Sutter recently bought the company that my kids' pediatrician works for. The changes so far have been sufficiently negative that I have to decide if I want to go through the pain of finding a new pediatrician or just stick it out for the next few years until my youngest switches to a GP.
>A single murderer rarely triggers societal change.
I was gonna bring up Franz but you said "rarely" not "never".
I think people are wising up to the fact that at scale modern forms of insurance, all forms not just health, is not a real product that delivers value to both parties, it's a contrived way to use government force to lighten everyone's pockets to the benefit of a few while paying out only as needed to justify the pretext and the only thing it really shares with it's free-ish market equivalents from 50+yr ago is the name. So there will probably be more murders before things change.
You can call things inevitable and on some level they likely are but +/-5yr makes a huge difference in the exact turns of events and the form that history takes because at the very least it determines who the parties involved are and/or affects the circumstances they are balancing. Do we still get Hitler if WW1 starts later or goes slightly differently? You don't get the modern world without Hitler.
Us typing this here and now with the world as it is is necessarily predicated on a ton of things who's details came down in large part to chance. And it goes back way, way, way further than that.
Note that most of his complaint is with experimental stuff. Why should insurance be required to cover experimental stuff? It's basically chasing the illusion of a solution.
Until you find yourself desperate for a malpractice suit, and Surprise! your insurer and care provider are on the same team and you already agreed to arbitration when you got that insurance.
A friend had his life wrecked by Kaiser, and none of the attorneys he consulted wanted to touch the case because according to the attorneys they had an army of lawyers and he'd already agreed to arbitration when getting the insurance. The max they claimed could be won wouldn't even cover the legal fees.
You definitely don't want insurance from the same team you're getting the insured services from. It's the conflict of interests to end all conflict of interests, especially in the context of health care.
From what you tell us, binding arbitration sounds like the actual problem. Not the insurer and provider being the same company.
To me the latter is an alignment of interests. The insurer will happily pay for preventive screenings and care to save itself costs on treatment later.
> From what you tell us, binding arbitration sounds like the actual problem. Not the insurer and provider being the same company.
No, the actual problem is that the insurer and provider want to screw over the paying customer. Binding arbitration is just one convenient method they've taken advantage of to accomplish that. Getting rid of binding arbitration is still a good idea, but you can bet they'll find some other way to screw over their customers because they clearly care more about profit than people. The actual solution would be to reform the healthcare system so that its goal is focused more on healing people than stuffing pockets with cash and so companies that only care about money are forced out of it entirely.
Since it's unlikely that anyone with the power to fix the deeply broken healthcare system will do it any time soon, the least people can do is avoid this insurer and healthcare provider since they've demonstrated themselves to be hostile to their own paying customers.
Kaiser's structure is complicated. Its health plan arm, which offers insurance, is non-profit. So is its hospital foundation, which owns and operates hospitals. Its medical offices are for-profit and owned by doctors.
I don't see a big profit motive for Kaiser because it's a non-profit. And because the same company owns the insurance provider and hospitals, they're incentivized to keep overall costs down. As long as they can't arbitrarily throw people off their plans, this means investing in preventive care and doing it cheap.
Traditional insurance providers don't care about that. They actually like it when hospitals raise prices because it allows them to charge higher premiums. Since they can only take up to 10% in premiums (or some other number, but it's a fixed %) as profits, higher costs and higher premiums are good for their bottom line.
Kaiser is how single-payer healthcare would look if it wasn't run by the government.
> reform the healthcare system so that its goal is focused more on healing people than stuffing pockets with cash and so companies that only care about money are forced out of it entirely.
What does that actually mean? What concrete steps would you take to accomplish this? Without specifics this is wooly, idealistic nonsense.
Again to take Kaiser's example: their doctors are salaried (at least the ones that work in hospitals). They have no incentive to overbill you or make you take unnecessary tests. The doctors make the same money no matter what procedures they do on you. And Kaiser owns the insurance company that's paying those bills. They also have no incentive to skip necessary tests. If they miss a problem it'll cost Kaiser more money later to treat you. Do you have a better way to "focus [only] on healing people" than that?
No one who lives (has lived) in California thinks Kaiser is a scam. You may not like Kaiser or HMOs, but they are not a scam by any measure. So its an odd or simply mistaken choice of words.
The Sutter Health Network / Palo Alto Medical Foundation routinely get caught committing widespread insurance fraud.
They also offer products that seem to be junk insurance to me, but I’m not a lawyer.
Here are three examples of their alleged widespread insurance fraud:
https://allaboutlawyer.com/claim-your-sutter-health-settleme...
https://www.sfgate.com/bayarea/article/sutter-health-accused...
https://www.justice.gov/archives/opa/pr/government-intervene...
Some of those suites involve other big providers, like KP. Not sure if any of the healthcare providers around here are reputable at this point.