🚀 go-pugleaf

In article <tse.748728158@foolish>, Gary Tse <tse@apple.com> wrote:
>She belongs to the Kaiser HMO in the Bay Area.  Last year, she had
>some pain in her shoulder when she moves her arm about.  She set up
>an appointment with her "personal" doctor at Kaiser Redwood City.
>No problem, they tell her, we can give you an appointment 3 months
>from now.  Fine, my mom said.

That's one problem.  Your mom said "fine".  If it's serious, she needs to
push it.  Now, I agree it shouldn't be that way.  But after fighting my way
through (helped here and there by Kaiser people) to see a specialist, I was
told (for better or worse -- just reporting, no flaming please) that the
squeaky wheel (or patient) gets seen.  My experience with that doctor was
quite different from my experience with other Kaiser doctors.  He had time
and he was interested in my problem.  But you have to be a pain.  (Actually,
about 50% of my doctors at Kaiser have been concerned and helpful.  I've had
some terrific care here and there.)

>She was so bothered by her shoulder
>that she finally went to see a doctor outside of the Kaiser system. 

I've done this, too.  So do many other Kaiser patients from what I hear.

>A couple of shots, some pills, and some physical therapy, and her 
>shoulder is now without pain.  Her doctor tells her the condition of
>her shoulder was deteriorating without treatment, and had she waited
>for her Kaiser appointment, treatment would have been much more 
>drastic.  Surgery might have been required, and perhaps there would
>have been some permanent impairment.

Given this information, I would bill Kaiser.  It's not that hard.  Take copies
of invoices and mail them in.  I've done this when receiving emergency care
outside Kaiser.  I'll bet they pay.  If it's enough you might need to sue.

>I switched my insurance carrier out of the Kaiser system after her
>experience.

Not a bad idea.  But from what I've seen (and heard) other HMOs aren't better.
For every person who hates loves Cigna/CaliforniaCare/etc I can find another
who doesn't.  

My point in all of this is "learn to work the system".  Be demanding.  Or
if you really find another system that works better, switch.  But I have 
enough advantages with Kaiser (same day appointments, cheap prescriptions,
weekend walk-in with 20 min wait max) that I'm hesitant to switch.
-- 
 
-- Alan                        # Mountain Dew and doughnuts...
   ..!ames!elroy!alan          # because breakfast is the most important meal
   alan@elroy.jpl.nasa.gov     # of the day.