4 ms·

Kaiser is the only non-broken part of the U.S healthcare system. They have never sent me a bill for a surprise out of network anything. Out of network doctors

Kaiser is the only non-broken part of the U.S healthcare system. They have never sent me a bill for a surprise out of network anything. Out of network doctors don't work there. All doctors are on salary. You get one bill from one company. No wonder they have been growing like crazy in California.

CGamesPlay 6y ago
They have sent me a bill for non-preventive services which should have been billed as preventive (aka free), but to their credit I was able to get them to refill with a not-too-tedious phone call.
dilyevsky 6y ago
Kaiser is amazing. Other than no surprise bills that you mentioned they also have your full history that is accessible to all doctors and to you. Also no scammy $200 new patient copays etc
throw123123123 6y ago
Kaiser is popular and 'a' model of care, but do note that it is extremely limited in coverage and is one of the most draconian in respect to providers. They hire people right out of medschool with the offer to pay their entire student debt if they stay with them for 8 years. They have massive burn out.
- wbl 6y ago
  Kaiser promptly volunteered to perform several minor surgeries I would have spent months hunting down preauthorization for other places. It was almost scary how efficiently they bumped me up to the right person with me having to do almost nothing to arrange it.
- disabled 6y ago
  Yeah, if you have a rare disease, which 7-8% of the general population collectively has (there are about 8,000 or so rare diseases), for example, then you are totally screwed if you have an HMO. Rare diseases are difficult to treat, frequently involve multiple systems of the body, often require many off-label non-FDA approved treatments, and require specialists that are often in niche fields of medicine.
- Gravityloss 6y ago
  Hmm is that kind of a contract legal? What happens if a person leaves after four years?
  - leetcrew 6y ago
    why wouldn't it be? if you leave early, you're no worse off than you were when you graduated med school. I guess you could be worse off if you wouldn't have gone to med school in the first place if the offer wasn't on the table... I'd guess if you leave early you have to pay off your own debt, possibly prorated by years on the job.
    - Gravityloss 6y ago
      To me it seems like such a long period of time that it starts infringing on the employee's freedom. What's the limit? Can you sign somebody up for 50 years of labor?
      - throw123123123 6y ago
        Seems to be frequent enough with debt I guess.
        Gravityloss 6y ago
        With debt you can still switch jobs or move or switch banks etc. This contract as presented was much stricter.
  - throw123123123 6y ago
    You have to return the entire amount of student debt. Kind of how signup bonuses work in tech, but this is for 8 years
ironmagma 6y ago
To say they work is a bit doubtful. Because they are both the insurance and the doctor, there is an incentive for them to find nothing wrong with you.
- refurb 6y ago
  The incentive is the opposite. Kaiser gets a fixed premium from its patients no matter how much or how little care they get.
refurb 6y ago
Kaiser is an integrated provider - both the medical care and insurance so any billing, approvals are all internal. The only issue I’ve heard is mental health care which is apparently quite lacking at Kaiser.
deleted 6y ago
[deleted]
kelnos 6y ago
Kaiser members I know who have needed mental health care have found that part of their system to be atrocious. Sure, maybe the billing part of it is still great, but the care itself is not.
ryanbrunner 6y ago
From the perspective of most of the world, having to limit yourselves to medical care that's provided by a particular company seems very broken. (unless I'm misunderstanding how Kaiser works). I can just go to whatever walk-in clinic, urgent care provider or emergency room I need, depending on the severity and get treatment (I do try to go to my GP if possible, but I have many options if that's not practical for some reason).
- leetcrew 6y ago
  > From the perspective of most of the world, having to limit yourselves to medical care that's provided by a particular company seems very broken. from the perspective of some people in the US, this is exactly what socialized medicine looks like, except you can't change the company.
  - ryanbrunner 6y ago
    Most countries that have socialized healthcare still have private providers - the government is paying for healthcare, but they're taking on the role of the insurance provider rather than the healthcare provider.
Balgair 6y ago
I agree, Kaiser is very very good for the US. However, they tend to be more of a 'standard' care kind of thing. Like, broken arms, colds, pregnancy, all good under Kaiser. But harder things like cancer, ALS, Parkinson's, it's a lot tougher for them to get you the right treatment. This, unfortunately, I know about as people close to me had to leave Kaiser to get dealt with. That said, Kaiser is still my gold standard for the US.

CGamesPlay 6y ago

They have sent me a bill for non-preventive services which should have been billed as preventive (aka free), but to their credit I was able to get them to refill with a not-too-tedious phone call.

dilyevsky 6y ago

Kaiser is amazing. Other than no surprise bills that you mentioned they also have your full history that is accessible to all doctors and to you. Also no scammy $200 new patient copays etc

throw123123123 6y ago

Kaiser is popular and 'a' model of care, but do note that it is extremely limited in coverage and is one of the most draconian in respect to providers. They hire people right out of medschool with the offer to pay their entire student debt if they stay with them for 8 years. They have massive burn out.

wbl 6y ago
Kaiser promptly volunteered to perform several minor surgeries I would have spent months hunting down preauthorization for other places. It was almost scary how efficiently they bumped me up to the right person with me having to do almost nothing to arrange it.
disabled 6y ago
Yeah, if you have a rare disease, which 7-8% of the general population collectively has (there are about 8,000 or so rare diseases), for example, then you are totally screwed if you have an HMO. Rare diseases are difficult to treat, frequently involve multiple systems of the body, often require many off-label non-FDA approved treatments, and require specialists that are often in niche fields of medicine.
Gravityloss 6y ago
Hmm is that kind of a contract legal? What happens if a person leaves after four years?
- leetcrew 6y ago
  why wouldn't it be? if you leave early, you're no worse off than you were when you graduated med school. I guess you could be worse off if you wouldn't have gone to med school in the first place if the offer wasn't on the table... I'd guess if you leave early you have to pay off your own debt, possibly prorated by years on the job.
  - Gravityloss 6y ago
    To me it seems like such a long period of time that it starts infringing on the employee's freedom. What's the limit? Can you sign somebody up for 50 years of labor?
    - throw123123123 6y ago
      Seems to be frequent enough with debt I guess.
      - Gravityloss 6y ago
        With debt you can still switch jobs or move or switch banks etc. This contract as presented was much stricter.
- throw123123123 6y ago
  You have to return the entire amount of student debt. Kind of how signup bonuses work in tech, but this is for 8 years

ironmagma 6y ago

To say they work is a bit doubtful. Because they are both the insurance and the doctor, there is an incentive for them to find nothing wrong with you.

refurb 6y ago
The incentive is the opposite. Kaiser gets a fixed premium from its patients no matter how much or how little care they get.

refurb 6y ago

Kaiser is an integrated provider - both the medical care and insurance so any billing, approvals are all internal. The only issue I’ve heard is mental health care which is apparently quite lacking at Kaiser.

deleted 6y ago

[deleted]

kelnos 6y ago

Kaiser members I know who have needed mental health care have found that part of their system to be atrocious. Sure, maybe the billing part of it is still great, but the care itself is not.

ryanbrunner 6y ago

From the perspective of most of the world, having to limit yourselves to medical care that's provided by a particular company seems very broken. (unless I'm misunderstanding how Kaiser works). I can just go to whatever walk-in clinic, urgent care provider or emergency room I need, depending on the severity and get treatment (I do try to go to my GP if possible, but I have many options if that's not practical for some reason).

leetcrew 6y ago
> From the perspective of most of the world, having to limit yourselves to medical care that's provided by a particular company seems very broken. from the perspective of some people in the US, this is exactly what socialized medicine looks like, except you can't change the company.
- ryanbrunner 6y ago
  Most countries that have socialized healthcare still have private providers - the government is paying for healthcare, but they're taking on the role of the insurance provider rather than the healthcare provider.

Balgair 6y ago

I agree, Kaiser is very very good for the US. However, they tend to be more of a 'standard' care kind of thing. Like, broken arms, colds, pregnancy, all good under Kaiser. But harder things like cancer, ALS, Parkinson's, it's a lot tougher for them to get you the right treatment. This, unfortunately, I know about as people close to me had to leave Kaiser to get dealt with. That said, Kaiser is still my gold standard for the US.