 Kaiser Permanente started and stopped several times before World War II started down the desert to provide health care that said Garfield got involved in. And then it was up at the Cooley Dam. That was the next big thing in Washington State because that was where Henry Kaiser was building the Cooley Dam. Then during World War II, Henry Kaiser and his people wanted to have a health care system for the workers working at the shipyards and brought in, again, Sid Garfield and people like C.S. Cutting and others like that. Near the end of the war effort, Henry Kaiser was going to close down the medical care system. So the Longshoremen's Union came to him and also to the physicians and said, if you'll continue taking care of us, we'll bring all of our members to you. It's remarkable if you stop and think about it because the origins of this organization from a private sector point of view lie with unions who promised to bring their members to the physicians. In the course of the next three decades, from 1950 to 1980, Kaiser Permanente grew phenomenally from 154,000 to 3.9 million members and from eight hospitals in two states to more than 125 hospitals and clinics in nine states. But difficult times lay ahead. People came to work for Kaiser and they stayed working for Kaiser because they liked the model of preventative care. And when that began to slump, the question was, how do we bring it back? The late 80s through the mid to later 90s were a period of profound turmoil in the medical care, health care industry. Healthcare was having problems. Kaiser was losing members. It was in the early 90s the rise of the HMOs and then in the mid to later part of the 90s, it was the emergence of the winners. And they were formidable competitors. Kaiser was under enormous pressure to keep its rates down, to drive its quality and its safety up, and to establish a reputation that distinguished it from all the rest. What transpired was that we saw a lot of upheaval during the late 70s, the 80s and the early 90s, which strikes. As Kaiser would introduce at the bargaining table, a concession. The employer came in with extreme cutbacks, cuts in wages, cuts in benefits. The union said, okay, no, we're not going to go for this. We're going to strike you guys until you understand what it is that we need and how we can help, you know, build the organization up also. When I was here in the 90s, we had something like 54 labor contracts and 35 or 36 unions that were involved in Kaiser Permanente in some form or another around the country. In the early 1990s, union locals joined together to gain strength at the bargaining table. The group formally organized as the coalition of Kaiser Permanente unions in 1996. So it sort of evolved as we were trying to get through making the various points of the corporate campaign that we were doing, continuing to go through the different rounds of the concession bargaining with the other unions. Things weren't getting much better. And at one point, at a meeting of the coalition of unions, we kind of came up with Peter's help that, you know, is there another way we can address this other than trying to go to a full blown war. This upheaval and the introduction of these concessions, not only at the bargaining table but also at the workplace, became such a distraction to them that they felt that they were violating their commitment to quality care. And so the time came when we had to make a decision as to how to proceed. They wouldn't help us as union members if the organization went out of business. So what they tried to do is say, OK, let's sit down and strategize how we can work together bringing the organization to the forefront but also strengthen the union at the same time. John Sweeney was the head of the international SEIU, the service employees union, before he became the head of the AFL-CIO. And Sweeney and I met several times and they were disastrous meetings. Al Bolden, who was the head of HR for Kaiser Foundation Health Plan Hospitals, came to me and said, look, let's see if we can arrange a meeting with you and Sweeney and see if we can talk this thing through. I think there may be something that we can do. We walked into the room, we were like dogs sniffing each other. We were just, yeah, our hackles were up, our tails were up. David Lawrence started out. He talked about the need for us to really change the direction that Kaiser was going in. Sweeney turns to DeChico and says, Pete, why don't you describe what an innovative labor management partnership looks like? I brought my experiences to them on those kind of cooperative relationships that worked and those that didn't work. He starts talking about this stuff and I honestly had to fight to keep from crying. It was like, holy crap, this really is exciting to listen to. This is exactly what we had to do. And I responded by saying, look, healthcare involves teams. You can't do it without teams. If we're fighting with each other, we can't take care of patients. It wasn't as radical to us because as nurses, I guess, we collaborate. We have to on the units. We're collaborating with the physicians, with the LVNs, with the patients' families. You know, we're used to working together. But I think what was radical about it was, wait a minute, these guys have been trying to kill us all for three years. And we're going to now try this. Well, it's official. On June 3, 1997, AFL-CIO union members approved a partnership with Kaiser Permanente that will change the way we work together in the future. Right from the onset, we agreed that we were going to share all information, the same information that Kaiser would provide its managers. They would also provide the union leadership. The hallmark of partnership is inclusion. With the unions and their members involved in decision-making with managers and caregivers at every level of the organization. It's also known for programs like workplace safety and wellness, job and career development, and community service. This joint approach helps ensure that Kaiser Permanente and the coalition of Kaiser Permanente unions remain leaders in health care. Union workers have benefited from the partnership in a lot of ways. First of all, we do have a very high standard of pay and benefits, which we're proud of, and in return for that, we also know that we have to have a high level of performance because with industry-leading wages comes industry-leading performance in order to be successful. It's more work for the workers to be working in partnership. There's much more learning they have to do. There's more education classes they have to have. We did a big project on workplace safety and got our workplace safety figures done, which was wonderful. It was obviously wonderful for everybody that was hurting their backs from lifting and that kind of stuff, and I don't believe we could have done it without the coalition and without the partnership. It's not easy, but it's all worth it. It is worth every cent and every time that I spent being part of this union. I tell people, if we ever had to go back to traditional, I would go ahead and put my retirement papers in. This is the way we run our business, so whatever it is we're doing, we're doing it in partnership with labor. Kaiser is now in every region that it provides care, considered the top provider of quality care in the United States. Not bad. Most importantly, the outcome is also about the care that we provide, and healthcare workers get into this work because they care passionately about the people they care for. And through the partnership, we give healthcare workers and their unions a voice not only in wages and benefits, but also in how care is delivered and people are treated, and that makes a big difference. We've had some challenges throughout these years, but when partners are committed to each other and most importantly committed to the common goal or vision or outcome that we're trying to achieve, that tends to be the galvanizing force and I think that our mission is such that the partnership will be forever.