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I was shocked to see this comment from QuarterHorseDem:

Kaiser just raised my premium 40%!

There is virtually no competition in Northern CA(Aetna dropped out of the market for self employed individuals), and I will be paying about $150 more PER MONTH(about $1,800 more per year than I am paying now) for a much, much crappier policy( now I have to pay 40% of all care after I meet my deductible which went up almost $2,000).  

Premiums alone will cost me over $6,000.

I wonder why the State of CA is allowing such a huge rate increase?  Why is this legal?  

Since I don't qualify for subsidies, I am really getting screwed.  Thanks, Rethugs, for fighting single payer and handing over huge profits to Kaiser since they just about the only game in town.

This surprised me... I thought Kaiser was going to be one of the cheaper options.

Once I finally got into the CoveredCA site to preview the plans I saw that Kaiser wanted $800ish for a Bronze and $1000ish for a silver. Both on the HIGH end compared to the other plans for me and my family of 5. (I'm 37, wife 35, children 5, 3, and 1 month in SoCal)

Now granted - still probably a lot cheaper than what COBRA would be although I'll see that price for sure soon.

I might have to look into another health care provider other than Kaiser.

But I also did some Googlin' and found this article:

Why does Kaiser have the highest premiums in the California exchange?

In California’s new state-run health insurance market, Kaiser Permanente will cost you.

The healthcare giant has the highest rates in Southern California and some other areas of the state, surpassing rivals such as Anthem Blue Cross and other smaller competitors. The relatively high premiums from such a strong supporter of the federal healthcare law surprised industry analysts, and it has sparked considerable debate about the company’s motives.
Some experts say Kaiser intentionally bid high to avoid drawing too many customers next year who are sick or who have been uninsured for years and may be costlier to treat. Others suspect Kaiser was worried that lower premiums would bring an influx of newly insured patients that could overwhelm its in-house roster of doctors and hospitals.

Here's some more from that article:
There is another reason that is perhaps the most important of all. Kaiser Permanente is a truly integrated health care delivery system with its own hospitals, clinics, health care professionals and other components of the health care delivery system. They can provide virtually all services to every one of their plan members. Carefully planning and executing system capacity is absolutely essential in the Kaiser model.

Large, abrupt changes in enrollment can be catastrophic from a business perspective. If they lose too many patients all at once they are sitting there with expensive excess capacity that is not generating revenues. On the other hand, if they have a sudden large influx of patients, especially patients who would require greater amounts of health care, they would strain their capacity, with overloads in their primary care clinics, with patients destined for admission waiting in the hallways because the hospital’s beds are full, and with intolerably excessive queues for patients waiting for high-tech and specialized services. Obviously, they would have very unhappy patients.

I like Kaiser... but the cost is making me look into cheaper plans on the exchange. I'll have to do my research.

What's everyone else's experience?

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Comment Preferences

  •  I Wonder if It Would Be Legal For Them to Simply (5+ / 0-)

    stop accepting new clients regardless of their circumstances from time to time, to keep from being overwhelmed, and then get by with more competitive prices?

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Thu Oct 03, 2013 at 12:44:31 PM PDT

    •  I'd guess that the exchange would forbid that (0+ / 0-)

      for the same reason as requiring the annual enrollment window that people have.

      I'd be curious if anyone knows if that limitation is specified in the ACA: that exchange companies must take all applications for 12 months as part of joining the exchange. (It sounds like a logical limitation to avoid gaming the exchange.)

    •  They can just do that with price changes (1+ / 0-)
      Recommended by:

      When you don't want many new customers, raise the price to the point where you would like the additional customer.  It makes no sense to offer a product or service at a price that makes you think you are worse off if you add a customer.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Thu Oct 03, 2013 at 01:20:27 PM PDT

      [ Parent ]

      •  Annual price change with the exchange. (0+ / 0-)

        Most health insurance plans are written for an annual basis, so insurance companies on the exchange won't be allowed to change rates midyear.

        “We do not inherit the earth from our ancestors; we borrow it from our children” ― Chief Seattle

        by SoCalSal on Thu Oct 03, 2013 at 02:59:54 PM PDT

        [ Parent ]

    •  What passes for economic theory (0+ / 0-)

      in these benighted times, when the inmates are in charge of the asylum, says that Kaiser should set rates high enough to hold enrollments within their capacity, and then plow the resulting surpluses into construction and hiring to expand their services. The law of supply and demand says that at some point rates would come down into equilibrium. Of course, when people realize how much better Kaiser care is than dealing with individual doctors and hospitals, that equilibrium could turn out to be the whole population, making Kaiser effectively Single Payer.

      I can dream, can't I?

      Unlike insurance companies, Kaiser cannot simply recruit more medical practices into a Preferred Provider Network.

      Ceterem censeo, gerrymandra delenda est

      by Mokurai on Mon Oct 07, 2013 at 09:56:23 AM PDT

      [ Parent ]

  •  In my limited experience (10+ / 0-)

    Kaiser in Northern California is head shy.  Some decades ago they opened enrollment and were swamped.  It took them years to build their way out of being oversubscribed.  Patient satisfaction suffered and people still think of Kaiser as that crowded place with long lines for treatment.

    I have been with Kaiser for 41 years.  They are an excellent HMO, truly a complete treatment option, but I can see why they are afraid to swell their customer base too quickly.

    "I watch Fox News for my comedy, and Comedy Central for my news." - Facebook Group

    by Sychotic1 on Thu Oct 03, 2013 at 12:52:06 PM PDT

  •  Kaiser's playing this for short term profit (0+ / 0-)

    Maybe they've resigned themselves to the eventual establishment of Single Payer and figure that a longer term strategy for market share isn't worth the gamble of capitol or the effort.

    Change does not roll in on the wheels of inevitability, but comes through continuous struggle. --Martin Luther King Jr.

    by Egalitare on Thu Oct 03, 2013 at 12:57:15 PM PDT

    •  Kaiser is a non-profit provider (3+ / 0-)
      Recommended by:
      SoCalSal, edrie, kurt

      They may be doing it to keep the books balanced but they are certainly not out to make a profit.

      You fell victim to one of the classic blunders, the most famous of which is "Never get involved in a land war in Asia".

      by yellowdog on Thu Oct 03, 2013 at 01:14:54 PM PDT

      [ Parent ]

    •  Kaiser is a non-profit (1+ / 0-)
      Recommended by:

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Thu Oct 03, 2013 at 01:21:45 PM PDT

      [ Parent ]

    •  Kaiser (0+ / 0-)

      is not only non-profit, but their rates have ALWAYS been higher than for-profit companies.

      (Is it time for the pitchforks and torches yet?)

      by PJEvans on Thu Oct 03, 2013 at 01:43:23 PM PDT

      [ Parent ]

      •  All of that means is that Kaiser doesn't... (1+ / 0-)
        Recommended by:

        ...distribute to shareholders. They do "husband" capitol for future projects and opportunities. In that regard the operate very much like their profit-seeking counterparts.

        I still contend they are willing to accept lower market share for some other long term objective in the Health Care sector.

        Change does not roll in on the wheels of inevitability, but comes through continuous struggle. --Martin Luther King Jr.

        by Egalitare on Thu Oct 03, 2013 at 02:28:22 PM PDT

        [ Parent ]

        •  you have to understand (2+ / 0-)
          Recommended by:
          SoCalSal, kurt

          that it started out as a program for Kaiser employees and their families.
          They've never needed a big market share. They're an option at a lot of companies in California, competing with BC/BS, but you probably won't get information about their plans.
          I understand that they're very, very good at preventive care, and their facilities are considered to be good.

          (Is it time for the pitchforks and torches yet?)

          by PJEvans on Thu Oct 03, 2013 at 02:48:37 PM PDT

          [ Parent ]

        •  "Husband their capital" (0+ / 0-)

          So you are castigating them for the fact they plan longterm to provide services for a growing client base [shakes head]


          •  I didn't read that comment as castigation (0+ / 0-)

            or criticism. That's simply a statement of fact, that nonprofit organizations put money into reserve accounts and capitol projects, money that would go towards shareholders in a for profit company. Some nonprofits (not all) go overboard with the reserve accounts and buildings, when the money could be better used to reduce costs to members/subscribers.

            “We do not inherit the earth from our ancestors; we borrow it from our children” ― Chief Seattle

            by SoCalSal on Thu Oct 03, 2013 at 04:23:04 PM PDT

            [ Parent ]

        •  That long term objective might be (1+ / 0-)
          Recommended by:

          to maintain quality health care delivery. And maybe Kaiser needs more brick and mortar before an influx of new subscribers in parts of California.

          Since the ACA passed, Kaiser in SoCal devoted lots of effort into raising standards and achieving quality goals. And Kaiser touts achievements at every chance (appropriately so). The Medicare Senior Advantage program is tops in the nation, the hospital has improved to the point of being one of the top rated hospitals. Yesterday, while getting a free flu shot at Kaiser, the medical tech proudly said that last year Kaiser was first in the world in the number of flu shots administered.

          In my experience, Kaiser does a good job in health care delivery. I think that a  big influx of subscribers would strain the system and degrade Kaiser's rankings.

          You're correct, of course, that nonprofits stash their money into rainy day/reserve funds and capitol projects.

          “We do not inherit the earth from our ancestors; we borrow it from our children” ― Chief Seattle

          by SoCalSal on Thu Oct 03, 2013 at 04:16:21 PM PDT

          [ Parent ]

      •  This wasn't true where I've lived... (1+ / 0-)
        Recommended by:
        Kane in CA
        their rates have ALWAYS been higher than for-profit companies.
        Kaiser's rates were competitive in three states that I've lived, over a 40 year period. I haven't shopped health insurance for the past decade; maybe Kaiser's rates are higher now.

        “We do not inherit the earth from our ancestors; we borrow it from our children” ― Chief Seattle

        by SoCalSal on Thu Oct 03, 2013 at 03:07:48 PM PDT

        [ Parent ]

    •  Kaiser is nonprofit (2+ / 0-)
      Recommended by:
      SoCalSal, edrie

      So I think that the explanation that they are worried about having the capacity to keep their standards as high as they are now if there is a large influx of new enrollees is probably a true explanation.

    •  um... wrong. i've been with kaiser since (1+ / 0-)
      Recommended by:

      2007 and find them amazing and efficient and (with rare exceptions) extremely competent!

      EdriesShop Is it kind? is it true? is it necessary?

      by edrie on Thu Oct 03, 2013 at 04:04:46 PM PDT

      [ Parent ]

  •  Seeing similar in AZ (1+ / 0-)
    Recommended by:

    Uncle there is looking at $600/month more than what he's currently paying for less coverage.  Can't understand how this is happening.

  •  This is one of the Good of Obama Care (0+ / 0-)
  •  I applied today for coverage in CoveredCA (0+ / 0-)

    The computer infrastructure scalability problems seem less. Response time was not bad.

    But now I ran into a bug.  Something about a child in my household that has parents outside the household.

    I tried everything I could to find out where they got this erroneous information but was unable.  I have a snapshot if anyone is interested.

    This software bug tells me that they haven't done enough testing.

    Daily Kos an oasis of truth. Truth that leads to action.

    by Shockwave on Thu Oct 03, 2013 at 01:17:01 PM PDT

    •  there is NEVER "enough testing" when something (0+ / 0-)

      goes "live" - that is how the bugs get fixed.  that is also why i never "buy" the newest generation of software instead i wait for the next release.  the initial rollout shows where the flaws are - it is normal and to be expected.

      that is why there are IT teams to correct the bugs when they show up.

      EdriesShop Is it kind? is it true? is it necessary?

      by edrie on Thu Oct 03, 2013 at 04:08:06 PM PDT

      [ Parent ]

      •  I have a bit of experience in this sort of thing (1+ / 0-)
        Recommended by:

        The bug that I ran into should not have been there.

        This is not Microsoft releasing their latest software and letting their users do the debugging.  This was a highly visible effort.  Too many dropped balls.

        When Apple released their iPhone map to compete  with Google maps they fired the guy that was in charge because of bugs.

        The Air Force scrapped a $1B software project last year because of bugs.

        The New York ACA system is down.  Colorado down.  The Federal has bugs when it runs.  Not good at all,

        I expected California, the Silicon Valley state, to do better.  

        Daily Kos an oasis of truth. Truth that leads to action.

        by Shockwave on Thu Oct 03, 2013 at 05:20:24 PM PDT

        [ Parent ]

        •  heh... i'm a former software consultant with (0+ / 0-)

          wang labs back in the late 80s - didn't program myself, didn't want to take the time to do something that was a temporary fun job (3 yrs).

          the thing we often forget is that programs are simply one (or a couple) of people's way of getting from point a to point b.

          it's not foolproof - therein lie the fixes.  some errors are obvious - some are stoopid - some are understandable - some are from two different people having different tracks on how to get to point b.

          the programs are only as good as the logic of the mapper - some folks just don't have the world experience to cover something as complex as healthcare - some of the learning comes from real world/pre-computer experience.  some comes from age.

          it'll get worked out.

          and, thank DOG it isn't microsoft based!!!!!!!

          EdriesShop Is it kind? is it true? is it necessary?

          by edrie on Fri Oct 04, 2013 at 03:00:07 PM PDT

          [ Parent ]

  •  Insurance Companies believe they're entitled (1+ / 0-)
    Recommended by:

    The Sherman Anti-Trust Law exempts insurance companies from competition, and they have a long history of not competing.  Car insurance, home-owners, and not health care.  They don't compete to keep the premiums high so they can make huge profits at our expense.

  •  I've been with Kaiser SoCal since I got married (3+ / 0-)
    Recommended by:
    SoCalSal, edrie, kurt

    We have had very good experiences and outcomes with our 4 kids. My husband was born and raised with Kaiser. Now I have in-laws that are with NorCal Kaiser and not so good with a trauma case that they screwed up--they didn't have the expertise to handle and wouldn't hand off.
    But for me and mine, I love Kaiser's integrated system. I don't have to wait to go out of system for anything. And they've worked hard in the last decade to computerize and link everything and to recruit more doctors to drop waiting times for appointments to almost same day.
    You get what you pay for, and you get quick referrals, same day appointment, vision and dental if you want to add, in house lab and x-ray, online test results are often next day, and generally very friendly helpful doctors and staff. I'd say it's probably a great place to work, because I have never run across a nurse, doctor or receptionist having a bad day on  me.

    The road to excess leads to the palace of Wisdom, I must not have excessed enough

    by JenS on Thu Oct 03, 2013 at 02:06:44 PM PDT

    •  everywhere has screwups - i had one with the pt (1+ / 0-)
      Recommended by:

      for my fingers and will have to undergo one or two more proceedures to get full use of my new implants - but, they also made possible something i never could have afforded otherwise.

      my fault for not being more vocal at the time.  i learned the hard way to be strongly my own advocate and not to be shy when i have questions.  it makes better doctors and makes better patients!

      EdriesShop Is it kind? is it true? is it necessary?

      by edrie on Thu Oct 03, 2013 at 04:09:58 PM PDT

      [ Parent ]

      •  That is how my in-laws are slowly improving their (1+ / 0-)
        Recommended by:

        situation. Everyone needs to be unafraid to question their care until they understand what and why and pursue other options if they don't feel they are getting the correct care. Like you say, no system can possibly be fool-proof. You are your own best advocate.

        The road to excess leads to the palace of Wisdom, I must not have excessed enough

        by JenS on Thu Oct 03, 2013 at 05:09:32 PM PDT

        [ Parent ]

  •  More Comprehensive Coverage (3+ / 0-)
    Recommended by:
    Karen from Maui, kurt, JenS

    My understanding as a Kaiser member and from talking to someone in their admin is that while the other insurance companies are going to put you into a defined network where you can only go to certain doctors, labs and hospitals, once you are in Kaiser, you have access to ALL of Kaiser's resources. You will have easier access to everything you need and because they are non-profit, they will provide everything you require without jacking you around. (I know, I know there are some bad anecdotes out there like with every insurance co. but this is the experience the 20+ people I know who have KP have.)

    Instead of having to figure out where to go for every little thing, you just deal with Kaiser, which means it's easier to use all their services - which has a value. Non-Kaiser insurance agencies choke off some of your useage by making things more challenging to get done.

    Insurance companies on the exchange are not allowed to promote themselves as being better than the others so KP or any of them can't just say "We're gonna be better for you." I know price is important but having insurance that is frustrating to use may not be worth a little savings.

    •  i'm kaiser santa clara and see a phys therapist (2+ / 0-)
      Recommended by:
      JenS, KenBee

      for my hand in san jose (she's the best one around) and had my gall bladder surgery and hospital stay in redwood city cuz that was where i was when i had the attack - all on the same coverage.

      the rc hospital had a full workup on my allergies, medical history within minutes of arrival - and, had i been unconscious, that same information is right there at their fingertips!

      i am pleased despite the finger screwup and they are going to fix that - haven't shied away from it a bit.

      AND my hand doctor said i SHOULD file a grievance so they can build a better pt dept at his hospital so this won't  happen again... without patient input, they would have no reason.

      after every new encounter with a kaiser team, i am sent an evaluation - asked for feedback - given ample opportunity to offer input.

      i am PART of my healthcare instead of the subject of it!

      EdriesShop Is it kind? is it true? is it necessary?

      by edrie on Thu Oct 03, 2013 at 04:13:40 PM PDT

      [ Parent ]

  •  i'm finally being released in about an hour from (0+ / 0-)

    kaiser - and i am 999.99 percent satisfied - but you have to be your own advocate.  

    the beauty of kaiser is the comprehensive, complete coverage of you as a patient - no multiple doctors prescribing counterindicative drugs that could kill you - a complete medical record available to you on a thumb drive to go where ever you travel - and everyone at immediate access.

    i'll write a bit more in the next day or so - with more details - but, especially for seniors, kaiser is top knotch.

    the co-pays are reasonable - the drug costs very reasonable - the specialists are there when you need them if you don't let the primary screener just reject - state why you want the coverage and it is given.

    i've friends with blue cross that have a $10,000 deductible yearly - and one had the misfortune of breaking her ankle and wrist in a fall in november - it cost her $20,000 deductible because the year flipped - not per incident.

    there are hidden costs to the "lower" plans that need to be closely looked at - deductibles, co-pays, availablilty of in-network, so much more.  like buying a car - check out all the "hidden" costs carefully!

    EdriesShop Is it kind? is it true? is it necessary?

    by edrie on Thu Oct 03, 2013 at 04:02:55 PM PDT

  •  Same experience (0+ / 0-)

    My Kaiser premium appears set, for what it deems to be a substantially similar policy, to go from about $250 a month (for a single 60 year old individual) to about $550.  I haven't had the chance yet to look into this further, or to see how out of line that is compared to other plans, but I sure need to!  Any advice or insight from anyone on this?

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