For simple, routine needs Kaiser really does shine. Easy appointments, quick, good staff. We recently had a baby through Kaiser and pre-natal and post-partum care as well as the actual delivery was a fantastic experience. Much more so than the experiences of my peers at other non-Kaiser hospitals. Cost is all covered in employee plan.
BUT as soon as you encounter specific issues, Kaiser breaks. I’ve had persistent GI issues and was never able to find consistent specialists on Kaiser. I also lost coverage to my therapist as Kaiser only does group therapy.
For the record, I pay the same for healthcare from UHC now and it would cover the $25k cost for the specialist because they're in the UHC network.
When my wife left her job several years ago (but post Obamacare) and needed to get insurance on the open market, her Northern California Kaiser plan was roughly the same price as her employee group plan (inclusive of employer contribution). Not too long ago my sister purchased a Kaiser Mid-Atlantic plan on the open market, which was also reasonable with nearly identical coverage to the group plans I've had.
As far I understand, Kaiser is largely an outlier regarding rough cost parity between group plans and individual plans. I'd be surprised if UHC cost the same as Kaiser for the same coverage on the open market, but if you confirm then I'll have to update my assumptions.
There's no guarantee KP won't bankrupt you, but it seems better than most.
A few years ago when I was working for a startup and had insurance through United Healthcare, I came down with a high fever and then started seeing blood in my urine on a Saturday. My only option was to go to the ER, which I did.
In the ER I had blood and urine tests, which determined that I had an infection in my kidneys. I was treated with intravenous antibiotics, and sent home a couple hours later with prescriptions for a couple more drugs to take for the next week or two.
IIRC my total bill for the 2-3 hours I was there was around $6,000, of which my insurance covered about $1500 and I was left with a $4500 bill to cover out of pocket. I remember thinking at the time that such an event would be financially catastrophic for most people - I was fortunate that I could afford it.
My wife has been with Kaiser for many years. Last year my wife started experiencing chest pains, which turned out to be pulmonary embolisms (blood clots in the lungs). She was admitted to the ER as well, where they ran some tests and got her on blood thinners. This was followed up with lung capacity tests and a few other things. Like me, she was in the ER for just a few hours, then sent home with appointments for follow-ups.
Total cost for my wife was about $50 all-in.
The magic of Kaiser is that when the insurance and the provider are both the same company, there's no dispute over pricing. There are no fights over bills, and no surprise costs that weren't covered. We have deductibles with Kaiser, but almost all services are a low fixed cost, so we don't eat into those deductibles much at all. This is not the case with other insurance companies.
In my mind the Kaiser model is what the US should have as a national health care system, that's really good at covering the 95% cases at a reasonable cost, leaving people the option to go to other providers for specialty care if needed.
Doctors aren't magicians, and they make plenty of mistakes. More to your point, no respectable doctor is going to ignore the cost and time element. Nor should he. There's no such thing as a cost-free diagnostic or procedure, even when money is no object. Even the very best doctor the world has ever seen is working with scarce time and resources; namely, his own. There's no avoiding conflicting interests and goals of some sort or another.
At the end of the day people should be choosing healthcare based on objective criteria. More importantly, our social policies should be built around objective criteria. By objective criteria Kaiser is one of the very best hospital systems in the country. There's plenty to complain about, but it's the nature of things.
Good for everyone else, I guess. :/ I ended up moving back home where the government covers my treatments.
US is a shithole country in relation to healthcare systems
Yeah with my plan I don't have access to outside doctors, so far however I didn't need them.
It wasn't until adulthood and having to navigate the fragmented world we have now, I realize how nice that was.
That and it was cheap(ish)!
I see a lot of folks praising KP in this post and it's very concerning.
When you look at how Kaiser is structured, they should be cheaper. I think they're just pocketing the difference between the market rate and what their costs are.
The whole thing is broken. A friend of mine is switching jobs and is going to forking over a third of her paycheck for COBRA until the new job enrolls her in their plan. Almost certainly, nothing will happen in that short time period, and she'll have wasted thousands of dollars. But if something did happen, and she didn't pay the extortion, sorry COBRA, she'd be up shit creek without a paddle and ruined.
https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/...
You can enroll after an event and it'll be as though you had insurance the whole time. You'll have to pay for the retroactive coverage, but it's a pretty smooth way (assuming nothing happens) to avoid paying for COBRA while still technically "having coverage".
Though I think there's a time-limit on it.
This is baseless and not really possible.
Insurers must spend 80% of premiums (85% for large group plans) on providing care for their insured.
When you can game the pricing you can always just slice 80% from an ever increasing pie.
It doesn't matter how much they play with pricing on the back end, the company can't make more than 20% profit from subscriber premiums.
That's completely illegal and it's just too noticeable for them to do it large scale.
The OP was making a baseless claim because they didn't know what they were talking about, and you're now grasping at straws supporting their claim for some reason.
>I think they're just pocketing the difference between the market rate and what their costs are.
The OP had made a very specific claim about Kaiser. That Kaiser is reducing their costs but pocketing the savings and not passing them on to consumers.
I pointed out that there is no legal way for them to do that. You've made 3 posts and so far nothing you've said in anyway refutes that.
There was a huge amount of waste in the system. 15-20% is a marked improvement.
The only place where I believe Kaiser falls short and gives the impression of pinching pennies is mental health care.
(Hope you’re feeling better)
I don't know if $725/per person is good or not, but when I've looked around at other plan, I've found plans with far worse benefits (high out of pocket costs) for more money.
The issue I see is that they are very reluctant to refer you to specialists even when the issue seems way over the GPs head. And they are somewhat fast-food-ish. Go in, do whatever it needs to be done quickly, then off you go.
But still way better (and cheaper) than the competition.
That said, it is terrible when traveling. It's almost as if they don't expect people to travel for more than a week at a time.
What do people do during long term travel?
I was briefly covered by a Kaiser plan, and have a lot of old friends who are either covered, work there, or worked there, and can say people really appreciate not only the relatively low costs but also the ability to just come to one place no matter the ailment and know you'll be able to get an appointment quickly and be taken care of, and won't have to haggle to get the care you need or deal with insurance company roadblocks. To the extent there are downsides (and of course there are) they are around not being able to have your own doctor (though I do think there is an approximation of that) and overzealous cost cutting (see the kidney center scandal).
My understanding is Kaiser has not spread much beyond California due to regulatory issues.
(Interestingly, Kaiser Steel was a major setting for Atlas Shrugged.)
[1] http://www.nytimes.com/2013/03/21/business/kaiser-permanente...