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Kaiser CEO calls for health care for all
Kaiser Permanente CEO George Halvorson.
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Kai Ryssdal: While Congress is getting tutored on health care, the White House has been holding its own informational meetings. Over the past couple of months President Obama has met with health-care groups and executives to talk about what he wants to get done. The pharmaceutical industry has been to the White House. Doctors' groups. And insurers, of course. The CEO of one the biggest non-profit health-care systems in the country has been in on those consultations, too. George Halvorson of Kaiser Permanente. When we spoke earlier this week, he said the media missed the point of the White House meetings. That the real discussion this time, behind those closed doors, is about changing the way care is delivered. Not about the cost.
GEORGE Halvorson: That's one of the really fascinating things about this wave of reform. Because in the Clinton era, people were talking about reconfiguring the care delivery system. This most recent reform has been more heavily about cost savings. And the president has said repeatedly that he wants higher-quality care, better care, and wants to get to the right outcome by making care more affordable by making it better. But the debate has gone off track from that point.
RYSSDAL: Let me pick up on that point for a second. We had on the day of the president's press conference last week, we had David Leonhardt on from the New York Times. And he had written a column about health care, and why it's so tough to figure out. And his lead question was, people don't understand what's in it for me. And that's a theme the president picked up on Wednesday night. So I want to flip that around and I want to ask you as a representative of the health-care industry at large, what's in for health care to get this reform going?
Halvorson: What's in it for health care is if we can cover everyone in America, we can do a much better job of taking care of people. Right now, a majority of kids do not get right care for asthma. And because kids have coverage, and they lose coverage, they go to a care site, they go to a different care site. There's no feedback from the emergency room to their primary care doctor. There is no consistency in asthma care, and that can't be fixed until the kids have continuous coverage and a continuous database. So if we're really going to fix care, we need everyone covered.
RYSSDAL: Universal coverage, that's your step one.
Halvorson: Universal coverage. Yeah. We need coverage for everyone in America.
RYSSDAL: So how do we get from where we are right now to universal care? How do we do that?
Halvorson: We need to do a couple of things. One of them is we just need to make sure we expand Medicaid to cover all low-income people, whether or not they're parents. We need to make sure there's intermediate subsidized care for middle-income people. We just need to make the commitment. Every other industrialized country has done it. And most of them do it with a double mandate. Everyone must buy coverage, and every insurance company must sell it.
RYSSDAL: Isn't it time, though, perhaps to get our brains around the fact that if we're going to do that, at some kind of reasonable cost, then everybody can't have all the care they want.
Halvorson: I don't think that's true at all. The issue is not that we need to ration care. We do not need to ration care. Right now, when you look at diabetes, 32 percent of the cost of Medicare is diabetes. It's the number one cost of blindness, it's the number one cause of amputations, it's the number one cause of kidney failures. And when you look at the care delivery patterns in America, we only get care right for diabetics 8 percent of the time. If we got care right for diabetics 80 percent of the time, we'd cut the number of kidney failures in half.
RYSSDAL: At the end of the day, are you hopeful or not that this time around we're going to get some kind of change to the health-care system done?
Halvorson: I'm extremely hopeful. I am extremely hopeful, I'm optimistic. I think that there are a lot of people pointing in the right direction. I think we haven't figured out the specifics of what the right direction is yet. And that works need to be done. It needs to be done quickly. But I'm basically very optimistic.
RYSSDAL: You've been following the terms of the debate, right? You've been reading what's going on.
Halvorson: Yes. Very directly.
RYSSDAL: And you're still optimistic?
Halvorson: And I'm still optimistic.
RYSSDAL: I have to ask you where that's coming from.
Halvorson: It's coming from a belief that we have to get it right this time.
RYSSDAL: George Halvorson. He's the CEO of Kaiser Permanente. Mr. Halvorson, thank you so much for your time.
Halvorson: Thank you for having me on the show.
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In 1998 I was with Kaiser and my health care for a family of 4 cost $303/mo. In 2006 the cost had risen nearly 650% to $1956/mo. The reason was clear. I reached 50 years old and Kaiser saw me as an expensive problem. Even though none of us had any serious health problems, Kaiser was determined to get rid of us before we did. At nearly $24,000/year the suceeded.
I find it incredibly hypocritical for the ceo of Kaiser to act as a spokesperson for improving health care while at the same time redlining seniors and those with health problems. Their touchy-feeley commercials sicken me but unfortunetly my health insurance won't pay for treatment, they only charge for it.
As a Kaiser employee, I do feel that we provide a great care for our patient daily. Our Interventional Neuro Radiology Service spends more than $100,000 for coils that we treat one patient for aneurysm for his/her visit. I however do not know how George Halvorson could suggest that we pay for all the uninsured when:
1. Dr. practices defense medicine because of lawsuits.
2. We can not cut cost and not compromising patient's care.
3. If we expect goverment to pay for this reform and with all the debt the future generation will pay, Mr. Halvorson can live comfortable with his CEO salary but we as frontline staff will not be.
Kaiser needs to be expossed for the horrible way they treat patients. They are corrupt greedy CEO's who will kill for the sake of a dollar. I know of two people close to me that died because of their mal-practice. I am about to be third on the list if they have their way. I am going to start a PETITION against them because as long as we continue to let them get away with murder they will continue to push drugs in place of quality care.
We must take a stand.
Folks, sorry to rain on the parade but has anyone noticed we're already mortgaging our childrens' futures with all the unfunded entitlement programs we already have? Anyone notice the two TRILLION dollar deficit we will have just this year alone? Perhaps rather than plowing another 30 million people (15 million illegals wouldn't be covered) into a broken government system, we should take all that purported "wasteful spending" and cut our deficit first. Let's see what we can really afford before we swipe that credit card.
Incidentally, the crux of the problem lies in a few areas that the media doesn't often mention: 1) doctors aren't saints, many are profit-seekers like the rest of us. Guess what happens when you put profit seeking doctors in charge of determining what care is necessary for patients -- and pay them for whatever they do? Hm... 2) Government is already responsible for about half of all US healthcare spending. Kind of hard to blame the broken system on everyone else when you are the biggest piece of all. One of the biggest problems with the government-created system is it's fee for service design...and because it's the largest payer pretty much every insurance company has had to go along with that same model. (See #1 for what happens with that.) 3) Medicare and Medicaid try to stretch their deficit dollars by underpaying providers anywhere from 20-50% versus private payers. These underpaid providers then jack up the rates that the rest of us pay them, and moreover do more and more procedures to make up for lost income, in what becomes a vicious cycle. This is a huge hidden tax.
Anyway, I'm sick of the blind arguments on both sides...there are some serious problems with our current system, and as ANY pragmatist can see, we should fix the problems with the current system and be honest with the public on what we can actually afford before we make wild new promises whose inevitable massive cost overruns and unintended consequences shouldn't be turfed onto the next generation to deal with. We've already tried that one before.
I had an entirely different experience with Kaiser. I'm a former Kaiser patient and I dropped my plan out of frustration and concern for any future care of myself and my family. Our experience was many cancellations with appts. We could never see the same Dr. twice, usually only nurse practitioners. There were many misdiagnosis and delayed diagnosis. Records were lost and requests for release of medical records were completely ignored and/or became lost. I'm very concerned about the electronic medical records which kaiser has blown alot of money on. EMR will make it that much more convenient for Kaiser to alter medical records at will, which is another thing Kaiser is known for. My family will stay away from Kaiser at all costs. We've seen way too up close and personal what happens when you go to Kaiser for care. Complete disaster.
Just to address a few issues; cost of prescriptions, test, co-pays, etc. are based on the agreement the company you work for has made with Kaiser. This is based on what the company is or is not willing to pay or cover. This is not based on Kaiser Permanente. Thus, the amount the member/patient would have to pay. Prescriptions can be filled anywhere you chose, just complete the necessary forms and you will be gladly reimbursed. I have received state of the art and exceptional care with Kaiser for over 10 years now. When I transferred to another clinic due to relocation; the new physician had all my medical history at her fingertips; literally. I know that Kaiser is striving to always improve care and access. There are just as many stories regarding similar healthcare plans and private healthcare. Look at the overall history, the improvements made over the years, and the success of Kaiser, all of the free healthcare they give to children in the community, and all the help Kaiser employee’s give; free of charge, to make our communities a better place. Compare to other large corporations. Go to JD Powers and see how Kaiser really does rate. You will be quite impressed. The fact of the matter is, whether in healthcare or not and you will find dissatisfaction and human error. We all make errors; no one person or company is perfect and never will be. And it is so unfortunate when an error is made and a loved one is damaged or lost. Striving to reach as close to perfection as possible; that shows the caring behind the company.
I have been with Kaiser for many years and cannot personally fault their care...it has been excellent and very responsive. I do question Halverson's "rush" to universal care. I think he, as most hospitals, are looking for 100% reimbursement for the indigent care they have to provide to anyone who walks through the door, as found in California. Any Hispanic, or otherwise indigent or uninsured persons can walk in and obtain emergency services and expensive tests (or be sued…often), and we taxpayers ultimately get most of the cost passed onto us. County facilities and local hospitals spend tens of millions of dollars on gang related gun shot victims, all of whom are uninsured, and WE already pay the bill through higher taxes.
The number of 47 million people who are uninsured is bogus. If you intelligently look at the breakdown it involves groups of persons who either refuse to pay for health care, or who can't afford it, or already have government subsidized “clinic†healthcare, and some who are gambling they are young enough to not need it. Fact, many of those, such as illegal Hispanics, already have "free" or highly subsidized health care through health care clinics in their communities, or through county health agencies, all at taxpayer expense. Like most of us natural citizens, we didn’t have children until we were employed and could responsibly pay for the birth and healthcare. Our health plans are set up so that we have deductibles for each visit, and pay more for emergencies, or afterhours care. Hispanics just show up at a county hospital, are warmly received, and get immediate “FREE†care, including expensive tests and pharmaceuticals, all at our expense, in both taxes and increased healthcare premiums.
The problem is the government can't run anything without screwing it up (name one thing the government controls that is not…one thing), and if you offer it free, those who don't work, refuse to work, will take advantage of the system, over and over again. That's why we have higher costs that fall to Medicare, an already broken system that doesn’t work. So rather than fix the “systemâ€, Obama wants to dump everyone into the “existing†and broken system and charge whatever it will cost to medium and higher taxpayers and corporations that employ most of the people. So, those who are here illegally; those who represent the forth generation to live off welfare by having babies out of wedlock and who are rewarded with more welfare for having more babies; those who refuse to purchase or carry health insurance because they are also milking the system; and those who feel the risk is better than paying an insurance premium, are going to pull down the “best healthcare system†of any country in the world.
The system is broke when Medicare is so poorly run that a Pizza Parlor can bill Medicare for a heart bypass, and a doctor in Florida can bill for ten sigmoigoscopies for the same patient, one the same day, and get paid! And, to top that off, our stupid congressional representatives and leadership are not even reading the bills before voting on them. To date, 96 congressmen and women have signed an oath to promise to read each bill completely before voting on them. All Republicans…not one Democrat! What were they elected for…blind allegiance to Reid and Queen Pelosi? We need to clean house folks, but that is another matter!
Right now, Medicare subsidizes Kaiser for the Advantage Health Plan I am on. I pay an insurance premium to Kaiser and to Medicare each month. If Kaiser cannot get some reimbursement from somewhere for the uninsured’s that walk in for expensive health care, my healthcare cost, or my taxes, or both, will go up. On a meager retirement, I will be forced to join the Universal Medicare Plan, which is probably okay with Kaiser as senior health care is the most expensive group to insure. So, Halverson is pushing the universal health care system to either dump or selectively cull out older seniors from the Advantage Plan, without legal liability, so Kaiser can insure those who are younger seniors or still employed. Those of us seniors, forced into a government run plan, will absolutely find rationed care, substandard hospital care and robot physicians who will follow Federal Guidelines on health care, and not provide what the patient needs. That is a very sobering proposition for those of us who have paid into this system over our entire working life. When we need good healthcare, we will not be able to get it, because those who abuse the system will benefit at our expense.
The obvious fact that Obama is cramming this thing down our throats should clearly indicate his true character and integrity...where is the transparency he so often pontificated would be found throughout his administration? No one questions the need for healthcare reform, as the present Medicare system will not be able to deal with the oncoming “baby boomer’s†now starting to come onboard. However, forcing seniors into a “universal system†run by bureaucrats, and bloated by the reported 47 million who already have “free†healthcare, or don’t deserve healthcare, or who refuse or don’t have insurance, is not the answer. He is pandering to the political far left, which is, after all, exactly where he came from!
For those of us seniors, who are facing this crisis, it is a matter of life…and death! For those of you reading this that are not here yet, what will be your reward for the years of carrying the tax burden of others. Will you be able to afford to fly to Thailand to receive your hip, knee replacement, or cardiac shunt to prolong your life?
It always baffles me when I read these articles labeling George Halvorson as some kind of visionary leader in health care reform. Am I the only one who reads and remembers the news about the scandals that have come out of Kaiser Permanente in recent years?
Just a few things that immediately come to mind:
There was the San Francisco Kidney Transplant Center that was closed down in disgrace after patients were delayed and denied transplants.
Kaiser was fined several million dollars by the State of California for its systemic failure to address patient complaints.
Five Kaiser Hospitals were found to have the highest mortality rates for pneumonia care.
KP was investigated and fined for illegally rescinding policies along with several for profit insurers.
And there have also been several successful lawsuits against KP by physicians and employees who were retaliated against for attempting to actually address the internal problems.
I could go on and on. If Mr. Halvorson is so keen on health care reform, why hasn't he reformed his own organization?
Halverson is spot-on. You can't fix health care without an integrated holistic approach which begins with universal care, and uses information technology capabilities to improve operational effectiveness, efficiency, and customer satisfaction (as has been done for years in many other industries).
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