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elmerjfudd

For you Kaiser Permanente fans...

Elmer J Fudd
4 years ago
last modified: 4 years ago

Kaiser's mental health care system has been a mess for years. This article mentions many incidents of fines and sanctions imposed by the state. It comments that insiders say that progress under a negotiated settlement is phony.

"Michael Torres, a pediatric psychologist in the San Leandro clinic, said that when it comes to ongoing therapy, little has changed in the 17 years he’s worked at Kaiser. His schedule is so packed that he is able to see his patients only every four to six weeks, even when a child is experiencing major depression and should be seen weekly. " Most insurance plans allow weekly mental health sessions. One wonders why this guy hasn't left Kaiser - it may be because it's a regular salaried gig, like a government job. Unlike in private practice, he has no business to run and no patient base to worry about obtaining and servicing. You'd think that frustration in being unable to properly treat his patients would have driven him out.

Kaiser Mental health woes

Comments (18)

  • Elmer J Fudd
    Original Author
    4 years ago

    Haha. Yes. Lots of customers and among them a few fans. Though some would say a Kaiser experience is often enough to change one's mind in the downward direction about the quality of service.

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  • Lindsey_CA
    4 years ago

    My sister has had Kaiser insurance for many, many years. She loves it. But, she has no significant health issues and has always had a good experience. I'd say that's quite rare, though.

  • theresafic
    4 years ago

    My husband and I have Kaiser.

    he had lymphoma. Received excellent cutting edge care, out of pocket expenses , less than. 200.00. While he was receiving chemo, I didn’t have to worry about bills or fund raising to get money.

    i have some chronic pain issues and saw an excellent Dr, who listened to me, showed me the mri, explained the issues and prescribed non-narcotic pain meds.

    No place is perfect, but I don’t pay for mammogram, shingles vaccination or yrly flu shots.

    My husband has multiple health issues, but because they have electronic notes, all of his care providers are aware of his medical issue and his medications.

  • sjerin
    4 years ago

    Elmer, you never miss a chance. We know for you, it's Stanford, UCSF or nothing. Kaiser does indeed have a problem with its mental health dept and needs to hire many more doctors and other staff members. But the rest of it is absolutely fine. Your title is quite deceptive. A friend switched from outside care to Kaiser and is thrilled as she is so easily seen by excellent docs. Why do you insist on bashing Kaiser, basing your opinion on a couple of friends who were unhappy....when? In my 35+ years with them, I knew of one person who was unhappy with her ob doc and switched, and this was back 30-ish years ago. It feels like you're a troll trying to drum up business for your relative by bashing the competition.

    Don't knock the umbrella effect 'til you've tried it. (Kaiser was the first to switch to electronic records.)

  • Elmer J Fudd
    Original Author
    4 years ago
    last modified: 4 years ago

    sjerin, it was a SJ Mercury article I read the other morning that I found appalling. Not appealing. I shared it.

    Read lindsey's comment. I suspect she knows many Kaiser patients as a former California state employee in Sacramento. Note Zalco's comment too.

    I wasn't baiting or taunting, I read an article and shared it. You (or maybe someone else) had said before that they thought news accounts of Kaiser problems were unfair and overblown. In response to that, I said that over a lifetime of living in "Kaiser territory" (SoCal and Bay Area), no single provider had had more bad press nor more frequent bad press about outrageous things that others seem to be able to avoid than Kaiser has had. This is just another example, years and years of interventions and fines from regulators and still patient care suffers and the problems persist.

    If your experiences have all been positive, great. I hope that continues. In the meantime, don't deny the veracity of the many issues and problems Kaiser and its patients have had that have continued for decades. If that's news to you, fine. It's not news to many others in your community.

  • SEA SEA
    4 years ago

    DD2 works at UCSF. HR asked her to sign up for health insurance, her being a new hire -- gave her the options, several were HMO, PPO, Kaiser and UCSF private care. DD2, being young didn't know what to pick and was going purely on cost. She chose Kaiser. HR rep asked her to think about that again, call your parents and discuss, advised that most staff do not go with Kaiser, then we'll do this again in a few days. I told DD2 that I've known many people over the years who have had Kaiser and they sit in two unbalanced camps: 80% who could not be more unhappy with it. 20% who have excellent experiences such as teresafic upthread (which I'm very happy to read about). My take away with Kaiser from the people I've known going back 30+ years is that if you have an illness or condition that is within their field of expertise, like cancer, hypertension, migraines, heart disease it can be a good and economical system. If you have something unusual such as vague, yet debilitating autoimmune disease, good luck to you, cause you are going to need it. Not even a life raft sent your way. Not my personal experiences. Only what people have shared with me over many years.

    DD2 ended going UCSF HMO. So far, she's being cared for, but it's within a referral system and the time lag is difficult for her. She can only see a physician within the UC system. Basically, don't get sick outside CA. The cost has been manageable for her, which is her main concern at this time, but it's very compartmentalized as fas as treatment goes...one dr for this...another dr for that...yet another dr for this, I guess if she had gone Kaiser, she would of had less referral wait time now that she sees how the chosen health system is working out for her. There is also a dr shortage being experienced with her chosen plan and appt wait times are months out. I told DD2 that God forbid anything catastrophic should happen, at least UCSF will care for her and hopefully the compartment methodology she has to go through presently would be excused for an emergency! On the flip side, we (the parents), with our health plan, can see any dr we wish to, for any reason we wish to, without a referral (which is why we/she make note of the referral lag time), but there's that pesky $10k deductible always hanging around. Which means dh and I only see a dr once a year for our "check up". Any other reason, both of us can pound sand 'till we feel better. Few perfect plans these days.

  • matti5
    4 years ago

    Several family members have had Kaiser for many years, with very few complaints (medical side). Just as with any other medical facility/health insurance, sometimes you have fight to get what you need.

    I have a close family member that I help care for who is with Kaiser and has mental health issues. Kaiser's mental health dept. is a nightmare to say the least. God forbid one should have a mental health issue Friday after 5pm thru Monday before 8am, there are no services available even going through the ER. I cant begin to count how many times she's been turned away and told to call Monday at 8am. The medical side does not communicate with the mental health side. You would think that being seen in the ER for mental health issues would all go into the same computer system, so mental health dept. would be aware when you call. No! I have had three mental health staff members complain to me about it. Getting Kaiser to approve outside referrals for mental health is even more of a struggle. I feel sorry for the mental health physicians/therapists/staff as they are so understaffed and overworked. Shame on Kaiser.

    Sorry for the rant

  • Elmer J Fudd
    Original Author
    4 years ago

    I have a relative (not closely related) who's a Kaiser member, as his parents were. The medical mishaps this family has experienced over the years would be funny if not so sad. They're needlessly frugal and excessively so. For so many decades they could have afforded to pay for better care but they forgive problems over and over and stick with Kaiser because it's a less expensive alternative.


  • wildchild2x2
    4 years ago

    I am no fan of Kaiser. Agree with Elmer wholeheartedly on medical mishaps as well as delays in getting important labs and testing . But I can attest that the entire state has a huge mental health care problem. The county Elmer and I live in has a horrid shortage of psychiatrists available. It's not just Kaiser. We have excellent supplemental insurance along with medicare and have full access to any Stanford affiliate as well as most major hospitals.


    My DH is Bipolar and today we learned he may have another condition that may add dementia into the mix of rapid cycling of mania and depression. Let me tell you, there is no such thing as weekly visits here. Appointments are monthly and you better not miss one. Rescheduling is a nightmare. I have been dealing with this system for over twenty years. Our own personal physician is needing to get psychiatric help that is rather unique for a family member and he is finding it a nightmare to get an appropriate doctor.


    On the 4th of July we had a mental health crisis. I called everywhere. Our psychiatrist is in one of the largest mental health groups in the area. They were closed. I called several hotlines. Leave a message. In desperation I called two separate suicide hotlines. Both had a machine answer saying leave a message.


    I finally called the police for help. No help whatsoever. I requested CIT (Crisis Intervention) trained units. I got one officer who tried to help but was over ruled by his superior with a big attitude. A thug behind a badge. My friend stayed with me all night in fear for me and the house itself.


    So picking Kaiser out as a scapegoat is pure bull. I would never have Kaiser insurance , they have a lot of problems but what that article state is no different county wide and i have been told statewide.


    Yesterday I had another crisis to deal with. Neighbors called the police. I was calling for help. The police came over an hour and a half later when I already had him inside and calmed down. We were lucky to get a great team this time. I was very grateful to them for the way they handled things and understood the situation and how I handled it. Even DH didn't get his feathers ruffled up by them. I let them know I was happy to have them and thanked the neighbor who called them. I also told them I hope that they could make a change. Our force is known by every lawyer and outside forces for their bad apples. If they moved on elsewhere I would certainly understand.

  • Zalco/bring back Sophie!
    4 years ago

    I am so sorry watchmelol.

  • Zalco/bring back Sophie!
    4 years ago

    My grandmother chose Kaiser for her medical care when she was in the US. I was appalled at the careless/uncaring, irresponsible mistakes made. She had congestive heart failure, hardly an uncommon condition, and yet, they royally messed things up. I only found out they were jerking her around when my grandmother was dying and I was explaining what was going on to a friend who was a cardiologist. I stupidly never thought to double check anything with my friend. I was just venting to her as I was cancelling some plans she and I had due to my grandmother's illness. Because of my grandmother's age and stubbornness, chances are, things would not have ended much differently had the correct diagnosis been applied, but at least she should have had the opportunity to decide for herself what she wanted to do or not.

  • Elmer J Fudd
    Original Author
    4 years ago
    last modified: 4 years ago

    ditto, very sorry watchme and zalco. Good luck.

    I wasn't aware of the psychiatrist shortage but there's also a primary care doc shortage too. I suspect for the same reason - low earnings compared to peers. A reduction in the ranks as older ones retire, there's not enough new docs coming along to take their place and handle population growth too. Insurance reimbursements favor specialties that do procedures and turn the thumbscrews on those who spend their days seeing patients in the office.

  • wildchild2x2
    4 years ago

    This article is over a year old but it goes further in depth than most regarding the shortage of mental health practitioners.

    https://www.sacbee.com/news/local/health-and-medicine/article214019489.html

  • SEA SEA
    4 years ago

    I'm very sorry you are going through/went through this, Zalco and watchmelol.

  • quasifish
    4 years ago

    Where I live, if you are not a senior on Medicare, having Kaiser means you can actually find a doctor who is accepting new patients. So many coworkers of DH's switch to Kaiser after the first year at work because they simply cannot find someone in the PPO to see them for even routine medical care.

    When my dad had mental health issues, he had stellar insurance. Even he would have had a 3 month wait for a great psychiatrist, except the administrator of the home he was staying in knew the doctor personally.

    My personal experience with Kaiser is that the doctors tend to be very good, but things fall through the cracks. You have to be vigilant, ask questions, and chase down information. The same thing seems to be routinely true for our non Kaiser friends.

    All that said, DH is going through a major medical issue right now. Not a common thing at all. Care with Kaiser sometimes seems a little slower than we'd like, but when compared to what my mother deals with her medicare and her cancer treatment, she has the same type of time constraints, and a lot more hoops to jump through. Still, ideally I wish neither of them had to deal with these systems.

  • Lindsey_CA
    4 years ago

    elmer wrote, "Read lindsey's comment. I suspect she knows many Kaiser patients as a former California state employee in Sacramento."

    The State of California offers 17 health plans to active and retired employees (some of which are only available to Peace Officers and CHP). The information on the health plans and rates is available online (calpers.ca.gov then click on the tab for Active Members (or Retirees), then on the tab for Health Benefits, then the link for Plans & Rates).

    I'm not sure if the "formula" is the same as it was when I was still an active employee (and I don't care enough to search out the answer), but the way the State used to determine how much $$ the State would contribute towards the monthly premium was to take the four most-subscribed-to plans, and then average the monthly premium for those four, and that's what the State would contribute. Kaiser was always one of, if not the least-expensive plans, so a very large percentage of employees would choose Kaiser because the premium was fully covered by the State's contribution.

    Over the years, though, more and more people switched to plans other than Kaiser, so the State's contribution went up. And a LOT of folks switched away from Kaiser when they retired, because Kaiser only covers parts of California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and Washington, DC. Kaiser will cover emergency and urgent care anywhere, but not routine or continuing stuff. People that want to live in states not listed, or live outside of the USA, need something other than Kaiser.

  • jakkom
    4 years ago

    If you want to live outside the West Coast, does it make sense to change to PPO? Sure it does.

    Does Kaiser make medical mistakes? Yup.

    So does the hospital and three different doctors in Macon GA that treated my friend's mother last year for a hernia. First they misdiagnosed her. Then they admitted her, gave her the wrong medications and almost killed her, delaying the surgery.

    When they finally did the surgery, they nicked a vein and THAT almost killed her.

    "A recent Johns Hopkins study claims more than 250,000 people in the U.S. die every year from medical errors" - per CNBC, 2018. Probably a good percentage of those were NOT Kaiser patients, LOL.

    Anyway, sorry for going OT.

    We're reasonably satisfied with Kaiser. We tried a different plan years ago, and ended up spending the entire year trying to find a doctor who was taking new patients. The health plan (I'm not naming names) was absolutely useless. Every referral they gave us wasn't taking new patients. The only doctor we could find was in a dumpy clinic in the absolute worst part of the city. No thanks, I'd like to come back and find my car intact, please.

    My MIL had the Blue Shield PPO plan. The care was very good, and we were lucky to squeeze her onto the practice of the ONLY geriatrician in the city on her plan. But I noticed that when she fractured her arm, her PT, which was done off-site in another city, really padded the # of sessions she received. They knew Medicare was going to pay for it even though it was obvious her final month's visits were unnecessary.

    The mental health system in the US is even more broken than the medical insurance system, and that's saying a lot. Not much point in being the wealthiest and most powerful country in history when we don't seem to take very good care of our citizens.