You’ve heard the rumors, and they might be true

Kaiser Permanente is the largest not-for-profit HMO in the U.S. Based in Oakland, California. It consists of the Kaiser Foundation Health Plan or Kaiser insurance, the Kaiser Permanente Medical Groups made up of the Kaiser doctors, and Kaiser Foundation hospitals. 

An integrated health delivery system, Kaiser organizes and provides all aspects of its members’ health care including, preventative care, hospitalization, medical treatments, and pharmacy services. 

Unfortunately, over the years, Kaiser has developed a bad reputation among many of its patients and even among some of its doctors. If you do a search of online reviews of Kaiser, you’ll discover a lot of complaints about everything from limiting doctor visits, long ER wait times, and decreasing service accessibility to limiting the number of contracted specialists, making appointments inconvenient, and increased office visit waiting times.

Over the years, Kaiser has been accused of using these and other tactics as cost containment strategies. The HMO has also been accused of promoting less-costly preventative procedures while concealing information about other elective and/or more expensive services. Patients often complain that, while it’s easy to get services with a primary care doctor, services involving specialists are more difficult to utilize.

Kaiser has a bad reputation

Another complaint by Kaiser members is the fact that Kaiser healthcare and insurance are the same company, making it easier for them to minimize costs on the insurance side by ordering the minimum number of diagnostic tests, and creating multiple visits with multiple copays, for example.

With traditional medical coverage, the hospital, your doctors, and your insurer are separate entities. Your doctor or the hospital can order tests or prescribe treatments; it’s then up to your insurance company to pay their part or deny coverage.

Perhaps one of the biggest reasons Kaiser has a bad reputation is due to their policy of forcing their patients with medical malpractice claims into arbitration. In 1978 the HMO implemented a provision in all group policies requiring these types of cases to be settled with a private arbitration system. 

Many medical malpractice victims who are members of Kaiser Permanente complain that this process undermines their claims and, therefore, makes it very difficult for them to get full compensation for their injuries.

Your personal nightmare

Take some time to do an online search for reviews from Kaiser members; you will end up reading a number of nightmare stories from Kaiser patients. You may also come across some bad reviews about the HMO’s complaint process, yet another reason for their bad reputation.

While Kaiser encourages members that have an issue to fill out and submit the complaint form on their website, they never really admit to or even acknowledge any wrongdoing, even in the face of very well-documented complaints.

So, the lesson learned? Don’t waste your time filing a complaint! If you feel that you or a loved one has been the victim of medical malpractice due to the negligence of a Kaiser healthcare provider or hospital, contact an attorney that has experience with Kaiser’s arbitration process and who will work to protect your legal rights.

In San Diego, that attorney is Scott S. Harris.