problem. Garfield made an arrangement with Industrial Indemnity Exchange, the largest insurer on the Colorado River Aqueduct project. The agreement with the insurance company was structured as a "prepayment" to the hospital -- a nickel a day per worker. The new "prepaid" financing plan was an immediate success.
Garfield was able to provide medical and hospital care for the workers for industrial accidents. The system worked so well, in fact, that Garfield decided to offer total medical care for the workers, for all of their needs, for an additional nickel a day from the workers themselves. About 95% signed up.
The Kaiser Richmond Field Hospital for the Kaiser Shipyards, financed by the U.S. Maritime Commission, opened on August 10, 1942. It was sponsored by Henry J. Kaiser's Permanente Foundation, and Sidney Garfield was the Medical Director. The Field Hospital served as the mid-level component of a three-tier medical care system that also included six well-equipped First Aid Stations at the individual shipyards, and the main Permanente Hospital in Oakland, where the most critical cases were treated. Together, these facilities served the employees of the Kaiser shipyards who had signed up for the Permanente Health Plan (commonly referred to as the "Kaiser Plan"), one of the country's first voluntary pre-paid medical plans, and a direct precursor to the Health Maintenance Organizations (HMOs) defined by the federal HMO Act of 1973.
By August 1944, 92.2 percent of all Richmond shipyard employees had joined the plan, the first voluntary group plan in the country to feature group medical practice, prepayment and substantial medical facilities on such a large scale.
After the war ended, the Health Plan was expanded to include workers' families. By 1990, Kaiser Permanente was the country's largest nonprofit HMO.
In part due to wartime materials rationing, Garfield's original Field Hospital was a single-story wood frame structure designed in a simple modernist mode. Intended for use primarily as an emergency facility, it opened with only 10 beds. Later additions increased its capacity to 160 beds by 1944. The Field Hospital operated as a Kaiser Permanente hospital until closing in 1995.