Comment by spiralpolitik
Comment by spiralpolitik 4 days ago
Kaiser does give a more integrated European style experience, however the experience largely depends on the quality of service you get from your local Kaiser doctors and hospitals.
Some are significantly better than others.
The only times I hear about consistent experiences from a health system is when it's consistently poor. Ones where you can get good quality service are universally inconsistent.
IMHO, Kaiser is usually (but not always!) adequate, and I'd rather have good enough and easy to access than have to deal with non-integrated health care. My most recent health care experience was going to a Pediatric office (Nurse Practitioner), getting a prescription for a asthma control inhaler, where the NP was aware that insurance coverage was very selective so they picked the most likely covered. Then going to the pharmacy after waiting a customary amount of time, being told the specific one wasn't covered but they would tell the NP which one is covered and I should be able to get it by the end of the day. Call the NP office and leave a voice mail, check in with the pharmacy near close of business and no new prescription. I ended up paying for the non-covered one the next day (Saturday) because I wanted to get the kiddo's asthma under control 2 days sooner than if I waited for Monday.
This would have never happened in an integrated system --- at Kaiser, often my prescription would be ready to pick up by the time I walked within the building from the doctor to the pharmacy. In an integrated system, the prescriber always knows what's covered, and usually what's available at the pharmacy when they write the prescription. I've definitely heard things like 'they want you to try this one first, and if it doesn't work, let me know and I can write you the other one', which can be frustrating, but it's better to hear it from the MD or NP than from the Pharmacist. Sometimes, specialists have huge backlogs in an integrated system, and that's not great either, unless it's really bad, you can't get care outside the system unless you pay full fare, and many injuries have worse results with untimely aftercare. With a non-integrated system, you can at least call around and maybe find an appointment with a specialist that's a little bit farther away.
Unfortunately, I moved out of the area of Kaiser. They have been purchasing some health groups around me, but they don't control any local hospitals, and the nearest office is not really close due to local geography; choosing to live on an island is on me, but I still need to have coverage for doctors on that island.