Complaint Review: Kaiser Permanente

First, I am a "member" of Kaiser Permanente, and pay over $300 per month for my insurance, plus more for my family. All told, I spend close to $900 a month for insurance, plus co-pays, etc. So, one might assume that a customer such as myself would be treated well, or at least as well as the average person who has Kaiser for their health insurance provider. If I am treated as well as the average member, let this be of warning to you if you are considering signing up through work with Kaiser, or if you are going to buy the insurance outright.

I have had numerous difficulties, but I will only relate those that have occured since Wed., November 23rd, 2005.

On the 23rd of November, I called Kaiser to set up an appointment with my primary care "physician" (most are actually nurses). I was told he wasn't taking appointments at this time. That did not sound correct, so I called his office directly (a no-no per Kaiser policy, but he gave me the number in the past if I had to reach him). There I was told that he is no longer seeing patients. He quit. I asked why I wasn't notified. I was told "he specifically requested that all his patients NOT be notified of his status.".

Apparently, primary care physicians, who are advertised by Kaiser of having such strong relationships with their patients can decide to take other positions within the Kaiser community but order that their patients not be informed first. It makes a difference for me as I have seen him and him alone for the last 4 or so years. I have a couple ongoing medical problems that I would have liked to address first, and would have appreciated a recommendation from him as to who I should now consider seeing as my new PCP. Alas, it is not to be. I have repeatedly called Kaiser, and know where he works, but cannot get any message to him.

This isn't good service, but it is just the beginning.

With Thanksgiving and Christmas and New Years, I did not make it back to Kaiser until January. I have a couple prescriptions that I pick up from the Kaiser pharmacy on a monthly basis. I called them in on December 22nd, to be ready to pick up on January 3rd. When I arrived, None of the prescriptions were ready. I had to wait for 30 minutes while they were put into bottles.

When ready, I realized that they had forgotten to fill 1 of the 3 prescriptions. My choice was to wait for another 30 minutes or pick up tomorrow. I own a business and was already about 20 minutes late to get to it and open it. I said I haven't the time to wait, please have ready this time and I'll be in at the same time tomorrow. After leaving the pharmacy, I went to "member services" in person to make an appointment with a new PCP. They found me one for the following morning.

January 4th I returned. First, I went to the PCP appointment. After waiting for about 20 minutes, I was taken in and had blood pressure and temp. checked. I was told my new PCP would be with me in a moment. 30 minutes later with no sign of the PCP or nurse or anyone checking in with me, I went to get dressed and go out of the cubicle.

As I was just opening the door, a nurse came in and said something like: "Sorry for the wait. Ms. ... is not taking new patients. They should have never made an appointment for you to see her in the first place. " Well, I went back to the "member services" area to get my co-pay returned. Then, I went to the pharmacy to pick up the prescription from yesterday. After waiting in line for 20 minutes, I waited another 10 minutes as they looked for the prescription.

Finally, the clerk came back and said there is no record of the prescription ever being written by my doctor. I said I know it is here, because I saw the actual paper yesterday morning, signed by a doctor. To no avail. I left to drive 1/2 an hour back towards where I came from to get my business open, again, about 15 minutes late.

That evening I called the pharmacy when I had time, and was told by a pharmacist that the paperwork was there, and had been there all the time. She said, the clerks are not the sharpest people in the building, and next time find a pharmacist to find the paperwork. Well, this morning, I had asked a pharmacist, but he had echoed the clerk's response. At least I knew it was there. So, my 3rd trip was made the following day, before work (20 miles from my business to Kaiser, btw). Of course, the prescription still wasn't filled, even though the woman I had spoken to the previous night said it would. The same clerk was working.

I reminded her of what had happened the day before, and complained, albeit nicely, about my time being wasted again today. No sympathy, no apology, just a curt "we are very busy here".

This is just the tip of the iceburg in dealing with Kaiser. I figured there would be an "ombudsman", a person who is employed by Kaiser to mediate problems that occur between the giant health care corporation and those who are clients of Kaiser. There is no such person that I can find, and I have called and written letters.

I have called the supposed "head person" of Kaiser Rockwood. I have yet to have a call returned. I will write a letter to the chief pharmacist, but I just don't have a lot of good time to throw after bad. When I joined Kaiser, I did not care that much about the insurance, because I was healthy. Now, for the last 3+ years I have had a bad back. Now I cannot get another insurance company to take me on, regardless of what I pay each month for health insurance.

SO BEWARE. Realize this type of "customer service" is pandemic with Kaiser. There have been AT LEAST 5 different times where I have made the trip to the office to be seen for an appointment, only to be told that my PCP is not in today. I got to the point where I called first, to make sure he was in. Even then, I was told, "yes, he is.", only to arrive and be told no, he is not in today.

If you wish to be treated like a giant pain in the a*s, then Kaiser would be a great place for you to give your health care money. If you expect to be treated like a paying customer, then Kaiser would be a bad choice for you. As a business owner, I shudder to think of what would have become to my business if I dared treated even a small percentage of my customers as Kaiser had treated me.

There is so much more that I could write here, but this should give you an idea of what they are like. I would love to see a response to this letter from Kaiser. If they do respond, I would be curious to know why they do not have an ombudsman. If they do, why do they keep him or her hidden in the layers of bureaucracy? Lastly, I have been philisophically opposed to national health care, because I am certain the service will be terrible. With Kaiser, I have a real good idea of what the service would be like. Since I spend so much money with Kaiser, and I can't move to another insurance company, I really don't care one way or another anymore whether or not we Govermentalize heath care.

Kevin
Sandy, Oregon
U.S.A.