Kaiser Permanente to Patients: Suck it up!

Dear Readers,

Madame L has always been amused by the Kaiser Permanente (KP) ads on TV and in full-color glossy magazines admonishing people to "Thrive!" 

Madame L loves the generic models representing every supposed age, gender, and racial group, while noting that not every economic group is represented. (That's because if you're poor, you can't afford to go to a Kaiser clinic. You have to be employed, and your employer has to be doing pretty darn well to afford to keep its employees covered by Kaiser.) 

But Madame L was astounded when she recently read a Kaiser Permanente full-color ad in a national news magazine,  bragging about how Kaiser provides for "the care you need close to home." The ad explains that Kaiser is providing this "close-to-home" care by building a new facility on Portland's west side.

Just last week, Madame L had to drive her husband to a Kaiser facility in Portland, a 40-minute drive at night (it would have taken more than an hour in commute traffic), for after-hours urgent care. That's because Kaiser closed down its after-hours urgent care in Vancouver, a 15-minute drive from Madame L's home, more than a year ago. 

When Madame L has asked Kaiser people about this, they have "explained" that there isn't a sufficient need for urgent care in Vancouver. One "customer-care" person at Kaiser shrugged her shoulders and said, "You just have to drive a little farther." 

It meant nothing to her. She was a health-care provider, Madame L was a unit of health care utilization, and, last week, at 7:45 pm, her husband was a person with a health record number, and Madame L had to provide all the details of his accident to three people before being told she could drive across a state line on a busy highway to get him seen by a doctor, but she had to get there before 8:30, when they would lock the doors.

Madame L is astounded. Do the people at Kaiser in the Portland-Vancouver realize that the only reason they have customers* at all is that they're the only game in town? (The answer, of course, is yes.)

*Customers: Madame L uses this word deliberately. You are a customer, or a client, at Kaiser Permanente. You are also very patient, of necessity, but you are not really a Patient. You are a person with a "Health Record Number" who must pay for every single "service" offered by Kaiser.

Since Kaiser Permanente is supposedly a non-profit, so Madame L wonders why they don't spend less money on advertising and self-promotion and more on actually taking care of people.

Bloomberg Business Week says no salary, stock-option, or total compensation information is available for Kaiser Permanente's CEO, George C. Halvorson. However, USA Today reports that he made more than $2.2 million in 2002, the year he started that job, and the man he replaced was paid a total of $7.4 million that year. Madame L guesses that by now, counting inflation, Mr. Halvorson may be making well over $10 million per year.

At any rate, we know he makes a LOT of money. Why? Because Kaiser itself would rank third in the nation in money-making if it went public. (It's behind only Columbia/HCA and Cigna.) This graphic (and other information provided here) are from a report by the California Nurses Association.

The U.S. "Billion Dollar" Club of Health Care Conglomerates (Amounts are in Thousands)

Rank	Company	Net Sales
1	Columbia/HCA	$19,909,000
2	Cigna, Inc. PA	$18,900,000
3	Kaiser Permanente CA	$13,200,000
4	United Healthcare Corp MN	$10,074,000
5	Aetna, Inc. (Health Plans) CT	$9,734,000
6	Humana, Inc. KY	$6,788,000
7	Tenet Healthcare Corp. CA	$5,559,000
8	Medpartners Inc. AL	$4,813,499
9	Pacificare Health Systems Inc. CA	$4,637,305
10	FHP International Corp CA	$4,179,284

Kaiser customers pay for the company's wealth, sometimes to the point of losing their lives. Kaiser corporate consultants receive wealth for their services, money which could be used to improve patient services.

The CNA explains Kaiser's business plan: Recruit healthy patients, especially healthy Medicare patients, and neglect the poor, the sick, and the needy.

Madame L could go on. But life is short, and she must get on with her "real" work of the day. 

She would add only one more thing: The actual people who cared for Madame L's husband's injury that night were wonderful, caring, and competent. Too bad such people aren't available to care for everyone, from every economic level, and in every place.