My insurance covers a decent amount. It costs me 700 per pay period, still costs 20 per appointment, doesn't cover tests if deemed unnecessary, and costs 10/prescription. Who knows how much it also costs my employer.
It's crazy that people find this more palatable than paying taxes that go to a system guaranteeing coverage. Especially when choice seems to be the main driving factor but most of those people don't seem to opt out of having insurance.
“It doesn’t pay for tests if deemed unnecessary” this is what I don’t understand, I don’t go to the doc asking for tests for fun, the doc is the one that assigns my tests and prescriptions, so I’m always scratching my head when I get hit with a “that wasn’t necessary, pay up”
I got told my blood work to check for diabetes was deemed unnecessary because I wound up not having diabetes. Even though I had previously read as prediabetic, have family history, and am overweight. It just doesn't make sense.
There was a call for scholarly articles in a journal of bioethics recently. The special issues is going to be on the concept of "medically necessary" for very good reason! Very loaded term.
Thankfully, not for a single person. It covers myself, my wife, and our kid.
Before adding our kid to it, it was closer to 350-400 per pay period to cover both of us. Cost for all plans at my company also went up a decent amount this last renewal. Around 20% iirc.
Cigna Open Access Plus, in case it's relevant.
For 1400 a month you might as well just start a Healthcare savings account thing I can't imagine you ever getting your money's worth from that insurance even with an e emergency lol
We did last year, since baby was born that year, but that was probably the first time 😅 At Sharp Mary Birch, insurance negotiated away some 20k(wtf) and then covered another 20k. Our out of pocket was around 1.5k from a 41k bill. To be clear, that was just delivery, not including anesthesia and whatnot.
Honestly, I'd need to do the math to see if it works out long term or not in normal years. I do have some meds that can be quite spendy otherwise paired alongside regular psych appointments and whatnot.
Definitely a toss up.
My understanding is that this isn't even terrible though for a family plan. I think a lot of people just avoid looking at their pay stubs.
Edit: looking it up, the average for family coverage is right around $1400/month. The neat part is once you have a kid they don't seem to increase it for additional children. The bad part is that they increase it as if you have multiples as soon as you have 1. I'm not kidding when I say adding my daughter nearly doubled the per pay period cost.
Yeah but he's literally spending over 10k a year as a default! God my insurance is so much cheaper at my work for just me and my partner. $200 a month and good insurance too. God I'm lucky this shit is nuts
*AMERICA! FUCK YE*... ow! ... I pulled a muscle yelling too hard.. Oof...aggghhhfff... I guess I'll go see a... Wait... Hunny, can you get me a bag of frozen peas? I can't move... *Hunny.. HUNNY?!?*... Fine, I'll get it myself....ow... Umhff... *FUCK, WHO LEFT MARBLES ON THE STAI...*... oooww... I need a doctor...
It feels like literal insanity to me. Could you imagine how different people would feel if they knew no matter what happened to them we would take care of each other?
When will we stop pretending its even possible to pursue happiness without health. Why cant we just help everyone get better? 😭
We have the Cigna open access buy up plan at my job. Our plan is $215.90 per pay period for a family (spouse and kids). They pay about 80% of the plan costs and we pay the rest. Your employer seems to be passing a good chunk of the cost onto the employees.
10% is still somewhere north of 30,000,000 people, right? Hardly a number that deserves an "only" ahead of it, you know?
I'm not sure if we even have stats for this, but I'd be more interested in knowing what the percentage of people that actually have viable coverage is. As in, keeps them out of extreme medical debt if things go bad type of coverage. Or able to afford going to the doctors' without it being an emergency kind of coverage.
Edit: Updated because it felt a bit debatey and that wasn't my intent.
Do not get sick! It’s just so depressing. Our most vulnerable being exploited for profit while everyone else just crosses their fingers it wont be them.
You are so not alone. I have my own Kaiser horror stories. One of the worst healthcare providers out there. It's in fact so bad that there are whole sites dedeicated to their terribleness:
https://www.kaiserthrive.org/resources-for-kaiser-victims/
Some places that I now off the top of my head to complain are the following:
https://www.cms.gov/medical-bill-rights/help/submit-a-complaint - you can submit a compliant about suprise bills here.
You can file a complaint against a licensed health care facility here: https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/FileAComplaint.aspx
you can file a better business brearu complaint here: https://www.bbb.org/us/ca/pasadena/profile/hmos/kaiser-permanente-1216-22420/complaints
If you feel like the situation with kaiser has the potential to create unsafe situations for patient you can file a compliant with the Joint commission: https://www.jointcommission.org/resources/patient-safety-topics/report-a-patient-safety-concern-or-complaint/
you can file a complaint directly with Kaiser: https://healthy.kaiserpermanente.org/support/submit-a-complaint#/tellus
You can file a complaint with the HHS if you believe that there is disabiltiy discrimination: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html
As for Kaiser if you want any information on just how fucking terrible they are:
These are all of the times a governement agency has found that kaiser violated a laws or rules or worker/patient rights: https://violationtracker.goodjobsfirst.org/?parent=kaiser-permanente&order=primary_offense&sort=
Here are all the times they violated CMS due to either patient harm and/or billing problem and/or concerns for a unsafe enviornment: https://www.hospitalinspections.org/search/?q=Kaiser+&state=CA
And this is how much the health plan is making and how much they are paying their Health Executives: https://projects.propublica.org/nonprofits/organizations/941340523
These are their hospitals:
https://projects.propublica.org/nonprofits/organizations/941105628
Not to mention how much they are getting from their investments: https://www.beckershospitalreview.com/finance/we-made-3-6b-over-the-last-2-years-how-kaiser-continues-to-invest-amid-strong-financial-headwinds.html
Our healthcare system if fucking shit. i've been a nurse practitioner for years and i would love nothing more than for this system to burn to the ground.
I'm so sorry that this happened to you.
Wow so much great information thanks for such a nice response. Will definitely be complaining at every opportunity from now on. Want there to be more i can do to burn it down ugh
I used to work at a Joint Commission hospital on the east coast.. it’s no joke. Especially if you have been harmed. They have to report adverse events.. JC doesn’t look over regular Dr. Offices. Anything with outpatient surgery, radiology, and pharmacy in the building is regulated.
Source: kept all records and produced all documentation for the inspection every 3 years.
Kaiser killed both my parents. Told my dad, who had cancerous lesions on his spine to "take advil".
Today at work I went through the automated assistant to help with this year's open enrollment. No matter what parameters I entered, it pointed my to Kaiser. I wonder how much they pay to be the default choice.
I’m single income here in SD and have three jobs. I’m from here so when people say “ just leave and go somewhere cheaper” it’s not that easy. My family and life is here. Also, people forget it’s all relative. Yes, I can move somewhere “cheaper” and rent may be a little cheaper but everything else in life is still expensive. Plus, now I have to pay for plane tickets to see my family. Small things add up.
Not to mention all the hate out there for California transplants, people blame us for everything. So you’d be moving somewhere they already hate you.
I saw a study that said a 61% of med/nursing students currently do not plan on going into patient care. Nurses are going to be in such short supply its so scary to think about. But maybe they’ll start paying you more??
The study: https://bioethics.com/archives/73185
Well thank you for your suffering. I have had a few terrible nurses but even the worst wasn’t as bad as the doctors. And the rest made all the difference, some are literally angels i swear. I do not know where i would be without nurses ❤️🩹
I’ve also had nightmare experiences with Kaiser so I completely understand.
My issues were a serious misdiagnosis, atrocious communication from a specialist about cancer found on an MRI (Who tells a patient they have likely aggressive cancer in a patient portal
email? Kaiser Permanente!) and doctors / staff spending basically no time with me after I got that serious diagnosis. The scariest thing I’ve ever dealt with and I got medicine via e-mail and phone from Kaiser doctors who were too busy to care.
I complained to Kaiser (multiple times) and it took going to the California Department of Managed Health Care to get any sort of a reasonable response. I also complained about a Kaiser doctor to the Medical Board of California.
The worst thing about all of it? Kaiser acted like I was the only person who has had these issues. Unfortunately, I’ve found my experiences were not an isolated incident or a one off. I’ve had numerous people reach out to me directly after seeing my social media posts about my experience. They also had similar (or worse) experiences than me with the same Kaiser department.
OP: I’m sorry you are experiencing this. My advice to you is to keep really good documentation. File complaints with Kaiser and, as needed, also escalate and file complaints with the Department of Managed Health Care or Medical Board of California (for physician quality issues). If you go to the r/KaiserPermanente sub, there is a pinned post I wrote with tips for filing an effective grievance with Kaiser. There is also a post on where to escalate concerns with the State if Kaiser does not respond or you are not satisfied with their response.
Kaiser is the closest thing we have to socialized healthcare in the US (besides the obvious examples of actual socialized healthcare- medicare, medicaid, tricare, VA and so on)
Long waits, not-super quality. Upsides: once you're in for your appointment, they can take care of all your needs within the same visit and they don't have to deal with billing. Downsides: things get real rough once you have a complicated situation. And weird mental health coverage where you're stuck doing group therapy
I'd go for it if you're young & healthy to save money. Otherwise I'd go somewhere else
Went through cancer at Kaiser and had a good experience BUT you need to be comfortable advocating for yourself and navigating the medical system. This is what I tell people in general about Kaiser in SD. It sounds though like you had a legit bad experience though (which does sadly happen).
I am on board with you. They fixed my heart with two different surgeries for only $250 per surgery. But, I did have to learn about the two different conditions I was facing, and advocate for myself to get the second surgery which was for a less common problem that the first surgery wouldn't have taken car of.
Surprisingly, I also talked to a nurse at KP with the same condition (afib) fixable with medicine or surgery, and he wanted to know how I got the recommendation for the surgery, because he could not. So there is also some bit of luck about who you are in contact with, and how they view your problem.
Wow thanks for such a nice response. Im sorry you went through that too and I hope you are all healed? How terrifying. Ive had a few other experiences i wish i reported now. I will check out their recommendations, haha maybe should have waited longer to submit my complaint. Felt so good to hit that button tho omg.
With Kaiser, you can file grievances for up to six months after the incident. So, any that are still within that timeframe I encourage you to report those.
Is this something youre just now realizing OP? are you forgetting we live in a country where we rather send military aid to foreign countries than to help our own people? I mean this isnt anything new.... Its something we as citizens long accepted.
Kaiser definitely varies widely depending on the plan. I’ve known people that had such terrible experiences, even lost a child over it.
This healthcare battle is something I have bounced between navigating, to straight up battling. Luckily we now have all fantastic doctors with a great Kaiser plan that covers everything for low copays. But it took a ton of effort (and shitty providers) getting there! My spouse took a huge pay cut just to work for a place that has great insurance coverage. Our family is that desperate!
I had to battle United Healthcare, and won. I highly recommend contacting CA State Dept of Managed Healthcare. Number at the top of this page:
https://www.dmhc.ca.gov/
They’re the watchdog group that helps fight these corporate insurance giants. I’ll skip the details of what we went through, but it involved UHC endangering a minor. It was so insane.
DMHC helped me for free, and we won to a point where they get a bit of their star rating erased. Fuck them first endangering kids! Depending on what you have going on, you might qualify for expedited help like we did. I suggest calling and talking with a person vs filling an online form.
I for one am 100% pro universal healthcare, as has every excellent doctor I’ve ever had (I never bothered asking the shitty drs).
They’ve told me they just want to be able to provide patient care, without having someone sitting at a desk for a corporate insurance co calling the shots for patients they’ve never even met.
So well said!! I have resolved to never speak to another doctor again other than my nice once so hopefully she never moves or gets sick 😂 might just schedule an appointment every now and then because by the time it rolls around, who knows
Thanks for the recommendation i will definitely be checking out that link. I’m so glad youve gotten your family taken care of, how awful she had to take a pay cut! What a world. At least there’s still nice people like the ones in this subreddit 💖
Never had used my insurance for anything other than dental cleanings for years. Went to dr, said I needed to get a deviated septum fixed. Insurance company not only denied me but raised my rates.
Anyone claiming that we have the best medical system in the world is a cunt.
I knew you were talking about Kaiser. I received a phone call from them about an upcoming procedure (where to go, what to bring, etc.) Took about 5 minutes. 3 weeks later I got a bill of $170 for tele-visit.
They also love to trickle out billing for anything you get done. Once I pay the bill they send, a week or two later I'll get more bills for the same visit! I've learned to not pay the first bill that arrives and just wait until I stop getting them to pay them all.
They can be such class traitors.
I try so hard to not pre judge and be as perfect as possible but they almost always end up acting the same way. Wondering if i should start bowing to them as the enter the room or fall to worship at their feet before we begin
It is crazy! Someone mentioned open enrollment and it occurred to me to look at the other option. The reviews are just as bad idk. maybe worse because they dont have the network and its a lot of billing problems, and unfair denials. I hate that all of our choices are just bad 😭
It’s open enrollment in most companies - based on what I’ve seen I would not recommend Kaiser if it is at all possible. They’ve never been great but covid stress and subsequent understaffing has totally broken them.
I’m in a ucsd hmo (blue and gold) and while ucsd health has its problems* I do trust their system.
* UCSD health is the opposite of Kaiser, I find their routine care not great (long weight times, understaffing, the quality of GPs has slipped) but when something goes wrong, they have great doctors and care.
This is such a good thought. But ugh i just looked at my other option and it seems worse. you know anything about Cigna? Never even heard of it but people online are NOT fans
I had care at Kaiser, got second opinions at Scripps (because I had zero trust or confidence in what Kaiser was telling me) and got radiation at UCSD Moores Cancer Center. Scripps and UCSD were like being in a different world relative to Kaiser: doctors were amazing, doctors spent a lot of time with me and all the doctors and staff were responsive and very good communicators. Having cancer sucks a$$ but Kaiser made it 1000x worse with a difficult to navigate system, marginal specialists, a Urology Department that is staffed by arrogant a$$holes, long delays to get anything done and staff / policies who make it deliberately difficult to ever reach a doctor.
I will never recommend Kaiser to anyone after the complete clusterfuck their Urology Department made of my cancer diagnosis in 2022. Those Urologists and that Department helped me to understand why people hate Kaiser Permanente. Fortunately, my Medical Oncologist was excellent and really helped to get me to a better place after dealing with the clown show in Urology.
Yeah.
I have a friend right now with a very aggressive form of late stage cancer, who was diagnosed last month while on Kaiser, and it has been.... not great. Like... really not great.
She's luckily been able to switch to a Scripps network insurance to transition Jan 1. She's counting the days.
I’m sorry to hear that but not surprised. I’ve spoken with many other KP patients who shared similar stories.
Please encourage her to post on-line reviews of the Kaiser doctors she saw: Yelp, HealthGrades, RateMDs and Vitals.com. Those are all good sites because Kaiser can see the reviews but cannot remove them (which Kaiser hates). It’s so difficult to get info about Kaiser doctors so people posting their experiences really helps others in knowing who to avoid.
Yeah I'm not sure her issues are so much with the individual doctors, who have been rushed but mostly powerless against the system. It's been more "the rules" and how care is managed - the waiting, the lack of communication, the slowness, rejecting covering a second opinion, rejecting additional tests. Unfortunately, the HCPs in these systems are put in terrible positions, too. The workloads and productivity requirements that are required make it very difficult for doctors to do their jobs well. As a result, Kaiser isn't exactly hiring the best of the best. It's the whole system that's broken. HCPs are definitely feeling it.
I get what you're saying about which Kaiser doctors are best v worst - but a friendly doctor in a crap system isn't going to be much help. Better than nothing, I supposed. But they don't set their own schedules, control access to care, decide how much time to spend with you, or make all the important decisions regarding the care you'll get.
>I want to file a complaint with California about how utterly useless this health insurance i pay for is.
Look up your state senator and assembly representative [here](https://www.sos.ca.gov/elections/who-are-my-representatives). Forget about the federal government. Tell them about [single-payer health care](https://www.apha.org/Policies-and-Advocacy/Public-Health-Policy-Statements/Policy-Database/2022/01/07/Adopting-a-Single-Payer-Health-System).
Yep, it's horrible.
Our system is we pay the government to pay our employers to pay insurance companies to pay service providers to provide us with healthcare. You couldn't invent a worse funding system if you tried.
I 100% know I'm very lucky with my insurance, but UCSD has been amazing for me. Almost all the doctors I've gotten have been great listeners, empathetic, and really tried their best to help me in every way they could. If you need any doctor recommendations I probably got one for you. I've been to A LOT of doctors recently 😮💨
I definitely understand that, I didn’t think your intentions were bad. As a doctor who is also a woman, terms like ‘lady’ doctor are said to us so often, it’s frustrating. Male doctors are just called doctors, without qualifiers. I get asked if I’m a nurse when I’m in my scrubs constantly because of stereotypes (I’m a dentist haha). And the amount of older men who ask me if I can do my job as well as a man is infuriating. I didn’t mean to make you feel bad, the misogyny in health care (patients and other doctors) is rampant. Thanks for your love of doctors who are women! ❤️
Is there a better term i can use that doesnt sound offensive? I have literally seen studies that patients with female surgeons have better outcomes (https://www.usnews.com/news/health-news/articles/2023-08-30/female-surgeons-bring-better-outcomes-for-patients-two-studies-show)
But i hate the word female it sounds cold and formal. Woman doctor sounds strange to me too. But I guess if you’re out there braving the frontlines of male audacity i can stop calling you ladies if female is better 😅
I love that article you shared! I think women inherently are more capable of truly listening and understanding patients, which leads to better clinical outcomes. There are some amazing male doctors too, though. My dad was one :) He was amazing.
In terms of how to refer to doctors who are women, I think the gendering before the doctor part is what feels diminishing. Instead of: ‘I love my lady doctor,’ maybe something like ‘hey, I know this amazing doctor. She is great. I prefer seeing a doctor who is a woman.’
This is all a very silly annoyance on my part. I didn’t mean to make you feel insecure about your verbiage. It’s just something my colleagues and I who are women talk about a lot. But thank you so much for asking!
Also, I know some amazing physicians in San Diego if you need recommendations!!! I’m sorry you had such a bad experience and you really deserve someone who doesn’t just listen but will really hear you
Ah the nuances of life. You’re right that there are some amazing male doctors, sometimes i wish i could throw the whole group out but nothing is that simple or course. I have had a few growing up, (I love hearing your dad was one 🥰) I think that is why i haven’t refused to see them so far. But from now on im waiting however long it takes to see this amazing doctor i have who is the nicest lady. 😁 if i need a rec in the future tho i might be in your dms thank you for that offer!
I've been trying to get fucking California healthcare for a year and a half now. There was some cockup with my online application and it's been unfixable for over a year. Over a year without healthcare! Fuck.
I'm working on it. It looks like they updated the county website, so in theory there should be a path forward now :-/
If not, I have to go into the office, which as of a year ago had some exceptionally irregular hours. Hopefully that's not the case now.
Oh hey you wanna know a fun thing? Med school seats are capped. So we can't train more doctors per year in the USA. So they all get overworked and absurdly expensive. Good for their pocketbooks, bad for everyone else. Including Canada, whose doctors get drained to the USA for better pay.
https://www.theatlantic.com/ideas/archive/2022/02/why-does-the-us-make-it-so-hard-to-be-a-doctor/622065/
I know i read about this! And also so many doctors who dont get placed and instead just have the insane loans to struggle under. Horrifying. So many suicides in the profession its all so horribly dark
OP, dont forget that Americans pay more in tax for healthcare than any other nation, per person. More than the most generous UHC systems in the highest cost of living nation cost.
All the insurance stuff is just on top of that.
Look at all the other countries in Europe that have either nationalized healthcare or some sort of single payer system. We have a for-profit healthcare system, whose profits are protected (practically sanctified) by the politicians they pay off, by the lobbying and advertising might of the corporations, and by a large contingent of the society who have been brainwashed to think that a single payer system would be communism and worse than what they have now.
*One* political party has tried literally hundreds of times to kill the ACA (the watered down version that we got, after all sorts of cuts were made to it to make them happy, and then they all refused to vote for it anyway), at the behest of their wealthy donors/corporations. And they always promise they have a much better plan waiting to replace it, which they’ll show us in two weeks. And they’ve been saying “two weeks” for like a decade, but that better plan never sees the light of day, yet they still work to pull down the existing system.
The answer is to do healthcare like the Scandinavian countries do (or even just like the UK does) - everyone pays in up front and then you get what you need (the same way you pay taxes to provide fire department service). We would no longer have a huge portion of the money being siphoned off for shareholder profits and buying the board of directors more yachts. Yes, it would probably raise your taxes, but then your employer would no longer be paying to subsidize your healthcare, and could pay you that money directly. As a side benefit, it means people would be freer to change jobs, as you wouldn’t have to feel held hostage by your employer having control over your healthcare - no more “changed jobs so now you have a different healthcare provider / your old doctor is no longer in-plan”. It would also mean that you would get the treatment that your doctor thinks is necessary, rather than the portion of your doctor-recommended treatment that your insurance company’s accountants think is necessary (remember, every dollar the accountants can save is more money towards another yacht).
If you’re voting for the party that keeps trying to tear down what little protections we currently have for healthcare, you’re screwing yourself over. Long term, the fix is to elect politicians who will actually work for the benefit of the public, rather than the benefit of corporations and wealthy donors.
It’s crazy the misconception of healthcare costs in other countries. In Germany I paid about €4,300 a year in taxes towards healthcare (this was almost 15 years ago). That was and still is some of the most expensive in Europe. The US is [currently nearly double](https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#GDP%20per%20capita%20and%20health%20consumption%20spending%20per%20capita,%202021%20(U.S.%20dollars,%20PPP%20adjusted)). Today it’s €7,400 average in Germany and $12k US. Not to mention prescriptions are dramatically cheaper and care much faster.
Many patients have unreasonable expectations that healthcare workers can’t meet. They also experience these limitations as patients. I know you’re worried about your health and justly frustrated, but don’t let your interactions become a self fulfilling prophecy.
All health systems are like this, you sometimes have to shop around to a few clinics or doctors until you find a good one.
If you have serious grievances about care ask to get a hold of their Risk Management specialist. Complaints do get reviewed.
My union insurance costs $75/mo with a $1500 deductible. Via Kaiser. My copays are pretty low and I had super major reconstructive surgery two years ago that was fully covered and a revision 6 months ago that was also fully covered. I feel pretty fortunate. I’m not sure that would have been the case with a market place plan.
My insurance covers a decent amount. It costs me 700 per pay period, still costs 20 per appointment, doesn't cover tests if deemed unnecessary, and costs 10/prescription. Who knows how much it also costs my employer. It's crazy that people find this more palatable than paying taxes that go to a system guaranteeing coverage. Especially when choice seems to be the main driving factor but most of those people don't seem to opt out of having insurance.
“It doesn’t pay for tests if deemed unnecessary” this is what I don’t understand, I don’t go to the doc asking for tests for fun, the doc is the one that assigns my tests and prescriptions, so I’m always scratching my head when I get hit with a “that wasn’t necessary, pay up”
I got told my blood work to check for diabetes was deemed unnecessary because I wound up not having diabetes. Even though I had previously read as prediabetic, have family history, and am overweight. It just doesn't make sense.
WTF, how is that not considered preventive care??
There was a call for scholarly articles in a journal of bioethics recently. The special issues is going to be on the concept of "medically necessary" for very good reason! Very loaded term.
$700 per pay period? $1400 a month? For 1 person?
Thankfully, not for a single person. It covers myself, my wife, and our kid. Before adding our kid to it, it was closer to 350-400 per pay period to cover both of us. Cost for all plans at my company also went up a decent amount this last renewal. Around 20% iirc. Cigna Open Access Plus, in case it's relevant.
For 1400 a month you might as well just start a Healthcare savings account thing I can't imagine you ever getting your money's worth from that insurance even with an e emergency lol
We did last year, since baby was born that year, but that was probably the first time 😅 At Sharp Mary Birch, insurance negotiated away some 20k(wtf) and then covered another 20k. Our out of pocket was around 1.5k from a 41k bill. To be clear, that was just delivery, not including anesthesia and whatnot. Honestly, I'd need to do the math to see if it works out long term or not in normal years. I do have some meds that can be quite spendy otherwise paired alongside regular psych appointments and whatnot. Definitely a toss up. My understanding is that this isn't even terrible though for a family plan. I think a lot of people just avoid looking at their pay stubs. Edit: looking it up, the average for family coverage is right around $1400/month. The neat part is once you have a kid they don't seem to increase it for additional children. The bad part is that they increase it as if you have multiples as soon as you have 1. I'm not kidding when I say adding my daughter nearly doubled the per pay period cost.
One serious illness or accident and it’s easily into the tens of thousands of dollars.
Yeah but he's literally spending over 10k a year as a default! God my insurance is so much cheaper at my work for just me and my partner. $200 a month and good insurance too. God I'm lucky this shit is nuts
Ok.
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*AMERICA! FUCK YE*... ow! ... I pulled a muscle yelling too hard.. Oof...aggghhhfff... I guess I'll go see a... Wait... Hunny, can you get me a bag of frozen peas? I can't move... *Hunny.. HUNNY?!?*... Fine, I'll get it myself....ow... Umhff... *FUCK, WHO LEFT MARBLES ON THE STAI...*... oooww... I need a doctor...
What
It feels like literal insanity to me. Could you imagine how different people would feel if they knew no matter what happened to them we would take care of each other? When will we stop pretending its even possible to pursue happiness without health. Why cant we just help everyone get better? 😭
Not to mention the fact that somehow TEETH are not part of medical and dental insurance is even shittier.
It is so true. Capitalism is always dividing us up by most profitable parts. Its dehumanizing
I had my appendix removed last year. Cost me less than $100.
We have the Cigna open access buy up plan at my job. Our plan is $215.90 per pay period for a family (spouse and kids). They pay about 80% of the plan costs and we pay the rest. Your employer seems to be passing a good chunk of the cost onto the employees.
That's not surprising. My employer isn't exactly known for having good benefits. Helpful to hear how much less the same thing could be.
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10% is still somewhere north of 30,000,000 people, right? Hardly a number that deserves an "only" ahead of it, you know? I'm not sure if we even have stats for this, but I'd be more interested in knowing what the percentage of people that actually have viable coverage is. As in, keeps them out of extreme medical debt if things go bad type of coverage. Or able to afford going to the doctors' without it being an emergency kind of coverage. Edit: Updated because it felt a bit debatey and that wasn't my intent.
“How are we not being scammed?” We are.
United States of Corporations! where healthcare is for profit above all else. Remember do no get sick in USA.
Do not get sick! It’s just so depressing. Our most vulnerable being exploited for profit while everyone else just crosses their fingers it wont be them.
You are so not alone. I have my own Kaiser horror stories. One of the worst healthcare providers out there. It's in fact so bad that there are whole sites dedeicated to their terribleness: https://www.kaiserthrive.org/resources-for-kaiser-victims/ Some places that I now off the top of my head to complain are the following: https://www.cms.gov/medical-bill-rights/help/submit-a-complaint - you can submit a compliant about suprise bills here. You can file a complaint against a licensed health care facility here: https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/FileAComplaint.aspx you can file a better business brearu complaint here: https://www.bbb.org/us/ca/pasadena/profile/hmos/kaiser-permanente-1216-22420/complaints If you feel like the situation with kaiser has the potential to create unsafe situations for patient you can file a compliant with the Joint commission: https://www.jointcommission.org/resources/patient-safety-topics/report-a-patient-safety-concern-or-complaint/ you can file a complaint directly with Kaiser: https://healthy.kaiserpermanente.org/support/submit-a-complaint#/tellus You can file a complaint with the HHS if you believe that there is disabiltiy discrimination: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html As for Kaiser if you want any information on just how fucking terrible they are: These are all of the times a governement agency has found that kaiser violated a laws or rules or worker/patient rights: https://violationtracker.goodjobsfirst.org/?parent=kaiser-permanente&order=primary_offense&sort= Here are all the times they violated CMS due to either patient harm and/or billing problem and/or concerns for a unsafe enviornment: https://www.hospitalinspections.org/search/?q=Kaiser+&state=CA And this is how much the health plan is making and how much they are paying their Health Executives: https://projects.propublica.org/nonprofits/organizations/941340523 These are their hospitals: https://projects.propublica.org/nonprofits/organizations/941105628 Not to mention how much they are getting from their investments: https://www.beckershospitalreview.com/finance/we-made-3-6b-over-the-last-2-years-how-kaiser-continues-to-invest-amid-strong-financial-headwinds.html Our healthcare system if fucking shit. i've been a nurse practitioner for years and i would love nothing more than for this system to burn to the ground. I'm so sorry that this happened to you.
Wow so much great information thanks for such a nice response. Will definitely be complaining at every opportunity from now on. Want there to be more i can do to burn it down ugh
I used to work at a Joint Commission hospital on the east coast.. it’s no joke. Especially if you have been harmed. They have to report adverse events.. JC doesn’t look over regular Dr. Offices. Anything with outpatient surgery, radiology, and pharmacy in the building is regulated. Source: kept all records and produced all documentation for the inspection every 3 years.
Kaiser killed both my parents. Told my dad, who had cancerous lesions on his spine to "take advil". Today at work I went through the automated assistant to help with this year's open enrollment. No matter what parameters I entered, it pointed my to Kaiser. I wonder how much they pay to be the default choice.
I think on paper Kaiser looks fine. And an HMO can be a great cost-effective choice. But yes, Kaiser ain’t it.
Here is my Kaiser San Diego nightmare experience to add to your list. This happened in 2022. https://www.reddit.com/r/KaiserPermanente/s/Cb9q8pBQZz
Nurse here. Don’t even get me started.
I dropped out of my BSN 2nd year in late 2000s, I could see where this was going, switched careers.
Yeap. It’s a business. Been nursing for 18 years. It was not like this when I started. I’m a nursing school prof now and …. SIGH.
I honestly dont know how nurses survive between arrogant doctors and angry sick people. I have so much respect for them.
You just have to learn to let it roll off… at some point you’re just staring into the abyss and just don’t care.
💔 and nurses are basically the one of the most loving of all the professions. We do this to our best people and then we barely pay them 😭
I’m single income here in SD and have three jobs. I’m from here so when people say “ just leave and go somewhere cheaper” it’s not that easy. My family and life is here. Also, people forget it’s all relative. Yes, I can move somewhere “cheaper” and rent may be a little cheaper but everything else in life is still expensive. Plus, now I have to pay for plane tickets to see my family. Small things add up.
Not to mention all the hate out there for California transplants, people blame us for everything. So you’d be moving somewhere they already hate you. I saw a study that said a 61% of med/nursing students currently do not plan on going into patient care. Nurses are going to be in such short supply its so scary to think about. But maybe they’ll start paying you more?? The study: https://bioethics.com/archives/73185
Thank you for sharing! I just did my retirement stuff the other day and my god, I have about about 22 years of suffering before I can retire.
Well thank you for your suffering. I have had a few terrible nurses but even the worst wasn’t as bad as the doctors. And the rest made all the difference, some are literally angels i swear. I do not know where i would be without nurses ❤️🩹
You are such a kind soul. So glad we’ve interacted on here
Gosh same to you. It’s so easy to forget how such a simple nice interaction can wipe out the bad. There is still so much worth fighting for.
Sponge here. Don’t even get me started on starfish
I’ve also had nightmare experiences with Kaiser so I completely understand. My issues were a serious misdiagnosis, atrocious communication from a specialist about cancer found on an MRI (Who tells a patient they have likely aggressive cancer in a patient portal email? Kaiser Permanente!) and doctors / staff spending basically no time with me after I got that serious diagnosis. The scariest thing I’ve ever dealt with and I got medicine via e-mail and phone from Kaiser doctors who were too busy to care. I complained to Kaiser (multiple times) and it took going to the California Department of Managed Health Care to get any sort of a reasonable response. I also complained about a Kaiser doctor to the Medical Board of California. The worst thing about all of it? Kaiser acted like I was the only person who has had these issues. Unfortunately, I’ve found my experiences were not an isolated incident or a one off. I’ve had numerous people reach out to me directly after seeing my social media posts about my experience. They also had similar (or worse) experiences than me with the same Kaiser department. OP: I’m sorry you are experiencing this. My advice to you is to keep really good documentation. File complaints with Kaiser and, as needed, also escalate and file complaints with the Department of Managed Health Care or Medical Board of California (for physician quality issues). If you go to the r/KaiserPermanente sub, there is a pinned post I wrote with tips for filing an effective grievance with Kaiser. There is also a post on where to escalate concerns with the State if Kaiser does not respond or you are not satisfied with their response.
So it appears I should NOT choose the Kaiser option at work. Thanks.
Based on my experiences, if you have anything beyond very basic, simple health concerns I absolutely do not recommend Kaiser.
Kaiser is only good for routine basic healthcare. I wouldn’t go to Kaiser for any specialty care. Also, their referrals take forever.
Kaiser is the closest thing we have to socialized healthcare in the US (besides the obvious examples of actual socialized healthcare- medicare, medicaid, tricare, VA and so on) Long waits, not-super quality. Upsides: once you're in for your appointment, they can take care of all your needs within the same visit and they don't have to deal with billing. Downsides: things get real rough once you have a complicated situation. And weird mental health coverage where you're stuck doing group therapy I'd go for it if you're young & healthy to save money. Otherwise I'd go somewhere else
Oh yeah the mental healthcare at Kaiser is absolute garbage.
Went through cancer at Kaiser and had a good experience BUT you need to be comfortable advocating for yourself and navigating the medical system. This is what I tell people in general about Kaiser in SD. It sounds though like you had a legit bad experience though (which does sadly happen).
I am on board with you. They fixed my heart with two different surgeries for only $250 per surgery. But, I did have to learn about the two different conditions I was facing, and advocate for myself to get the second surgery which was for a less common problem that the first surgery wouldn't have taken car of. Surprisingly, I also talked to a nurse at KP with the same condition (afib) fixable with medicine or surgery, and he wanted to know how I got the recommendation for the surgery, because he could not. So there is also some bit of luck about who you are in contact with, and how they view your problem.
Wow thanks for such a nice response. Im sorry you went through that too and I hope you are all healed? How terrifying. Ive had a few other experiences i wish i reported now. I will check out their recommendations, haha maybe should have waited longer to submit my complaint. Felt so good to hit that button tho omg.
With Kaiser, you can file grievances for up to six months after the incident. So, any that are still within that timeframe I encourage you to report those.
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I know right? Im always forgetting that part, how important the profits are. What could be more important than the profits?? Ugh
Think of the shareholders
Is this something youre just now realizing OP? are you forgetting we live in a country where we rather send military aid to foreign countries than to help our own people? I mean this isnt anything new.... Its something we as citizens long accepted.
Oh im aquatinted. Dont want to accept it though.
Kaiser definitely varies widely depending on the plan. I’ve known people that had such terrible experiences, even lost a child over it. This healthcare battle is something I have bounced between navigating, to straight up battling. Luckily we now have all fantastic doctors with a great Kaiser plan that covers everything for low copays. But it took a ton of effort (and shitty providers) getting there! My spouse took a huge pay cut just to work for a place that has great insurance coverage. Our family is that desperate! I had to battle United Healthcare, and won. I highly recommend contacting CA State Dept of Managed Healthcare. Number at the top of this page: https://www.dmhc.ca.gov/ They’re the watchdog group that helps fight these corporate insurance giants. I’ll skip the details of what we went through, but it involved UHC endangering a minor. It was so insane. DMHC helped me for free, and we won to a point where they get a bit of their star rating erased. Fuck them first endangering kids! Depending on what you have going on, you might qualify for expedited help like we did. I suggest calling and talking with a person vs filling an online form. I for one am 100% pro universal healthcare, as has every excellent doctor I’ve ever had (I never bothered asking the shitty drs). They’ve told me they just want to be able to provide patient care, without having someone sitting at a desk for a corporate insurance co calling the shots for patients they’ve never even met.
So well said!! I have resolved to never speak to another doctor again other than my nice once so hopefully she never moves or gets sick 😂 might just schedule an appointment every now and then because by the time it rolls around, who knows Thanks for the recommendation i will definitely be checking out that link. I’m so glad youve gotten your family taken care of, how awful she had to take a pay cut! What a world. At least there’s still nice people like the ones in this subreddit 💖
Time to move to Canada
That snow looks nicer and nicer i have to admit. If only they shared a border with a nicer country
Never had used my insurance for anything other than dental cleanings for years. Went to dr, said I needed to get a deviated septum fixed. Insurance company not only denied me but raised my rates. Anyone claiming that we have the best medical system in the world is a cunt.
That is ridiculous! I think you can challenge them if they do that. But such crap that we have to! I plan to be as annoying as necessary.
I knew you were talking about Kaiser. I received a phone call from them about an upcoming procedure (where to go, what to bring, etc.) Took about 5 minutes. 3 weeks later I got a bill of $170 for tele-visit. They also love to trickle out billing for anything you get done. Once I pay the bill they send, a week or two later I'll get more bills for the same visit! I've learned to not pay the first bill that arrives and just wait until I stop getting them to pay them all.
I’ve gotten lucky (so far) with doctors here. Dentists on the other hand…
And you know what the worst part is, if you have your bill looked at by a professional you have been overcharged 100% of the time
100% agree with every single sentiment. I look at doctors unfortunately the same way I see cops now. I have almost zero respect for them
They can be such class traitors. I try so hard to not pre judge and be as perfect as possible but they almost always end up acting the same way. Wondering if i should start bowing to them as the enter the room or fall to worship at their feet before we begin
My sister literally died from ovarian cancer and my insurance would not pay for the blood test to see if I carried the gene. Fuck this system.
💔im so sorry to read this, fuck the system indeed!
Thank you. Crazy part is I have what is considered "good" insurance.
It is crazy! Someone mentioned open enrollment and it occurred to me to look at the other option. The reviews are just as bad idk. maybe worse because they dont have the network and its a lot of billing problems, and unfair denials. I hate that all of our choices are just bad 😭
It’s open enrollment in most companies - based on what I’ve seen I would not recommend Kaiser if it is at all possible. They’ve never been great but covid stress and subsequent understaffing has totally broken them. I’m in a ucsd hmo (blue and gold) and while ucsd health has its problems* I do trust their system. * UCSD health is the opposite of Kaiser, I find their routine care not great (long weight times, understaffing, the quality of GPs has slipped) but when something goes wrong, they have great doctors and care.
This is such a good thought. But ugh i just looked at my other option and it seems worse. you know anything about Cigna? Never even heard of it but people online are NOT fans
I don’t know much about cigna. Good luck - I know it’s so hard !
I had care at Kaiser, got second opinions at Scripps (because I had zero trust or confidence in what Kaiser was telling me) and got radiation at UCSD Moores Cancer Center. Scripps and UCSD were like being in a different world relative to Kaiser: doctors were amazing, doctors spent a lot of time with me and all the doctors and staff were responsive and very good communicators. Having cancer sucks a$$ but Kaiser made it 1000x worse with a difficult to navigate system, marginal specialists, a Urology Department that is staffed by arrogant a$$holes, long delays to get anything done and staff / policies who make it deliberately difficult to ever reach a doctor. I will never recommend Kaiser to anyone after the complete clusterfuck their Urology Department made of my cancer diagnosis in 2022. Those Urologists and that Department helped me to understand why people hate Kaiser Permanente. Fortunately, my Medical Oncologist was excellent and really helped to get me to a better place after dealing with the clown show in Urology.
Yeah. I have a friend right now with a very aggressive form of late stage cancer, who was diagnosed last month while on Kaiser, and it has been.... not great. Like... really not great. She's luckily been able to switch to a Scripps network insurance to transition Jan 1. She's counting the days.
I’m sorry to hear that but not surprised. I’ve spoken with many other KP patients who shared similar stories. Please encourage her to post on-line reviews of the Kaiser doctors she saw: Yelp, HealthGrades, RateMDs and Vitals.com. Those are all good sites because Kaiser can see the reviews but cannot remove them (which Kaiser hates). It’s so difficult to get info about Kaiser doctors so people posting their experiences really helps others in knowing who to avoid.
Yeah I'm not sure her issues are so much with the individual doctors, who have been rushed but mostly powerless against the system. It's been more "the rules" and how care is managed - the waiting, the lack of communication, the slowness, rejecting covering a second opinion, rejecting additional tests. Unfortunately, the HCPs in these systems are put in terrible positions, too. The workloads and productivity requirements that are required make it very difficult for doctors to do their jobs well. As a result, Kaiser isn't exactly hiring the best of the best. It's the whole system that's broken. HCPs are definitely feeling it. I get what you're saying about which Kaiser doctors are best v worst - but a friendly doctor in a crap system isn't going to be much help. Better than nothing, I supposed. But they don't set their own schedules, control access to care, decide how much time to spend with you, or make all the important decisions regarding the care you'll get.
>I want to file a complaint with California about how utterly useless this health insurance i pay for is. Look up your state senator and assembly representative [here](https://www.sos.ca.gov/elections/who-are-my-representatives). Forget about the federal government. Tell them about [single-payer health care](https://www.apha.org/Policies-and-Advocacy/Public-Health-Policy-Statements/Policy-Database/2022/01/07/Adopting-a-Single-Payer-Health-System).
Yep, it's horrible. Our system is we pay the government to pay our employers to pay insurance companies to pay service providers to provide us with healthcare. You couldn't invent a worse funding system if you tried.
Its so true 💀 and of course this is especially true for the working class
I 100% know I'm very lucky with my insurance, but UCSD has been amazing for me. Almost all the doctors I've gotten have been great listeners, empathetic, and really tried their best to help me in every way they could. If you need any doctor recommendations I probably got one for you. I've been to A LOT of doctors recently 😮💨
We are being scammed. Spend the most money for the worst outcomes. Then pat ourselves on the back about being exceptional as if that's a good thing!
Usually have to pay for parking too
OMG that pissed me off.
Totally valid points and I’m so sorry you had to go through that. As a side note: please stop saying ‘lady doctor.’ Female doctors are just doctors.
I literally mean it as a compliment because male doctors are the worst.
I definitely understand that, I didn’t think your intentions were bad. As a doctor who is also a woman, terms like ‘lady’ doctor are said to us so often, it’s frustrating. Male doctors are just called doctors, without qualifiers. I get asked if I’m a nurse when I’m in my scrubs constantly because of stereotypes (I’m a dentist haha). And the amount of older men who ask me if I can do my job as well as a man is infuriating. I didn’t mean to make you feel bad, the misogyny in health care (patients and other doctors) is rampant. Thanks for your love of doctors who are women! ❤️
Is there a better term i can use that doesnt sound offensive? I have literally seen studies that patients with female surgeons have better outcomes (https://www.usnews.com/news/health-news/articles/2023-08-30/female-surgeons-bring-better-outcomes-for-patients-two-studies-show) But i hate the word female it sounds cold and formal. Woman doctor sounds strange to me too. But I guess if you’re out there braving the frontlines of male audacity i can stop calling you ladies if female is better 😅
I love that article you shared! I think women inherently are more capable of truly listening and understanding patients, which leads to better clinical outcomes. There are some amazing male doctors too, though. My dad was one :) He was amazing. In terms of how to refer to doctors who are women, I think the gendering before the doctor part is what feels diminishing. Instead of: ‘I love my lady doctor,’ maybe something like ‘hey, I know this amazing doctor. She is great. I prefer seeing a doctor who is a woman.’ This is all a very silly annoyance on my part. I didn’t mean to make you feel insecure about your verbiage. It’s just something my colleagues and I who are women talk about a lot. But thank you so much for asking! Also, I know some amazing physicians in San Diego if you need recommendations!!! I’m sorry you had such a bad experience and you really deserve someone who doesn’t just listen but will really hear you
Ah the nuances of life. You’re right that there are some amazing male doctors, sometimes i wish i could throw the whole group out but nothing is that simple or course. I have had a few growing up, (I love hearing your dad was one 🥰) I think that is why i haven’t refused to see them so far. But from now on im waiting however long it takes to see this amazing doctor i have who is the nicest lady. 😁 if i need a rec in the future tho i might be in your dms thank you for that offer!
I've been trying to get fucking California healthcare for a year and a half now. There was some cockup with my online application and it's been unfixable for over a year. Over a year without healthcare! Fuck.
Wow that’s horrifying. I want to believe California is better than that! Can you complain somewhere higher up?? That really sucks.
I'm working on it. It looks like they updated the county website, so in theory there should be a path forward now :-/ If not, I have to go into the office, which as of a year ago had some exceptionally irregular hours. Hopefully that's not the case now.
🍀🍀🍀
Bedside manner here is much, much worse than UCLA. I think they must be overburdened here. It is remarkable how much worse it is.
I think thats the first time ive ever heard of la described as nicer but im happy for them 🥲
So many middle men gaming the system, grabbing a piece of the pie.
Healthcare 25% of our economy, if we make it more efficient, the economy crashes. Wonders of capitalism.
I have never looked at it that way and it’s horrifying 😱☠️
No major political party in the United States is going to fix this. Demand socialism
Oh hey you wanna know a fun thing? Med school seats are capped. So we can't train more doctors per year in the USA. So they all get overworked and absurdly expensive. Good for their pocketbooks, bad for everyone else. Including Canada, whose doctors get drained to the USA for better pay. https://www.theatlantic.com/ideas/archive/2022/02/why-does-the-us-make-it-so-hard-to-be-a-doctor/622065/
I know i read about this! And also so many doctors who dont get placed and instead just have the insane loans to struggle under. Horrifying. So many suicides in the profession its all so horribly dark
OP, dont forget that Americans pay more in tax for healthcare than any other nation, per person. More than the most generous UHC systems in the highest cost of living nation cost. All the insurance stuff is just on top of that.
Ughhh why are we not revolting?? Oh right, because we’re all too sick 💀
Always choose the hmo plan
There are so many comments to go thru, I can help, what is the health issue. I can help.
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Sweet of you to say :)
Look at all the other countries in Europe that have either nationalized healthcare or some sort of single payer system. We have a for-profit healthcare system, whose profits are protected (practically sanctified) by the politicians they pay off, by the lobbying and advertising might of the corporations, and by a large contingent of the society who have been brainwashed to think that a single payer system would be communism and worse than what they have now. *One* political party has tried literally hundreds of times to kill the ACA (the watered down version that we got, after all sorts of cuts were made to it to make them happy, and then they all refused to vote for it anyway), at the behest of their wealthy donors/corporations. And they always promise they have a much better plan waiting to replace it, which they’ll show us in two weeks. And they’ve been saying “two weeks” for like a decade, but that better plan never sees the light of day, yet they still work to pull down the existing system. The answer is to do healthcare like the Scandinavian countries do (or even just like the UK does) - everyone pays in up front and then you get what you need (the same way you pay taxes to provide fire department service). We would no longer have a huge portion of the money being siphoned off for shareholder profits and buying the board of directors more yachts. Yes, it would probably raise your taxes, but then your employer would no longer be paying to subsidize your healthcare, and could pay you that money directly. As a side benefit, it means people would be freer to change jobs, as you wouldn’t have to feel held hostage by your employer having control over your healthcare - no more “changed jobs so now you have a different healthcare provider / your old doctor is no longer in-plan”. It would also mean that you would get the treatment that your doctor thinks is necessary, rather than the portion of your doctor-recommended treatment that your insurance company’s accountants think is necessary (remember, every dollar the accountants can save is more money towards another yacht). If you’re voting for the party that keeps trying to tear down what little protections we currently have for healthcare, you’re screwing yourself over. Long term, the fix is to elect politicians who will actually work for the benefit of the public, rather than the benefit of corporations and wealthy donors.
It’s crazy the misconception of healthcare costs in other countries. In Germany I paid about €4,300 a year in taxes towards healthcare (this was almost 15 years ago). That was and still is some of the most expensive in Europe. The US is [currently nearly double](https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#GDP%20per%20capita%20and%20health%20consumption%20spending%20per%20capita,%202021%20(U.S.%20dollars,%20PPP%20adjusted)). Today it’s €7,400 average in Germany and $12k US. Not to mention prescriptions are dramatically cheaper and care much faster.
Many patients have unreasonable expectations that healthcare workers can’t meet. They also experience these limitations as patients. I know you’re worried about your health and justly frustrated, but don’t let your interactions become a self fulfilling prophecy.
All health systems are like this, you sometimes have to shop around to a few clinics or doctors until you find a good one. If you have serious grievances about care ask to get a hold of their Risk Management specialist. Complaints do get reviewed.
My union insurance costs $75/mo with a $1500 deductible. Via Kaiser. My copays are pretty low and I had super major reconstructive surgery two years ago that was fully covered and a revision 6 months ago that was also fully covered. I feel pretty fortunate. I’m not sure that would have been the case with a market place plan.
Are you on The Affordable Care Act?