blog.fixkp.org

The Los Angeles Times today has a number of letters to the editor that were written in, most praising the paper for its in-depth coverage of important health issues at California hospitals. One, though, criticized the paper’s editors for not printing more positive stories about Kaiser Permanente:

The [Devin Valenzuela] story is the latest in an ongoing series portraying Kaiser Permanente in a negative light. As a Kaiser Permanente physician, I see firsthand the excellent quality of care we provide to our members on a daily basis. I cannot recall the last time I read a positive story about our organization in The Times. When we commit to the costly deployment of one of the largest electronic medical record systems in the country to benefit our members, we are criticized by you unfairly. When we are compared quite favorably with other healthcare providers by independent national evaluators, nothing is written.

We do not claim to be perfect. However, we are committed to delivering the highest quality of care and access in a cost-effective manner. Kaiser Permanente should be the type of health plan you judge objectively, rather than publishing only negative stories (as exhibited by your track record).

Stephen Munz, M.D.
Anaheim

The Los Angeles Times certainly doesn’t need my help, but I believe Dr. Munz has missed a number of recent stories in which the paper has, in fact, noted Kaiser Permanente’s achievements. The truth is that Dr. Munz has a point: there are nearly 170,000 people at Kaiser Permanente doing the right thing every day. Unfortunately, under George Halvorson and Daniel Garcia, a culture of corruption at the highest levels has grown, a culture that covers up wrongdoing instead of addressing it. In Baby Devin’s case, for example, the Times article said that the head of the Northern California physician group, Dr. Robert Pearl, was aware of issues surrounding Hamid Safari, and did nothing.

Until George Halvorson is gone, until the leadership of Kaiser Permanente recommits itself to the principles it was founded on, I can only imagine that horrific stories will continue to come to light, like the kidney transplant program breakdown, like the systematic, unethical treatment of homeless patients, like the electronic medical record system fiasco, like the coverup of an allegedly incompetent perinatologist accused of killing babies.

It’s worth, remembering, though, once again, that there are over a hundred thousand caregivers at Kaiser Permanente, including people I care deeply for, who believe passionately in their work, who go to work every single day to try to help make our members’ lives better.

Just in case Dr. Munz missed it, from earlier this week:

“…For overall clinical quality, Kaiser Permanente got the highest score…notching three out of four stars, or a ‘good’ rating.” [Los Angeles Times, October 18, 2007]

This story was originally posted at justendeal.com.

Ever heard of the so-called Foundation for Support of Health and Development in Africa? No? Me neither. It was a supposedly not-for-profit organization that was involuntarily shut down by the Louisiana Secretary of State. Do you think it had any connection to a so-called CentralHealth of Louisiana, Inc.? Which was incorporated for less than a year, and then dissolved?

I’d like to ask George Halvorson if he knows anything about these two mysterious entities…

Better yet, remember The Council of Ethical Organizations, from yesterday’s post? I wonder if they might have anything to say about the matter? You’re right. I really better not ask…

Moving on. Remember J. Clifford Dodd’s connection to that outside company that Kaiser Permanente paid millions of dollars to? You know, back when he was serving as an officer of Kaiser Permanente and a director of the so-called “Tanning Technology”? I wonder if the Kaiser Foundation Health Plan Board of Directors ever bothered looking into that? It’s not like it’s their duty or anything… I’m just asking…

Speaking of which, maybe it’s time California Attorney General Jerry Brown gives a visit to his hometown of Oakland, California? There’s a bit of a mess there, that maybe he can help clean up?

This story was originally posted at justendeal.com.

This is the third Who Will Be Kaiser Permanente’s Next CEO? entry.

“The Health Ethics Trust, a division of The Council of Ethical Organizations, named Vicky Gregg, president and CEO of BlueCross BlueShield of Tennessee, as its 2007 Fellow of the Trust for her accomplishments and leadership in advancing health care ethics and compliance.”

You guessed it. My third candidate to succeed George Halvorson as chairman at Kaiser Permanente is Vicky Gregg, the chief executive officer of Blue Cross and Blue Shield Tennessee.

I wonder how The Council of Ethical Organizations feels about George Halvorson? You’re right. I better not ask.

But back to someone better, Vicky Gregg. Ms. Gregg is a registered nurse who leads a progressive, not-for-profit, 2.3 million-member health plan with over $17 billion in annual claims. Before joining Blue Cross Blue Shield, Ms. Gregg was a vice president with Humana.

Filling a key void for Kaiser Permanente right now, Ms. Gregg is a recognized leader in electronic health records. In 2004, she was appointed to the United States National Institutes of Health Commission on Systemic Interoperability. She also sits on the Tennessee eHealth Advisory Council. You can read here a speech she gave in 2006, “The Promise and Progress of Health Information Technology in America.”

While the Kaiser Foundation Health Plan Board of Directors might be a little unfamiliar with the possibility of having a chairman who has been named a “Fellow of the Trust,” perhaps they’ll still consider taking a look at Ms. Gregg?

Update: Speaking of trust. Kaiser Permanente “responded” to the Los Angeles Times article on Devin Valenzuela. Unfortunately, the “response” goes on to almost lie through its teeth. “In regard to the Fresno Hospital matter, the hospital took action more than two years ago…and reported him to the state medical board.” I say “almost” lie through its teeth, because two responsible Kaiser Permanente physicians did report Hamid Safari to the state medical board, after Kaiser Permanente suspended them and cut their pay because they dared bring up their concerns up internally. The Times article was prompted by those same two responsible physicians filing suit against Kaiser Permanente for its actions against them, to try to cover up the Hamid Safari affair. Obviously George Halvorson’s gall hasn’t subsided as much as his job security has.

This story was originally posted at justendeal.com.

(…it’s a dirty job, but somebody’s got to do it…)

Last week, I said I would write a series of posts under the title: “Who Will Be Kaiser Permanente’s Next CEO?” The response I received from folks inside Kaiser Permanente was overwhelming: it’s time for George Halvorson to go. I wrote last week that perhaps the Kaiser Foundation Health Plan Board of Directors should consider bringing in Mary Brainerd to clean up George Halvorson’s mess. While I think that’s somewhat unlikely, today’s possibility is much more realistic. Let me introduce you to Howard Kahn.

If you live in Los Angeles, you may be familiar with L.A. Care. It’s the largest non-profit, public health plan in the country. It is headed up by a man by the name of Howard Kahn, a respected man in the healthcare industry and in the community. In fact, two members of L.A. Care’s Board of Governors are selected by its members. Now there’s a novel idea.

What’s remarkable about L.A. Care is that it actually tries to do the right thing. The California Department of Managed Health Care’s Complaint Results Report for 2006 couldn’t make that clearer: Kaiser Permanente members registered over 1,500 complaints against the organization. By contrast, L.A. Care had barely two complaints.

Think about that. Kaiser Permanente has just over six million members in California. L.A. Care has a bit shy of one million. But two complaints compared to well over 1,500? There’s no comparison there. Obviously L.A. Care and Howard Kahn are doing something very right (and obviously Kaiser Permanente is doing something very wrong).

Let’s put it a different way. For every ten thousand members, Kaiser Permanente had 2.59 complaints. By contrast, L.A. Care had 0.03. Think about that. Out of the 49 full service health plans in California, Kaiser Permanente was barely beat for last place by Blue Shield of California. Why is that particularly disappointing? Because even the for-profit Blue Cross of California substantially beat the “not-for-profit” Kaiser Permanente (with 1.83 complaints per ten thousand members).

Until Kaiser Permanente has a chief executive officer who believes in its not-for-profit, preventive, responsible medicine principles, none of this is going to change. Maybe Howard Kahn is the man to turn Kaiser Permanente around?

Stay tuned. In the next couple of days, we’ll take a look at candidate number three.

By the way… You can now subscribe to receive email updates whenever I post a new entry to the blog. Give it a try!

This story was originally posted at justendeal.com.