2 ms·

The people I know with Kaiser hate it. YMMV I guess!

dekhn 5y ago
Many people who have kaiser hate it but after I understood the what and why of Kaiser I concluded its model was far better than the alternatives.
- sanderjd 5y ago
  And yet people hate it. I agree that it seems good in theory. In practice, it seems quite bad (because again, people hate it). This is one of the things that makes me less convinced about universal healthcare proposals than I innately would be. They also seem much better on paper, but if in practice people would hate it, then that would be a bad outcome.
  - saltcured 5y ago
    What I've seen from others and what I've read in attempted quantitative reviews is that Kaiser quality, perhaps not surprisingly, varies by region and facility. I don't know if anybody has invented a management strategy which can truly remove this variance. Qualitatively, as a patient, I'd say the biggest difference with Kaiser is that you engage something more like a government bureaucracy. You do not get complicated billing adventures when you go to your Kaiser clinics, hospitals, etc. But, you do get some long waits, occasional referral limbo, and sometimes indifferent treatment from overworked nurses or clerical staff. Of course, there are still individuals involved in each care event. I have seen two different family members have different levels of satisfaction and frustration from the same facilities, and my take is that the personalities of the patients had more to do with the different experiences than the facility or staff. I liken Kaiser to going to the DMV for treatment. This is most true as a young to middle-aged person, where your common care needs might be for unplanned, urgent care rather than periodic checkups or predictable chronic care. I know others who have used Kaiser in the same regions for more chronic and acute conditions including psychiatric, metabolic, and geriatric care. I have been reasonably impressed and would like to keep myself in the same system when I retire and grow old. I may be biased by having known the system since I was a child, but I prefer this to the non-HMO US experience I know mostly second hand. Instead of the DMV, I've had friends and relatives liken their healthcare to engaging a car dealership or some boutique investment firm, with every interaction transactionalized and tinged with financial worry.
Supermancho 5y ago
I have had kaiser for over 40 years. Note Kaiser isn't available everywhere and I'm primarily talking about California+Washington State. Kaiser has strengths and weaknesses, which is unsurprising in healthcare. Dermatology is garage-level bad. Cardiac care is world class. Reconstructive surgery for joints is amazing. Pediatrics has always been great, since that's what Kaiser started with. Psych is mainly pharmacological, if you can be purely medicated it's great. If you have anything very exotic like McCune-Albright syndrome, they can't do anything but medicate you (which Kaiser is very liberal about). Yeah, Kaiser GenPrac are pretty low rent, but that's true everywhere for General Pracitioners. My family (all Kaiser), my coworkers, and ofc myself, have had a lot of time with Kaiser. Yeah you can get better cardiac care at the NIH or neurological treatment at UCLA, but Kaiser will make the recommendation for you and you can get that treatment if you want. Anyone who thinks Kaiser is categorically bad, doesn't know what they are talking about, imo. Go see an independent that has Blue Shield/Cigna/etc and it's not even a question.

Many people who have kaiser hate it but after I understood the what and why of Kaiser I concluded its model was far better than the alternatives.

sanderjd 5y ago
And yet people hate it. I agree that it seems good in theory. In practice, it seems quite bad (because again, people hate it). This is one of the things that makes me less convinced about universal healthcare proposals than I innately would be. They also seem much better on paper, but if in practice people would hate it, then that would be a bad outcome.
- saltcured 5y ago
  What I've seen from others and what I've read in attempted quantitative reviews is that Kaiser quality, perhaps not surprisingly, varies by region and facility. I don't know if anybody has invented a management strategy which can truly remove this variance. Qualitatively, as a patient, I'd say the biggest difference with Kaiser is that you engage something more like a government bureaucracy. You do not get complicated billing adventures when you go to your Kaiser clinics, hospitals, etc. But, you do get some long waits, occasional referral limbo, and sometimes indifferent treatment from overworked nurses or clerical staff. Of course, there are still individuals involved in each care event. I have seen two different family members have different levels of satisfaction and frustration from the same facilities, and my take is that the personalities of the patients had more to do with the different experiences than the facility or staff. I liken Kaiser to going to the DMV for treatment. This is most true as a young to middle-aged person, where your common care needs might be for unplanned, urgent care rather than periodic checkups or predictable chronic care. I know others who have used Kaiser in the same regions for more chronic and acute conditions including psychiatric, metabolic, and geriatric care. I have been reasonably impressed and would like to keep myself in the same system when I retire and grow old. I may be biased by having known the system since I was a child, but I prefer this to the non-HMO US experience I know mostly second hand. Instead of the DMV, I've had friends and relatives liken their healthcare to engaging a car dealership or some boutique investment firm, with every interaction transactionalized and tinged with financial worry.

Supermancho 5y ago

I have had kaiser for over 40 years. Note Kaiser isn't available everywhere and I'm primarily talking about California+Washington State. Kaiser has strengths and weaknesses, which is unsurprising in healthcare. Dermatology is garage-level bad. Cardiac care is world class. Reconstructive surgery for joints is amazing. Pediatrics has always been great, since that's what Kaiser started with. Psych is mainly pharmacological, if you can be purely medicated it's great. If you have anything very exotic like McCune-Albright syndrome, they can't do anything but medicate you (which Kaiser is very liberal about). Yeah, Kaiser GenPrac are pretty low rent, but that's true everywhere for General Pracitioners. My family (all Kaiser), my coworkers, and ofc myself, have had a lot of time with Kaiser. Yeah you can get better cardiac care at the NIH or neurological treatment at UCLA, but Kaiser will make the recommendation for you and you can get that treatment if you want. Anyone who thinks Kaiser is categorically bad, doesn't know what they are talking about, imo. Go see an independent that has Blue Shield/Cigna/etc and it's not even a question.