About the Project

Over the last thirty-five years, medical care in the United States has undergone rapid, often unpredictable change. Ironically, even though Kaiser Permanente (KP) provided the single most important model for legislation (the 1973 HMO Act) designed to cure the growing inadequacies of a medical system based on fee for service, it, like every other medical-service provider, found adjusting to an increasingly complex environment no easy matter. Efforts to adapt led to questioning whether the principles guiding KP’s founding and initial growth were still valid. In a process of assessing competing strategies for change, KP in the late 1990s arrived at a collective affirmation of the organization’s historic core values, renewed its internal stability, and enjoyed new growth in membership.

Oral history is an effective research methodology for examining the embedding of core values in the KP organizational culture and for clarifying how the relation of values to everyday practice provided a basis for resolving debates over KP’s direction. Interviews in this series recount the struggles over the choices KP had to make in the words of the participants themselves.

The story is as complex as KP and reaches deep into the organization. It requires understanding what those in KP’s regional organizations thought as well as the opinions of national leadership. At the heart of the story is the everyday relation of clinical practice, research, government relations, and community benefit activities that had developed over the years. To engage the breadth of KP experience, ROHO has or will interview a nearly 100 individuals; the interviews will last from one hour to eight hours, although most will be around four hours in length.

Project Team

Richard Cándida Smith, Principal Investigator
Martin Meeker, Project Director and Interviewer

Funding

This project has been funded by a grant from Kaiser Permanente Foundation Hospitals and Health Plan.

Statement of Scholarly Independence

Although funded by KP, this project was designed and is being executed as an independent scholarly research project; individual interviewees are covered by UC Berkeley Committee for the Protection of Human Subjects guidelines that provide for sealing portions of interview transcripts at the discretion of the interviewee. While the research design and interviewing are independent of KP, we have been assisted by KP staff in identifying research themes and in selecting and locating potential interviewees.