The site I’m looking at is Kaiser Permanente, so-called because you’ll be ‘permanentely’ bankrupt if you have to use them. It’s the one you might not have heard much about because apart from The Guardian and The Mirror, the papers tend not to shout about it. Tom Pride’s website does which is why I’ve added a link where he points out that Theresa May’s plan is to quietly break the NHS and then bring in this lot. Go to their website and it features photos of people who look as though they’ve fallen face first into a vat of Prozac.
I’ve also included a link to Political Concern and Vox Political. It seems that mainly bloggers are paying attention to the coming health catastrophe. Maybe the Daily Mail, Times and Telegraph writers who are subject to their overlords should think about whether they can personally afford private healthcare? From what I hear the Times doesn’t pay that much.
There is also a lot of twattle about ‘the finest medical minds’ and how ‘your needs come first’ alongside pics of hunky docs. Or actors in white coats.
Plus lots of random pictures of happy people. Serving coffee . . .
There are doctors being all bedsidey manner with little children
So there’s all this stuff about ‘finest medical minds’ and ‘your needs’ blah blah on the Kaiser website (and no I’m not linking it). And yet they are somewhat coy about actual price lists. Not even a few guidelines. Instead you are invited to have a cosy chat with one of their health professionals (sales people) who will then inform you that not only will your cancer cause you significant pain and distress and possibly death, but also bankruptcy.
The NHS is being deliberately broken
Most of us don’t think about the reality of the NHS being broken up even further under the Tories. That the Healthcare Trusts set up in the 90s are a way of forcing the NHS to act like a business and think in terms of saving money and that privatisation by stealth is happening under our nose.
So: Theresa May’s plan to replace the NHS with Kaiser Permanente. She will make great play of Kaiser’s boast that it is ‘free at the point of use’, but not that this only covers people who are working. It won’t cover the disabled either. That’s nice. It means that KP can carry on with the Tories work of destroying disabled and unemployed people. But even if you are working, it doesn’t mean you get all the care you need – your tests and procedures are strictly limited. Oh and the patient reviews aren’t exactly glowing.
It’s quite simple. If you run a healthcare system for profit you will get poor quality care, more mistakes, and a higher level of misdiagnosis. Especially since patients have uniformly complained about their care – with one of the biggest being poorly trained medical staff. Oh and how they treat people who complain. Actually just reading that website is an education in what Kaiser is like for patients.
Kaiser has also been criticised for having huge cash reserves, but this is how private healthcare works. It’s in their interests to not give care, particularly to those pesky long term illnesses like cancer patients with those rounds of chemo or radiotherapy and drugs, because that’s how they keep more money. In 2014 18,000 Kaiser nurses went on strike, over (guess!) poor pay and dangerously low staffing.
It all seemed bad but vaguely ‘over there’ until I got sick and began to think how much my illness would cost
I’ve been twattling on about my colitis, and this has necessitated two gastroscopies and a colonoscopy. The doctors discovered three ulcers over six months and I had one A&E visit with excruciating abdominal pain. After last week’s chokily unpleasant gastroscopy I had another one, within a week, because the doctor said it was urgent. The point being that my care was/is led by medical need and not by insurance companies or need for profit.
So how would Kaiser treat Crohn’s disease or colitis – a painful and debilitating disease? Back in January I was taken to A&E. What would Kaiser have done? Their website on urgent care informs that they are here for their members day and night. So everyone else can bugger off frankly. Or pay for unininsured care. By the way an uninsured person in the US who suddenly finds they need a colonoscopy or gastroscopy would pay about $5400 (£4150) and $4000 (£3080). That is per single one of each. Not for any follow up or medication. Think about paying for your colonoscopy next time you go to the toilet and find blood . . . .or when you have trouble swallowing or experience abdominal pain.
But hang on. What if I am a KP member? If you have an injury or illness that is not life or limb threatening but cannot wait, our urgent care departments can help. So I’m vomiting with pain and barely able to speak but I’m meant to phone and explain my symptoms and a person at the other end will decide whether or not my case is urgent? Not quite the same as dialing 999 and waiting for qualified paramedics.
So what are the figures? Well as with all US healthcare it depends on your level of coverage. So what if you are covered? Colonoscopies are supposed to be free as they are preventative. But if KP finds a problem then it becomes a treatment procedure and they will slap a huge charge on you. Let’s just say there’s a really big incentive to find a problem then.
A colonoscopy with removal of tissue (not including medication which I presume means sedation or pain relief or aftercare) $1143 but depending on where you live it can cost up to $2000. I found this on a helpful article that baldly stated: How Much is My Colonoscopy Going to Cost? You also pay for lab tests, anaesthetic and something called a facility fee. What the hell is that? Also there’s the cost of a gastroscopy. Again a very helpful piece. The national average is $4000 or £3080. Those US people are so skilled at writing questions and getting answers or maybe it’s decades of living with a profit run healthcare system. (You should also get used to prefacing your care with how much will this cost? if the Tories get back in. And you might ask what a facility fee is because the chances are you’ll be paying for that too.)
I’ve had three gastroscopies in the past year and one colonoscopy. Each time there were four people in the room; a doctor, two nurses, and a lab technician (hey! Maybe that’s the facility fee! Employing the lab as a place? It turns out I was half right) The total cost of two gastroscopies and a colonoscopy would be if I were insured by KP in pounds about: £1550 plus £6000 (two gastroscopies) = £7550 plus any medicines I might need + that facility fee.
Actually I did find out what that facility fee means. It irritated me so much I went back and had a look. I will allow Harold Miller, chief executive officer for the Center for Healthcare Quality and Payment Reform in the US to explain
At a hospital outpatient provider, the provider payment was $62 and the facility fee was $390.49, totaling $452.89.
Oh my God. You mean they can basically charge what they like?! That’s £300 extra!
When a service is provided in an independent practitioner’s office, it brings one single payment. But when the same procedure is performed in a facility, either an outpatient department or an ambulatory surgical center, Medicare pays twice: To the facility and to the provider. These fees are meant to cover hospitals for overhead that a freestanding physician’s office does not carry.
Hospitals charge these fees because, like many providers, they aren’t paid for a large part of what they do, Miller says. They get no money specifically for having an emergency room that can treat patients 24 hours a day.
“There is a legitimate case to be made that they charge more than others,” he says. “People will be unhappy when a hospital is closed at night, and they have a heart attack.”
But hospitals are purchasing physician practices at a fast clip and, according to the Medicare Payment Advisory Commission (MEDPAC), these practices are increasingly being converted into outpatient departments, which allows the hospital to be paid more for various services than does a freestanding physician’s office.
Wow. Even Kaiser have admitted the facility fee is a surprise. They also say that:
“It’s like a barber saying, ‘That’ll be $20 for a haircut and $10 for sitting in my chair,’ ” said Wisconsin state Rep. Chuck Benedict, a Democrat and retired neurologist from Beloit. Benedict’s bill to require hospitals to post notices about the fees and furnish upfront cost estimates was defeated in 2007; he has introduced a similar bill again this year. Legislation has also been proposed in New Hampshire.
I love the way they put Democrat as though that’s a disease. It probably is to the Kaiser Board.
The most pertinent quote is this:
One billing consultant has estimated that the fees could generate an additional $30,000 annually per physician for hospitals.
Wow. Huge fees, high insurance costs, treating patients badly, and that facility fee for the cost of not having a 9 – 5 A&E. The NHS is looking really good to me right now. No wonder Kaiser prefer to feature happy smiling people rather than the costs. This is really the future if the Tories get in. High priced healthcare and pictures of random people looking happy for no reason. Least of all because of their healthcare.