The night before Obama's big healthcare summit, NBC Nightly News offered some advice. "There's a place where policymakers could look for some tips on how an affordable, well-run system operates," anchor Brian Williams told viewers. "It is already running here in the U.S."
Correspondent Robert Bazell explained: "Many experts agree that whatever happens in the health reform debate, a good model is Kaiser Permanente." Bazell went on to describe how Kaiser's salaried doctors "have no incentive to order unnecessary tests or office visits." He also pointed to cost savings from use of electronic medical records.
"To be sure, patients sometimes complain about Kaiser," Bazell concluded, "but it gets decent ratings in consumer surveys and tends to be one of the less expensive options when people get to chose health plans."
As NBC itself has documented (Dateline, 6/17/07), one of those complaints is patient-dumping; in 2007 Kaiser accepted a settlement after prosecutors charged it with sending a mentally ill homeless woman away from its emergency room in a cab. The woman was caught on camera being dumped by the cab on Skid Row, where she wandered in her hospital gown and slippers until a shelter worker found her. The shelter soon learned she was suffering from high blood pressure, anemia and pneumonia, and she had to be readmitted to a hospital.
The video aired many times on television and was featured prominently in Michael Moore's documentary Sicko–which also pointed out that it was Kaiser that helped convince Nixon HMO's were a good idea. Edgar Kaiser, son of Kaiser Permanente's founder, lobbied Nixon aide John Erlichman in 1971 for the HMO Act, who then successfully lobbied Nixon:
Ehrlichman: "Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it …. I had Edgar Kaiser come in…talk to me about this, and I went into it in some depth. All the incentives are toward less medical care, because the less care they give them, the more money they make."
President Nixon: "Fine." [Unclear]
Ehrlichman: [Unclear] "ÃƒÆ’Â¢ÃƒÂ¢”Å¡Â¬Ãƒâ€šÂ¦ and the incentives run the right way."
President Nixon: 'Not bad.ÃƒÆ’Â¢ÃƒÂ¢”Å¡Â¬Ãƒâ€šÂ
Kaiser's also the place the L.A. Times found (5/17/02) "awarded financial bonuses to call center clerks who spent the least amount of time on the phone with each patient and limited the number of doctors' appointments." And the Sacramento Bee recently reported (2/15/09) on lawsuits against Kaiser for "[trying] to bully outside doctors into transferring patients before it is safe, threatening to withhold payment otherwise" and for its "special, doctor-to-doctor call operation that has become a target of legal actions alleging malpractice and failure to pay claims."
All in all, sounds like a great model. Thanks for the suggestion, NBC!
For another healthcare model that you won't likely find NBC News personnel endorsing, see the new FAIR study, "Media Blackout on Single-Payer Healthcare" (3/6/09).