HEALTH PLANS: Kaiser transplantation scandal-Will we ever know the truth?

Meanwhile, despite the fuss about the HealthConnect project–elsewhere the real Kaiser scandal may be whimpering out as the man behind it, Kaiser whistleblower David Merlin settled his lawsuit for unfair dismissal .

I had a very frank conversation about the kidney transplant issue with outgoing KP N.Cal President Mary Ann Thode during and after her keynote at UC Berkeley Haas health care conference on Feb 3. She essentially said, well it’s in litigation and the lawyers won’t let us talk about what happened, but if we could we would tell you the other side of the story…

She also had the chutzpah to say that once they took the “hard decision” to shut down the new kidney transplant unit they did that part (the transferring patients back to the UCSF and UC Davis lists) very well. The rest of her talk was all about how only a non-profit organization had the correct mission for health care. I wasn’t exactly impressed—particularly as most of the issue is about the relationship with the decidedly for-profit Permanente Federation from which nothing has been heard about the kidney fiasco.

Letting the lawyers tell them what to do is rank stupidity. KP needs to prove that a) it does the right thing, and b) if it has screwed up that it’s going to transparently find out why and get it right the next time. At the time I called for a full public inquiry in which KP put a reputable outsider in charge of the investigation and promised to do what s/he recommended. Of course that never happened.

Buying off Merlin doesn’t exactly given a great assurance that next time they’re going to do better. And if they don’t state their case, their haters will do it for them.

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  1. While I’m distressed at how poorly Kaiser has come across re the kidney transplant scandal I’m hopeful that public attention to what happened there (and re other transplant programs in the state) will not flag.
    Despite Kaiser’s amazing lack of post-scandal transparency, I want to point out that there was major public inquiry into the problems (albeit late and less complete than it could be) by three oversight agencies/organizations: CMS, DMHS and UNOS, all of which produced scathing reports.
    In addition, at the California Assembly Committee on Health hearing on transplant issues (including the Kaiser situation) held last August in Sacramento – legislators claimed to be committed to following up this session with more hearings to discuss needed legislative and regulatory changes to head off similar fiascos in the future. As the last person testifying at that hearing, David Merlin’s comments underscored these needs: 1) greater health care worker whistleblower protection for reporting on quality rather than simply financial (fraud) problems; 2) more effective patient complaint systems; and 3) better oversight of capitated medical groups (like TPMG) whose competence and ethical failures seem to fall through the cracks of the current regulatory system; neither the Medical Board nor DMHC seems to claim any responsibility for monitoring or ensuring related quality of care.
    Rather than appealing to Kaiser and TPMG to behave more responsibly, the next step should be to put pressure on California legislators to hold hearings (a good first move would be a joint hearing of the Assembly & Senate Health Committees) to explore solutions and generate bills. I’m in the process of doing that now.

  2. More Kaiser Screwups!!
    Laptop Stolen With 22,000 Kaiser Patients’ Data
    In yet another instance of laptop theft potentially endangering personal data, Kaiser Permanente is in the process of notifying as many as 22,000 patients of a possible breach of their private medical information.
    The personal information was located on a doctor’s laptop computer stolen from the Medical Center in Oakland at the end of last November.

  3. Anonymous, your comment on confusion over the behavior of “not-for-profit” institutions vs those “for profit” is right on. Hospitals, physicians, clinics, etc all have bottom lines to generate and protect, whether they be for-profit or not-for-profit and their behaviors reflect that fact.
    “I believe that many insurance companies will choose to withold treatment from a patieint if it increases their bottom line.”
    I think you mean to say that many insurance companies will choose to withhold reimbursement . . .”
    At the same time, it’s pretty clear that there are health care providers who will choose to withhold treatment if in their judgment to provide it would be harmful to their bottom line. This is one reason Medicaid has trouble finding more physicians willing to participate- i.e the insurer (in this case the federal government) does not sufficiently compensate the services to be provided.
    These behaviors will not change, it seems to me, unless perhaps physicians become employees of the state, and the federal government assumes ownership of the hospitals, clinics, etc.

  4. A general comment here. Simply being a non profit organization in health care does not absolve it from having conflicts of interest due to profits. I believe that many insurance companies will choose to withold treatment from a patieint if it increases their bottom line. Non profits are non profit in name only, as it is a tax code designation, but they actually do earn a lot of profits.