Kaiser Permanente: Hypocrisy

By Michael Davoli of Portland, Oregon who describes himself as "a liberal political consultant and legislative campaign consultant currently working on state and federal tax policy."

A person cannot turn on the television these days in Oregon without seeing the countless ads promoting Kaiser Permanente Health Care. These ads promote Kaiser as a company for the people. I think an even more fitting description would be: Kaiser stands for hypocrisy.

After a year of being a part of a group plan with Kaiser I found myself switching jobs and needing to apply for an individual family plan. Since I was very happy with my Kaiser doctors I decided to stay with Kaiser. I am a 30 year old man in general good health who works out regularly and eats healthy. My only health issue is a minor condition that costs approximately $16 a month for medication. The health plan that I applied for has a monthly charge of nearly $200.

After applying in January I received a letter a month later notifying me that I had been denied coverage. In the letter it gave a once sentence explanation: 'pre-existing condition, (neurological)'. The company who believes in laughter and penicillin and kids and families was denying me coverage for an extremely minor disorder. After calling to complain, I was instructed to get a letter from my Kaiser doctor explaining my condition and that I should not be denied.

A month after filing my appeal, I received another letter from Kaiser again denying me coverage. However, this letter was literally identical to the first denial letter so I thought perhaps a mistake had been made. After being told that the first letter from my Kaiser doctor was insufficient I specifically asked exactly what was needed to be included in the letter. My Kaiser doctor again quickly wrote me a new letter specifically addressing the points told to me by the supervisor.

Despite my Kaiser doctor's second letter I was denied for the third time and for the third time no explanation was given other than the same once sentence explanation: 'pre-existing condition (neurological)'. Angered, I called Kaiser again and spoke to a supervisor. I requested in writing a detailed explanation as to why my specific condition disqualified me from coverage. Five days later I received what I thought would be my last letter. I was expecting this letter to offer some sort of explanation as to why I was being denied. In four words Kaiser wrote: 'Neurological condition -- Tourette syndrome'.

Not only do Kaiser Permanente officials have so little regard for the health of Oregonians as is evident in the fact that they refuse to offer coverage to all but those in perfect health, they don't even have to decency to give me a real explanation as to why they have denied me coverage.

Since then I have been accepted for coverage by Blue Cross/Blue Shield of Oregon. Last night when I arrived home from work I found a letter waiting for me from Kaiser. After opening the letter I almost fell to the floor in disbelief. Kaiser was now charging me $38 for the two phone calls that I made to my doctor seeking a letter for my appeals.

For a company who says they stand for kids and families they have a strange way of showing it. The truth is that Kaiser Permanente stands for hypocrisy and it is unfortunate that so many good doctors, nurses and staff work for such poor corporation. I only hope our lawmakers realize that I am not alone in this frustration.

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    I thought the health care portability provisions passed under Clinton prevented this kind of pre-existing condition denial?

  • Tom Civiletti (unverified)
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    diagnosis: screwed up healthcare insurance

    prescription: single payer healthcare system

  • gadfly (unverified)
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    Here are some resources to help you if you want to look into Kaiser's false advertising.

    First, here is a Kaiser presentation providing their results on a large 2002 study on how to manage public perceptions:

    http://kaiserthrive.org/gallery/view_album.php?set_albumName=Kaiser-Reputation-Management&page=1

    Also, you can find Brand Campaign documents that contain various remarks on Kaiser's intent to deceive in the left side nav bar here:

    http://www.kaiserthrive.org/

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    Unfortunately, this kind of story is all too common these days. I have a good friend who was turned down by an Oregon health insurance company for a very minor condition that has no impact on his health. Fortunately for him, he has the wealth to subscribe to one of the new "concierge" practices, where doctors charge patients a monthly fee and bypass the insurance system altogether.

    For their monthly fee (usually a few hundred dollars) patients get hour long appointments, extensive yearly physicals, phone and email followup from their doctors, even house calls if they need it.

    Between the insurance companies refusing to cover more and more people and the wealthy opting out to get more expensive, personalized care, can the demise of the entire system be far behind?

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    I certainly don't doubt your experience, but I've been way more satisfied with Kaiser than Blue Cross Virginia. It may well be the coverage plan negotiated with the City, however--and I don't have any preexisting conditions, even minor ones.

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