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2000
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seniors.kaiserpapers.org
In
the year 2000, The California Nurses Association put out a warning to
Seniors about the Kaiser Permanente Senior Advantage Program.
It
is displayed here for you reference. http://seniors.kaiserpapers.org/cnasenadvantage.html
I think that you will find that not much has changed.
"10 percent of Kaiser’s business
is Medicare+Choice" - G.C. Halvorson - Current
CEO
"Too many
people leave this life with a bit too much morphine in their system for
their death to be considered natural."
With the
act of
euthanasia, the sick or elderly are killed by action or omission, out of a
misplaced sense of compassion or misguided mercy or for a
corporation to make more money.
The
best thing that
we can recommend
for seniors is
to have nothing to do
with ANY Kaiser Senior Health Plan.
"Compelling
as some of the arguments of euthanasia campaigners might be, relaxing
of the law is fraught with possibilities for abuse. In a world in which
familial relations are often vexed and financial considerations
frequently to the fore, the pressures and opportunities for the infirm
and their families are such that base motives might find their way into
life-ending decisions; further, that elderly people uncomfortable and
afflicted by adverse medical conditions might be inclined to feel
themselves a burden on others and seek to end their own lives."
For
Basic Physical
Therapy that your family can help with.
This is where I go t
the information to give my father his
Physical
Therapy. Kaiser of course billed Medicare for the work that I
did.
Kaiser staff was also upset that we did any physical therapy for
him.
It kept him alive and undid much of the damage done while he was " In
The Hands of
Kaiser."
See also: Contrary
to Kaiser recommendations for Hospice patients with difficulty
breathing
to take Morphine - Many Physician's Disagree and do not recommend that
it be used for this situation!
http://www.kaiserpapers.org/senadv.html
The
key to Kaiser's business success is to pull in seniors as enrollees -
free
seminars for conservators - and then withhold the patients'
care.
Seniors
do not have a strong advocacy
group; they have a less suable
life span; their diseases can be blamed on aging; they are harder to
study
for outcome; and few Western families can use the Asian approach of
camping
out by the bedside and watching every care event." Seniors - If you are in
California and
have a problem with Kaiser is it unlikely that The Department of
Managed
Health Care will choose to assist you. In 2001, Federal
Judge Ronald
Lew wrote that the Federal Level was the correct jurisdiction for
Medicare
related
matters under Social Security Act Title 1856 section (b)(3)(B) and
Federal
Code Title 42 U.S.C. 1395w-26(b)(3)(B). . Please
see: http://www.hmohelp.ca.gov/hpp/memos/2001/011217.pdfand http://www.ssa.gov/OP_Home/ssact/title18/1856.htmWhich
states
that Federal Law supercedes state law. and
http://www.ssa.gov/OP_Home/ssact/title18/1856.htmSo
this
means in general that CMS is the agency that you need to
contact
for assistance. In turn it is likely that CMS will refer you
back
to DMHC stating that they indeed should be handling your case after
all. DMHC may then just deny your existence and not do their
job.
They may also continue to give you the run around and refer to you to
whatever QIO has the contract at the time for review.
A
QIO is a
"Quality Improvement Organization." This is not a government
agency. This is a trade organization owned by those in the
health
industry, such as Kaiser and often run by Kaiser and DMHC former
employees.
By sending you to the QIO which
has no
authority, they are wasting your time. By the time that
their
investigation is done the statute will be tolled. That might
be
their intent.
All we
can
suggest is that you
collect the letters from the
various agencies you have to contact. Send copies of your
letters to the next agency that they
refer you to. Eventually, someone may finally decide to do the
right thing and show you respect as a citizen, and finally assist you.
Why
Kaiser shafts
the Senior Population:
"Current
financing
trends
(e.g., Medicare Prospective
Payment System) put the hospital at risk, and in order for it to
survive,
a hospital must obtain the support and cooperation of its medical
staff.
This shifts a considerable economic responsibility to the physicians
when
any fixed price payment (per case, per patient, or per subscriber)
results
in a fixed budget." From: http://businesspractices.kaiserpapers.org/kaiserpayoff.html -
Source: Payments to physicians in the
Permanente
Medical
Group - a
report
prepared
for Congress by Kaiser and the For-Profit Permanente.
You
can help fight Medicare Fraud and
Abuse. Check out this link
if you believe that Medicare Fraud is taking place. http://www.kaiserpapers.org/fight.html
In
the case of a Senior that has
the misfortune to have the Senior Advantage package, don't count on
your
contract to be honored by them when you really need it.
Kaiser will
pretend that they have budget cuts, no knowledge or staff capable of
treating
your needed medical situation and the end result will be that you will
suffer.
Kaiser does not care one little bit about your health. They
only
care about your premiums that the government is paying to them three
months in
advance.
You
will find the occasional
geriatric
specialist that will care for you to keep you alive as long as some
administrator
doesn't decide you need to be part of their so called hospice
program.
That is telling Medicare that is their final payment for your
medical care. Once that program kicks in you can count on
living
just about 85.2 days after
that. At 90 days the government computers may trigger an audit of those
systems that still have patients on their program. No
corporation
wants that to happen. Please
view page
74
http://medicalserialkillers.kaiserpapers.org/pdfs/odyssey.pdf
If
you
insist on staying with Kaiser here are
a few self help links that you will need to survive:
Recently
we
have received
numerous
reports of in hospital and at
home Kaiser patients dying from urinary tract infections where the
blame
has been laid on a catheter. Rather than voice any one
persons opinion
on this epidemic the following links on this subject are
provided.
Arm yourself with as much knowledge as possible if dealing with this
situation
and are under Kaiser's care!
Kaiser is known as a "Mean
Machine" by everyone
that works at Kaiser.
This Mean Machine is being fed by your Medicare payments.
It's
growth
and benefits are not shared with you. It is a self serving,
manipulative
and slothful entity that does not deserve to receive your Medicare
premiums.
Did
you know that Kaiser receives your Medicare money in advance from the
Federal Government? Did you also know that if they sign
someone
into their psuedo hospice program that they are prepaid but that if you
live longer than 90 days in this program that a Federal Audit may be
triggered?
Did you also know that Medicare pays a higher rate to Kaiser for
shipping you off into their hospice program?
They
just don't provide half of the services that you had before this
program became involved. If you die before the 90 days is up
they
get to keep all that money and avoid any recertification and audit
problems. For Kaiser this really is a win win
situation.
This translates into higher shareholder dividends for the Permanente
Doctors that probably never even visit a patient of theirs that they
shoved off into the Kaiser hospice program.
Did
you also know
that all those excuses as to why you
have to see a nurse instead of your assigned physician is an
intentional
act? I am sure that you will hear all sorts of excuses about
how
busy the doctor is, but the truth is if they put your care Into The
Hands of A Kaiser Nurse that doctor can bill for lots of
patients at
the same time without ever seeing them. Maybe someday, if no
one
complains your doctor will get around to reviewing your medical records
but I wouldn't count on it in this lifetime.
Your
greatest chance
of survival is to go straight Medicare
and purchase a Medi Gap Policy. Forget the outdated,
previously over
rated and falsely advertised Kaiser Senior Advantage Plan if
you
want to be around to see your children and grandchildren in the
future.
Kaiser's
"physician responsibility"
term is the
code words for the strategy of do not go beyond one pass at providing
care
for a senior. Complications go to hospice or home
care. Cancer
is to be ignored early and diagnosed when too extensive to
treat.
Pneumonias may be sent home at the midlevel Class C severity - the
point
at which the "best evidence" says admit - because the 2% mortality rate
is worth the (unexplained to patients) risk.
Seniors,
Kaiser
believes that you should not absorb too
much treatment cost as part of their "patient responsibility" to their
Kaiser enrollees, the latter hidden agreement is never explained in the
ads or contracts.