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Sidney R. Garfield

Sidney R. Garfield
Born 17 April 1906
Elizabeth, New Jersey
Died 29 December 1984
Orinda, California USA
Education University of Iowa College of Medicine, 1928
Medical career
Profession medical doctor

Sidney R. Garfield (17 April 1906 – 29 December 1984) was a medical doctor and a pioneer of health maintenance organizations. He co-founded the Kaiser Permanente healthcare system with businessman Henry J. Kaiser. He graduated from the University of Iowa College of Medicine in 1928, which is now called the Roy J. and Lucille A. Carver College of Medicine.

In 1933, Garfield opened his Contractor's General Hospital in the Mojave Desert, east of Los Angeles, California. 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 water from the Colorado River 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 that Garfield decided to offer total medical care for the workers for an additional nickel a day from the workers themselves. About 95% of the workers signed up.

The Kaiser Richmond Field Hospital for the Kaiser Shipyards, financed by the United States Maritime Commission, opened on August 10, 1942. It was sponsored by Henry J. Kaiser's Permanente Foundation and 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 Kaiser Permanente hospital in Oakland, California, 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 Health Maintenance Organization Act of 1973.


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