I have written from time to time about a close friend who is a cancer surgeon.
He is a member of a volunteer team of surgeons who are called upon periodically to remove and harvest organs suitable for transplant from people who have died.
Sometime soon, he'll receive an urgent call that organs are available. Then, we've agreed, he'll call me to accompany him. I'll tell you first hand what happens during one of these retrievals.
The organs he harvests go to very sick people, some within days of dying.
I understand that these precious scarce organs are apportioned and transplanted according to a strict code of ethics.
The good work of my friend, is the backdrop for a harrowing story about the organ transplant program at Kaiser Permanente in California.
Kaiser Permanente is an HMO. As an HMO patient, you are at the total mercy of your HMO. If you seek treatment outside the confines of the HMO--you pay.
My friend and his fellow surgeons abide by an honorable and time tested code of professional conduct.
It would appear medical ethics and just about everything else, including minimal standards for patient care at the Kaiser kidney transplant program have broken down. Yet anther tragic story about our shattered health care system.
The Los Angeles Times has reported in a horrifying series of articles about the chaos, confusion and egregious treatment of patients awaiting kidney transplants at Kaiser.
You can read this breathtaking series here:
Kaiser Slow to Transfer Patients
May 5, 2006
By Charles Ornstein and Tracy Weber / Times Staff Writers
Kaiser Permanente launched its massive kidney transplant program in 2004 without holding basic discussions with regulators about how to safely transfer up to 1,500 of its patients from other programs to its San Francisco center, according to a Times...
http://www.latimes.com/...
And this.
Kaiser Denied Transplants of Ideally Matched Kidneys
May 4, 2006
By Tracy Weber and Charles Ornstein / Times Staff Writers
Twenty-five Kaiser Permanente patients in Northern California were denied the chance for new kidneys that were nearly perfectly matched to them last year during the troubled start-up of the giant HMO's kidney transplant program in San Francisco, a Times...
http://www.latimes.com/...
And this.
Kaiser Put Kidney Patients at Risk
May 3, 2006
By Charles Ornstein and Tracy Weber / Times Staff Writers
In mid-2004, more than 1,500 Kaiser Permanente patients awaiting kidney transplants in Northern California got form letters that forced them to change the course of their treatment. Kaiser would no longer pay for transplants at outside hospitals, even...
http://www.latimes.com/...
Today the Los Angeles Times describes the fear among Kaiser transplant patients:
Kaiser Transplant Patients Express Their Fear and Fury
With reports of disarray added to their existing frustration, some don't want the HMO performing their surgeries.
http://www.latimes.com/...
And would you want your surgery performed by Kaiser?
Kaiser Permanente "endangered patients" awaiting kidney transplants by "forcing them into a fledgling program unprepared to handle the caseload," according to a Los Angeles Times investigation.
In 2004, Kaiser told more than 1,500 patients on kidney transplant waiting lists in Northern California that it would no longer pay for treatment at outside hospitals. Adult patients were transferred to a new Kaiser transplant center. http://www.californiahealthline.org/...
Health Care Renewal is a health care blog. It's mission statement is one we can applaud: "Addressing threats to health care's core values, especially those stemming from concentration and abuse of power"
Among other things, Health Care Renewal tracks problem plauged managed care organizations like Kaiser. It reports, "managed care organizations, like other large health care organizations, are beset by problems that go far beyond bureaucracy and low reimbursement rates. Some of the posts on Health Care Renewal have featured how:
Kaiser Permanente mismanged the initiation of its kidney transplant program
WellPoint in California allegedly had a unit which retroactively denied patients coverage if they made mistakes on their applications form
UnitedHealth gave its CEO a cache of stock options now worth a staggering $1.6 billion, while its mission proclaims its support of "affordable health care", while UnitedHealth's board of directors include academics with potentially major conflicts of interest.
Many US urban health care markets have become dominated by one or a few managed care organizations or insurance companies
http://hcrenewal.blogspot.com/
Returning for a moment to the neglected and frightened Kaiser patients. These are the words of desperate people--American citizens.
"I don't know what's going on here," Bernard Burks wrote to Kaiser Permanente's kidney transplant program last October, "but whatever it is, it's wrong."
His daughter was willing to give him one of her kidneys -- a good match -- to rescue him from grueling rounds of dialysis. But no one at Kaiser seemed to care.
Kaiser staff hadn't read their own files, he continued: "You stated in your letter, 'If you have a family member or friend who might want to discuss donation of a kidney for you, please have them call us.' Check your damn records. It appears you are a bunch of incompetents who fail to communicate with each other."
"I don't want those guys cutting on me now," said Burks, a real estate appraiser in the Sacramento area. "I'm afraid.... I just don't trust them."
http://www.latimes.com/...
This is the face of health care in America in 2006. Not the best, the most expensive.