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FrankenPC On March - 13 - 2010

This could be a very large post, but I will try to boil it down to what I perceive as the essentials.

What is the REAL problem with health care in America?  I believe the lack of socialized medicine is not the problem.  Or, more precisely, socialized medicine is not the cure.  Here’s one tiny example of how private health care can actually work.

I recently joined a medical group on the West coast of America called Kaiser Permanente.  They are a single payer non profit system.  Given their status, they have every reason to digitize their records and introduce efficiency at every stage of the operation to save money.  To date, they have achieved their goal.  This story is about my relationship with Kaiser and how they have responded to my needs.  I make no claims that my experience is homogeneous.   I’m sure some of the more taxed Kaiser facilities will give different experiences.

That being said.  I’ve had two experiences that have molded my view of this particular organization.  The first was with my wife.

Cindy is my wife.  One night, she woke me from sleep writhing in agony.  She felt like she wanted to vomit and her whole body was cramping.  It was horrible to witness.  I walked her out to my car and drove her to the Hayward emergency Kaiser facility.  Not 10 minutes away.  I slid her Kaiser ID card through the magnetic reader and the printer spit out a tag that I wrapped around her wrist.   Within 5 minutes, a nurse guided us into a private room where we were asked a series of questions including how much pain was being experienced and where.  Immediately, the nurse directed us out a door opposite the one we came in which was the emergency room proper.  Cindy was laid down on a gurney and administered morphine.  Then a cart came with an ultrasound device and they checked the area where she was experiencing pain.   It turns out she had an attack of pancreatitis (sic?).  During all this, her primary care physician was contacted at home and was administering advice on how to deal with this including an immediate MRI.  Cindy got the MRI and after all was said and done, she was fine and the pain was gone.  This all happened in a period of about four hours.

I challenge a for profit hospital to do the same thing as efficiently.

My next experience was with myself.  I had a bad blood sugar attack one day that led me to the Dr’s.  My hyperglycemia was wreaking havoc with my system causing me to be confused.  I was concerned that I was getting adult onset diabetes.   So, I approached my Dr and using a computer he prescribed an entire blood analysis.  He checked off everything from liver and kidney function to blood sugar and cholesterol.  Oh, and he threw in vitamin D deficiency among others.  I walked out of the Dr office and across the court to the lab and waited five minutes for my name to be called.  Then they took three blood tests and had me deliver a urine sample.

This is where the genius of Kaiser comes in.  within two hours, my blood tests started streaming into my email box.  The exact test results along with what is considered acceptable ranges.  Also, a hotlink to a web site that explains the test itself.  These tests are also copied to my Dr who then calls me and follows up with solutions to my health problems.  ALL AUTOMATICALLY.

Kaiser is a machine.  The perfect example of how health care needs to be ran in this country.

Kaiser is affordable.  Kaiser has no limits on what kind of service you can have and for how long.  Kaiser delivers it’s own meds so it controls costs.  It’s perfect.  One time I actually emailed my Dr when my lower back went out and he simply electronically ordered vicodin and a muscle relaxer delivered to the pharmacy.  No Dr visit needed.

The whole point of this is this:  If government sponsored health care was this efficient, they could cover everyone for little to no cost.   The fantastical solution to our health care problems doesn’t need to be an elaborate capital hill solution.  it just needs to be ran in an efficient manner by efficient people.

21 Responses so far.

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  1. Questinia says:

    I DO think for-profit hospitals can be as efficient as not-for-profit. Kaiser has had years to perfect their system. I work part time in a not for profit clinic and let me tell you, they waste time, resources and frustrate patients to no end.

    It’s like a band, they can be tight or off. That doctors are happy working at Kaiser has more to do with the rewards of doing a job well within a smooth system that has the kinks worked out.

    You Left Coasters are so much more evolved than us antediluvian Easterners.

  2. choicelady says:

    I am near you, Franken, and I use the Davis U. Med Center. My records are impeccable, but the service sucks. I have few problems, but my physician is wedded to throwing major meds at me even when I’ve said over and over and OVER that some of them are not right. I was also at Kaiser some years ago when the doc gave me a sulfa drug that did me enormous damage then said too late that I did NOT have what he’d prescribed the drug for. Never did find out what was wrong, but I had body pain and a huge, black blister in the palm of my hand that gave me a fever and a goose egg swollen gland under my arm. He sort of figured it for “shingles” but no one ever had THAT happen with shingles. It came back regularly, and he said to come in immediately for a culture of the blister -- but he forgot to tell that to the appointment people who would NOT let me back EVER for at least two weeks. By that time, it was gone. Oh -- the sulfa drug? Tore up my digestive system, and now I have massive food intolerances. Thanks for nothing, Kaiser.

    However we pay for it, good care will always be a crap shoot. And if you’re a person of color, an aging person, an immigrant? Good luck to ya.

    Physicians do NOT get good training in nutrition, in alternative meds, in reading the patient as an individual. I have never been with either for-profit insurance OR for-profit medicine, and I HATE most of the doctors with whom I’ve worked. The only one I liked was a woman from Italy who was just great, but I moved, and that ended that.

    Good medicine depends on well trained and caring doctors, nurses, nurse practitioners, whoever. At least I like my phlebotomist who draws blood twice a year…

  3. KQuark says:

    So true I think your article could almost be called the real solution for healthcare in America. My cardiologist went all digital a couple years ago and the hospital where I have my procedures went digital a few months. They work great in tandem and things went much smoother my last procedure. Unfortunately not all my other specialists or one lab are using digital records.

    Under the exchanges that will eventually be established under the HCR plan a company like Kaiser would have an advantage over others and it would only be more affordable and accessible.

    Actually Kaiser foundation has a good page now where you can compare what the impact of subsidies would have on premium costs.

    http://healthreform.kff.org/SubsidyCalculator.aspx

    • FrankenPC says:

      Or “Another health care solution”. Outlaw for-profit health care period.

      • KQuark says:

        The sad part is many private insurers are technically nonprofit like BCBS but not really because they bloat overhead and CEO salaries.

        Many people don’t realize that in the healthcare bill they are going to set up nonprofit NGOs (non-government organizations) in the exchanges. These are the same options that Federal employees have. The difference is these nonprofit NGOs don’t have the high overhead of nominal nonprofit privates. These nonprofit NGOs are really not that much different from a PO and they are not bullshit co-ops.

        • escribacat says:

          Everyone’s obsessed with the term “Public Option” and anything else creates OUTRAGE!!

        • choicelady says:

          Is BCBS Bad Care for Body and Soul?

        • FrankenPC says:

          True. I think the Kaiser success is directly tied to being a single entity. Since they have “eyes” on all stages of the process, they know exactly what’s going on and the Dr’s have no reason to rip off the system as they are salaried.

          I forgot to mention something, after my Dr. visit, I got a “Evaluate your Dr” form which basically grilled me on my entire experience. So, the Dr’s themselves are being held accountable to quality standards.

          That’s something you won’t see in a normal medical system.

  4. SueInCa says:

    Franken
    I too have Kaiser and I was extremely pleased with their new format. I never have a problem seeing the doc, she calls me and I can email her with non-emergency issues. The longest wait I have had is for an upcoming colonoscopy, but I am just fine with that wait LOl.

    We had Kaiser many years ago and it was ok, but we moved to PruCare for the same co-pays as Kaiser and liked it much better. Unfortunately I called them one day with a question and the entire company was in a meeting, the meeting was to tell them PruCare was shutting down. How sad for them and us, next up was United Health Care, ugh is all I can say. Then BlueCross which was fine but it was more costly by a long run.

    I will take Kaiser over any of them nowadays.

    • FrankenPC says:

      It used to be the reverse. PPO’s were much more viable and single payer HMO’s were annoying as hell. But Kaiser proved they could become a game changer through technology.

      An interesting side effect of this is the Kaiser employees themselves seem so relaxed and friendly now. I guess when the inefficiencies were removed from the system, they were enabled to do their jobs as fast as they wanted. Also, the patient’s impatience went way down so on the job stress appears to have diminished greatly.

  5. Khirad says:

    Sure, we had Kaiser Permanente in my hometown back in Washington.

    Well not personally, but I knew of their reputation as being different.

    • KQuark says:

      I don’t know about Kaiser much but I do know that smart insurance companies should get out in front and start making themselves more efficient instead of acting like Healthpoint and BCBS who keep on milking the cash cow.

    • FrankenPC says:

      Kaiser used to be really bad. When they went full digital, they turned everything around. It’s phenomenal.

  6. bitohistory says:

    Franken, I go to a university teaching hospital and their cancer research clinic. It is very similar. I don’t get info on my home computer, but every Dr. and clinic can access your records. My basic blood tests are ready in 30-45 minutes (or the Doc is pissed). My oncologists are known nation wide in their studies/research on blood cancers. They work and teach and are paid a salary, not by the visit.
    I agree with you that the delivery system of healthcare can be more efficient, but we have a group of alarmists worried about “The Government” might find out your blood type or your latest colonoscopy. I have my blood, tissue, DNA typing from here to Australia because I volunteer for clinical programs. I’m not worried about Government, I’m worried about Insurance companies.

    • Khirad says:

      Lord I still remember the talk of the census -- not taking it ’cause “they’ll” know too much, big gubmint. Guess what, they already know where to find you to send you the notice letter, they know your social security number, your driver’s license, and still -- I was getting a fishing license a few years back and the guy in front of me raised a storm about giving away a few personal details as if it were the end of the world. What is wrong with these people?

    • FrankenPC says:

      Life for profit IS the problem. I agree.


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