Our ER clerk had a family emergency so I was filling in running the desk. The ER doc was seeing a patient from the Bay Area who was in our area visiting some family and had developed an infection in their surgical incision. The patient belonged to Kaiser which is the biggest HMO in California.
The doctor brought out a card that the patient had given him with the name of the surgeon and a number to call 'in case of problems.' The doctor asked that I try to reach the surgeon. It was 11:17 am.
I called the number on the card and got a phone tree. The first thing I heard was to push 1 to continue in English. (Warning: I am going to be politically incorrect. I live in America and this is an English speaking country. If you choose to move to this country - learn to speak the language! If you want to speak Spanish, Hmong, French or whatever, go back where you came from. I would not move to Cambodia, Mexico or whatever and expect the whole country to work around me.) Gritting my teeth I pushed 1 and got a recording telling me that I had reached the appointment line and to please enter my medical record number to proceed. It was 11:28. I entered the patient's Kaiser medical record number and was placed on hold.
I was on hold for 14 minutes. In the meantime the phones are ringing off the hook, the doctors are giving me charts with orders to process and people are asking for pages to be made. At 11:32 a human answered and I explained that I was trying to reach a patients surgeon for the ER doctor. The human told me they couldn't help me with that and transferred me to another number that hung up on me.
I looked up the Kaiser facility on the Internet and found another number to try. I called it and got a phone tree that asked me to push 1 to continue in English. I gritted my teeth a little harder and stabbed the number 1 button and was placed on hold again. It was now 11:43. I was on hold for 8 minutes before a human answered. I explained who I was trying to reach and why and was transferred to the wrong clinic. I called back the number, pushed the fucking 1 button and spent another 7 minutes on hold before another human answered. By now I was extremely annoyed and told her so in no uncertain terms, for God's sake - I am calling from a health care facility and can't get a doctor, what hope does some poor patient have? This human did manage to transfer me to the correct clinic which was closed for lunch. I got a recording that instructed me to leave a message and "someone will return your call." I left a message, and it didn't even have any four letter words! It was now 11:58.
I spent 41 minutes trying to reach a doctor that never did call back. Kaiser patients boy do I feel bad for you.
This is a taste of what we might get with free health care. As horrible as Kaiser is it can't hold a candle to the VA. We all know how the government can make a complete bollocks out of the simplest thing and we want them to take over health care? I think not.
Be careful what you ask for, you just might get it. Free does not equal more and it certainly does not mean better.
Sunday, November 16, 2008
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25 comments:
Hi there. Long time lurker, but I thought I'd comment on this one.
I totally agree with you. Everyone seems to think that government-run free health care is the solution, and I think it is the most awful idea I've heard. I don't think it will solve the so-called "health care crisis" by any means. If anything, it will make it worse. Yes, you might be able to see your PCP if you don't have insurance or medicare, but it may take six months to get in...
i.e. those folks will end up going to the ER anyway.
A neighboring FD has a Kaiser office in their patch. THey are constantly going there for all sorts of things that should have been actuall 911 calls from the scene of the incident. The most insidious I remember hearing about was a child who fell off a horse and hit their head. The parents called Kaiser help line to figure out if they're covered for going to the ED, and the person on the other end tells them to come into the office and we'll make a determination. Long story short, parents take kid into the Kaiser office, where the doc promptly freaks out over the altered LOC of the kid, and calls 911. Kid turns out to have a depressed skull fx and a severe concussion.
BUT...Kaiser just had to see them first to figure out if it was a 'real' emergency....
Aaargh...you're so right.
I dial the doctors' office and hit "0" right away, usually that skips the crayzee phone tree nonsense and puts you right through to whoever normally pages out calls.
Sometimes, though, there are newbies answering the phones at clinics and they don't understand that an ER call means you interrupt the doctor and don't transfer you to the nurse line or take a message line or whatever.
That's the stupid crap I deal with when I have to do pre-cert treatment when I work in psych assessment/intake. On hold forever and then when I finally get a hold of someone human, they practically want the life story of the patient (and the person calling, it seems like) before they will agree to cover days for treatment. As much as I'm grateful to have insurance, sometimes it's a real pain in the ass
Yeaaaaa!
If you don't want to speak the language... go back home!
I am first born in the US and proud of it!
Thanks for saying what I am sometimes afraid to say... GOOD FOR YOU!!
{kisses}
You hit it right on the nail! Thank you for the refreshingly honest post! I love your blog.
New reader here, seasoned 12+ ER nurse. I can't agree with you more about the speak English issue as I live in Phoenix. It is soooo annoying to have to get someone to translate for me because these people have been in the US 3+ years and refuse to speak language. Also...I hate the "push this button" "Push that button" where you never speak to a human. Ugh. DE ;)
new here!!! i love your blog because its related to nursing. and i am a nursing student! love it!
I whole-heartedly agree that government taking over healthcare is a bad idea. But insurance companies/HMO's taking over health care is just as bad. And that has pretty much already happened.
/off to see my chiropractor.
//$35 per visit, no insuarance required (it is $42 with insurance)
In a twisted and sad way - it's kind of nice to know that it's not only patients who receive this kind of indifferent response -- sigh.
I had Kaiser for the last 8 years or so. I recently switched to Blue Cross to save money, and I now see how good I had it with Kaiser. At least the Kaiser in Sacramento, is quite good and reliable.
So let me get this straight: you have problems with an HMO and assume that this is what state run healthcare would be like? Seriously, the inference ie so logically impaired it hurts.
Basically you do not like kaiser and do not like single payer ( which is what state run healthcare is), so you assume the two must be the same. Seriously, the argument is limping of both legs.
Speaking from the POV of someone who does live in a single payer healthcare system, I ahve to disagree. I strongly recommend you experience what you're badmouthing before doing so. It helps.
Actually, English is not the official language of the United States as we do not have one. It is the most common language and the most used language but that can change over time.
Kaiser has lots of pros, but I have found it depends a lot on the facility and the doctor. (just like ANY healthcare, duh!)
The phone tree is the absolute worst part. There are some clinics that will give you a direct number. You can e-mail your doctor and ask for a return phone call, which works well and is great for non-urgent questions.
My local Kaiser ER is the best part. If you call in advance, they are actually WAITING for you and have your information and a bed set up. We've been there 3 times at night on the weekend and never had to wait.
The other best part is for my kids - there is a regional pediatrician that has hours ALL WEEKEND until 8PM. So I don't HAVE to go to the ER when I know it's not warranted. I appreciate the phone tree nurse helping sort out that decision.
i agree with that!
A taste of things to come. Yes, because one example of inefficient health care in a currently underfunded system= how it will run everywhere, forever. And no one has ever had one bad experience in private, I'm sure. FAIL.
I work in the Canadian health care system, free for everyone (well except for prescription drugs and a few other things). We just look after the patient's medical problem and don't worry about the money at all. So much better than having to call your insurance company before you even go to the ER. There is no reason to equate government run health care with the bureaucratic mess you are describing....
I disagree with the Canadian writer. My parents visit there often, and some of their Canadian friends have come to the US to have procedures done that they would have to wait months for in Canada. I have huge issues with the system we have. When people do not pay for something, they don't take care of it..like our healthcare system..and then complain when the er's are overcrowded. I have worked 6 yrs in the er, and have dealth with it each and every shift!
If you have to wait to see a doctor - well at least you can afford to see one! I'll gladly wait a month or more to see a specialist knowing it's not going to break me when I do. America should look to Australia for a hint on how to run a health care system.
Another Canadian who can't imagine dealing with the HMO nightmares I see described on US blogs. Our system ain't perfect but when I get sick I'm not worried about whether I can afford the care or making sure I can get some bureaucrat to agree to let me see a doctor, I'm just worrying about getting better. It's not a perfect system but I would most definitely NOT want to trade!
I am a pharmacist in the SF Bay Area & I have to deal with Kaiser patients. When everything is covered by Kaiser - medical, drugs, PT, OT, etc - all goes well.
But, if you are an "outside provider" like me, going thru the Kaiser system is like a mine field. It takes up to a week to get a response on a refill, you can never get clarification of drug problems so its easier to send the pt back with a note of explanation & each & every call to Kaiser goes thru a "call center" which then re-routes it to who they "think" is the appropriate person - often not who you want in the first place!
Horrible!
I have to agree with soppermouse and the others - I empathize with the horrible experience you had, but it doesn't make sense to equate a private health care company with what a government health care system can provide.
Unless of course you hav very low faith in the intelligence of your fellow countrymen and particularly the ones hired by the government - though the medical profession is generally full of smarter types, so even if you're that cynical I hope that's not the case!
I work as a consultant for the American, Canadian and UK health systems. Each of those systems have problems. None of those compares to the mess of problems that American "Free Choice" health provides. Government health care in Canada and the UK is ***NOT FREE*** It is paid for by the taxpayer instead of directly by the employer/employee. It is also not provided for any differently overall than American healthcare. There are quotas, budgets, etc.
How anyone can say that a healthcare system that leaves millions of people at risk is a healthy societal choice is beyond me. Even the staunchest UK conservative would not dream of giving up social healthcare. Ontario Canada is in the process of hiring up to 9000 additional nurses. The Hospital for Sick Children in Toronto is one of the finest of its type in the world with world leading research facilities. Royal Marden is an incredible cancer facility on par with anything in the US that I have worked for.
I would rather have government run healthcare than a for profit bureaucracy. When I work in my home country or in the UK I never worry about accidents, or emergent medical issues... that all changes the second I cross the border and start working in the US. I know my employer provides the best insurance possible to cover me when I travel, but I have still been through the wringer at "Best Hospital in the World" ED when I present with a migraine because I can't find my insurance card and instead hand them my credit card.
For the responder that talks about the "months long waits" those are for elective surgeries. Often those procedures are not covered by insurance in the US or only partially covered. In the UK and Canada they are covered, but there is a waiting period for them. If you are talking about a life threatening situation requiring surgery, then you are going to get immediate care. Also I chose my own PCD, I chose the Paediatrician for my children, and my husband chose his own PCD (different than mine), and we never wait more than a week for an appointment and can see them all the same day if there is a need for it. And I don't have to go through a phone tree to contact them.
BTW, I am glad you are blogging again. These blogs are invaluable research tool for me.
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