Oliver Goldsmith

Medical Director and Chairman

Southern California Permanente Medical Group, Kaiser Permanente

As Kaiser Permanente's highest-ranking local executive since 1994, Dr. Oliver Goldsmith oversees the plan's 2.7 million-member, 3,300-physician Southern California operation.

But the operation's sheer size hasn't been the most challenging part of Goldsmith's job. It has been making sure Kaiser, the state's largest HMO, "remained a cohesive and idealistic organization at a time in which health care resides in the eye of a storm," he said.

That storm has centered on Kaiser, possibly more than any other health plan.

First, in announcing it would impose double-digit premium increases next year, Kaiser drew sharp criticism from two of the nation's largest health purchasers, the California Public Employees Retirement System and the Pacific Business Group on Health. (Nonetheless, a state program that provides insurance to small businesses in April approved a Kaiser rate hike of up to 14 percent for next year.)

The rate hikes come in the wake of a $270 million loss posted by Kaiser for 1997 and could result in a loss of members for the first time in years. That prospect looms large for Goldsmith, who said one of his proudest accomplishments was establishing "growth and stability of our organization following several years in the early 1990s when we were losing members for the first time in our history."

Another controversy involves the plan's decision to not cover Viagra, the hugely popular new male anti-impotence drug. The decision drew criticism from patient advocates and the medical community, and it triggered a state investigation.

Goldsmith, a board-certified internist and gastroenterologist, defended Kaiser's decision and said he has engineered "a measurable improvement in the quality of services the plan provides." He added that Kaiser's increased use of mammography, immunizations and other common screening tools has resulted in "measurable improvements in the health of Kaiser's members."

Goldsmith started his career at Kaiser which grossed close to $10 billion statewide in 1997 in 1969 as an attending physician at the plan's Los Angeles medical center. He received his M.D., as well as an undergraduate degree in English literature, from UCLA, where he is currently a clinical associate professor of medicine.

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