kaiserfraud ([info]corphq) wrote,
@ 2006-11-09 14:47:00
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Entry tags:kaiser lawsuit, kaiser permanente, kaiser tech, kaiser workers

Kaiser Hasn't Assassinated Me (Yet)
Hi, all - I'm at a "Web 2.2" meetup, and I'm having a lot of trouble with the wireless connection. Therefore, I apologize for any delay in moderating comments.

In the meantime Pound of Cure found another interview with Justen. I'm going to copy my whole comment here:

Wow, that looks like a mug shot of Justen! I'd like to point out that as the "anti-Kaiser web site" that broke the story, I refrained from posting Justen's email. I still haven't posted it. Because of my own experience, I knew what he was in for, and I didn't want to add to what he was going to go through.

As for the issue of "keeping it internal", though, Justen did set up fixkp.org as a public web site. He intended to take the problem public. But Justen is probably going through a lot of turmoil right now with all sorts of people who don't know him commenting about his motives. I tried to warn him that he wouldn't be treated well by Bay Area press. Hopefully this story will be covered by media venues that have less of a stake in Kaiser as a backbone of the Bay Area economy that employees friends, family, and career influence-brokers.

Also, Matthew Holt of The Health Care blog still thinks the bloodletting has nothing to do with the EMR. However, he does think Cliff "Changed-My-Name-to-John" Dodd may have made a wee faux pas by not disclosing the million dollar conflict of interest caused by his Board gig at Tanning.

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Matt Holt = Kaiser Apologist
(Anonymous)
2006-11-10 03:14 am UTC (link)
Matthew Holt has, on more than one occasion, demonstrated an uncanny ability to overlook the evidence in favor of apologizing for Kaiser Permanente.

It was all a big misunderstanding and the dolts in charge had no idea.

Mr. Holt is not stupid. It's pretty obvious he's protecting his future income stream by continually helping Kaiser play its "disgruntled employee" card.

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Re: Matt Holt = Kaiser Apologist
[info]corphq
2006-11-10 03:22 pm UTC (link)
I think in his eyes, a national health care system would look a lot like Kaiser. Plus, he's been push health providers to get on board with the EMR future. Major EMR failures may lead to hesitation, and mon dieu, alternative solutions.

To which I would say: a COLOSSAL BILLING SYSTEM is not an EMR intended to improve patient care.

(Reply to this) (Parent)
Matthew Holt's future income stream
(Anonymous)
2006-11-12 01:26 am UTC (link)
Hmm.....You are all welcome to examine my client list for the past 6 years and see where on it Kaiser fits. The answer is of course nowhere -- almost all my work is for tech companies and start-ups, and almost none of it deals with their relationships with end clients, and I haven't even been peripherally involved in any of my clients relationships with Kaiser. And given that I work for lots of different companies (and publications) my loyalties are only to myself and what I consider to be my integrity. If KP is sending me a big check, then it sure hasn't shown up yet!

I absolutely agree that an ideal health system for the US would have far more big integrated systems in it than the current disorganized mess. Does that mean that KP should be allowed to be so opaque and get away with malfeasance? Absolutely not. I'm the one who called for the full public enquiry about the kidney transplant fiasco.

But any reasonable person will realize that what KP is trying to do on the EMR front is both good for their members and very hard to do.

But if you think that I am justan apologist for Kaiser because I don't think that all 100K plus employees are the living embodiment of Satan, then I don't think there's too much to debate about.

Matthew Holt

PS Gadfly, these comments are a pain in the arse to use

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Re: Matthew Holt's future income stream
[info]corphq
2006-11-12 02:17 am UTC (link)
Sorry you're finding the comments a pain, Matt - LiveJournal is really made for mutual users of LiveJournal.

I've always regarded you as someone trying to get a working health care plan in place, and you see HMOs and, more particularly, EMRs as being important building blocks. While you might be right about EMRs in general, I think you're wrong about how well Kaiser's approach is going to work as a model.

One of the main problems, which no one has mentioned, is that the Kaiser EMR was never about the patient (unless you count enhanced ability to pick the patient's pocket). The EMR was about a bunch of doctors who wanted to be IT thought leaders/venture capitalists. Doctors have the same problem as teachers - the rest of the world wants them to live a life of public service. Doctors, however, are also individuals who want to carve out the best career for themselves that they can - and, even better, get rich doing it. I can't count the number of times I heard doctors complain about how they should have gone into IT so they could make big money like all their Silicon Valley friends.

So what's an envy-ridden doctor to do? Miracle of miracles - HIT and Informatics and the EMR started to look like a whole mountain of Next Killer Apps. All the doctors wanted to get out of dealing with the sick people and gain cred as IT Project Managers. Their business justification? Doctors should be making important decisions about health care, including IT decisions. This built-in incompetence factor is why Kaiser ends up wasting so much money. And I'm still waiting for Kaiser members to relate the size of their monthly fees to the scope of that waste.

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Re: Matthew Holt's future income stream
(Anonymous)
2006-11-12 06:29 pm UTC (link)
Please God spare us from HMOs. If the future of medicine in this country is built on HMOs then we are all doomed. You might as well get your diagnosis out of a cracker jack box. I can tell you with all certainty that the BEST medical attention that my family has received has been from private doctors who take NO INSURANCE!!!!! (Yes, there are exceptions to every rule, but very very few.)

I"m sure I'm not such a learned scholar as Mr. Holt, and I do agree that health care industry in this country is so whacked something needs to be done, but not by increasing HMOs that have incompetent doctors. Maybe it could start at med school where doctors could learn to treat their patients as human beings, and not liabilities to their bottom lines. Nope, doctor's are taught to act like demi-gods whose words aren't to be questioned. Instead of admitting that they don't know what's wrong with you, they make up a diagnosis and turn on the salesman pitch. And heaven forbid if you come in to their exam room and have an idea of what your symptoms may indicate - then you are labeled a hypochondriact and ignored altogether.

That modus operandi may have worked in the early and mid part of last century, but this is the era of information access. Doctor's need to wake up and understand that people aren't going to sit around while they do nothing. Doctor's should embrace this and understand that it's their patients participating in their health care. (Isn't that what the damn 'thrive' campaign is all about?)

Instead, in the HMO mentality it's get them in and get them out. Kinda like a quick oil change. Can't spend more than 15 minutes per patient, cuz their stacked, backed and racked in the waiting room. My wife had begged me for so long to get a physical. I hate going to the doctor, but finally gave in. So I made an appointment why my HMO, and went in. Since this was the first visit, I filled out the requisit medical history forms and then was called into the exam room. I put on the lovely gown they give you and waited. Nurse came in and took som vitals, and then Dr. HMO came in, asked me a few questions, listend to my heart, did the cough test, asked if there were any STDs he should check for, ordered some blood labs, and said I could go. All in about 5 minutes. After he left the room, I sat their stunned. I've had physicals before (as a child and teen) and they were far more comprehensive. I felt like I had just wasted my copay.

Only thing that really transpired out of that was that I got my cholestorel results back and along with a photocopied sheet of what to do reduce it. Funny thing is, you could tell how dated the suggestions were, cuz they suggested I use margarine instead of butter. Sure... I'll just eat more hydrogenated oils, that's really healthy.

Anyway, my point is HMOs are not the answer to our healthcare crisis in this country. Getting the real medical decision makers out of the process (the insurance companies), reducing the kickbacks between doctors and pharmaceuticals, taking the red tape out of the claims process is, and most importantly establishing ethics in the medical industry. To coin a phrase by paraphrasing something I hear over and over again - there is a human being at the end of that scalpel/stethoscope/syringe/(insert your favorite medical instrument here). That person isn't there to make your day miserable, or to waste your time. That person has a medical need that needs attention, and you are their hope of getting it fixed. Treat them the way that you would want to be treated. Would you like to be told that you are imagining the sheer pain that you are feeling? Would you like to be 'treated and streeted'? Probably not.

Unfortunately, free market healthcare is a two-edged sword that destroys alot of lives along the way.....

(Reply to this) (Parent)(Thread)
Re: Matthew Holt's future income stream
[info]corphq
2006-11-12 06:43 pm UTC (link)
One of the problems in California is that IT booms and busts have created horrible inequities in wealth. Successful professionals feel like they missed out on a chance to become bazillionaires, and even the temporary loss of a job can devastate a family because inflation hit us right in the necessities - housing, food, etc. And it doesn't help that the career gurus are always advising people to spend even more money to get back in the game: do your hair and nails or even get plastic surgery, get into the social circuit so you can "network", and pay for high-priced events. I'm so sick of hearing that I have to go broke and be stressed out all the time just to have a shot at earning a living.

I don't think we need a planned economy - but some curbs to reduce the robber-baroning a little would be nice. And one of the bonuses would be doctors who care about doing their jobs again instead of this constant nattering for venture-capital style "incentives".

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Re: Matthew Holt's future income stream
(Anonymous)
2006-11-12 07:43 pm UTC (link)
Author of the Kaiser Apologist comment here.

I know you don't make money directly from Kaiser. I think you apologize for Kaiser to maintain a certain image for current and future clients. It's not very fashionable to criticize Kaiser in the health care world, and anyone who does is written off as a nut with a grudge. JMO, and creating false choices between being a Kaiser apologist or thinking all Kaiser employees are Satan doesn't do much to change it.

None of Kaiser's critics believe all Kaiser employees are evil. The problem is a corrupt corporate culture, but you seem unwilling to accept that even when the evidence suggests otherwise. I believe you will eventually come to understand this. You just need to hear the same lame excuses come out of Kaiser a few more times, and then it will be more difficult to dismiss the problems as isolated incidents. Like I said, I don't doubt your intelligence one bit.

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Re: Matthew Holt's future income stream
(Anonymous)
2006-11-13 08:01 pm UTC (link)
Well I'm certainly not intelligent enough to be the several chess moves ahead that you think I am. I call it the way I see it, and KP does far too much that is good and positive for their patients and members for me to call the whole thing corrupt and useless as you do. Or alternatively everyone I've ever met there is such a good actor, they should all be making the next Borat and I've been fooled. Explain to me where I am apologizing for them?

And Gadfly/the other anti-HMOers, you have to get real about both the US' health care problems and how to solve them. And I can tell you for no money that expecting doctors to provide care to the unisured for free is not going to be the solution.

Still fun that Gadfly thinks I'm an a list bogger and her's is repressed!

Matthew Holt

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Re: Matthew Holt's future income stream
[info]corphq
2006-11-13 08:12 pm UTC (link)
Hi, Matt - MSM coverage definitely puts you on the A-List! You're a health care blogging rock star!

Health care: I think if there's no universal employment, then there has to be universal coverage. Right now people are looking at doctors to donate their services because there's no system to cover them otherwise.

As for my stance on Kaiser: for three years I have pointed out wrongdoing to myself and others. Kaiser has never done anything to remedy the damage it has done. To anyone. In fact they've just made the problems worse through their efforts by using PR to cover up and manipulate the media. When Kaiser starts behaving differently, then perhaps I will revise my opinion. However, everything they have done over the last three years shows me that when they do horrible things to people, they will do anything they can to get away with it.

(Reply to this) (Parent)
Re: Matthew Holt's future income stream
(Anonymous)
2006-11-13 09:55 pm UTC (link)
"...KP does far too much that is good and positive for their patients and members for me to call the whole thing corrupt and useless as you do."

I said corrupt. I didn't say useless. Kaiser's critics want it to change how it operates, and that means problems must be addressed honestly when they occur, which as Gadfly rightly points out Kaiser never does (and I do mean NEVER). No one claims Kaiser botches everything it does, or that no good is being done there.

The problem is that Kaiser's internal complaint process is geared toward finding ways to deny everything and cover up wrongdoing by Kaiser, rather than resolving the problem. What happened to Gadfly happens to every other employee with a grievance. Patients go through the identical process. Kaiser's lawyers pull every dirty trick in the book to revictimize people in arbitration who have already been harmed. Kaiser ruins lives, and every time you say you don't believe it's true you are apologizing. Because you do have the respect of people in the health care world, in a small way that means you are helping to prolong the misery. I don't believe it is intentional.

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