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November 19, 1997

To Serve the Greatest Number: A History of Group Health Cooperative of Puget Sound

Author Affiliations

Monterey, Calif

JAMA. 1997;278(19):1630. doi:10.1001/jama.1997.03550190100061

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Prepaid medical care had its start in this country in 1798 when President John Adams signed a law assessing every arriving seaman 20 cents a month to pay for health care for all seamen. In the century that followed, numerous industries adopted similar programs without the aid of governmental direction—mining, railroads, and the like.

The first formal physician group practice was inaugurated at the Mayo Clinic in the first years of the 20th century. The first endeavor that combined prepayment with a formal group practice structure, the now defunct Ross-Loos Medical Group, was established in Los Angeles in 1929. The better-known and more successful Kaiser Permanente program traces its roots to 1933 but began serving the general public in 1945.

To Serve the Greatest Numbertells the saga of the Group Health Cooperative of Puget Sound (GHC) on the occasion of the 50th anniversary of its founding. The author

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