As you know, I had intimate experience with the American system of Health last year. I have belonged to the Kaiser Permanente System for 40 years - insuring my whole family until they became adults. The service was very good. I had three Day Surgeries and each time as I left I was presented with a plastic wrapped tulip - a nice touch. I've called the Kaiser the best private National Health Service in the world.
That it may be.
My wife came to Canada with the English disease - bronchitis. This turned out to be Bronchiectasis and there was talk of operating on her lung. Our doctor said that if she were to stay in Ontario she would have to stay indoors all winter.
So, now you all know why we left Canada for Southern California.
Over the years, Gwen's lung problems continued and she developed emphysema. In due course she needed oxygen continually, supplied from tanks and a portable for use shopping and suchlike. This cost $235 a month of which I had to pay $39. The rest was covered - presumably by a mixture of Medicare and Kaiser.
I should say that about $1,000 is deducted from our Social Security for Medicare. Three years ago, Kaiser charged nothing. Two years ago they began to charge $20 each per month. A year ago, this was raised to $35 a month each.
So the direct annual cost for the two of us was about $1,900 a year. Ordinary costs are $10 to see a doctor. However, if we then get X-Rays, lab tests, specialist appointments, surgery - there is no additional charge.
It used to be $3. I suspect the price increased to stop unnecessary trips to the doctor.
These are costs to a private patient, the most expensive way to go. Unions who choose Kaiser offer (say) 20,000 members. Costs to these members are, I understand, much less.
Harry Jr is thinking of joining as a private patient. If he does, it will cost him $266 a month - more when he is over 60. At 65, Medicare will kick in.
Prescription prices are good. For brand names, our prescription cost is $25. For generics, which are mostly prescribed, the cost is $10. I checked the "cheap" Costco price of Azmacort - an asthma inhalent treatment. It was $71 for each one. Kaiser supplied 4 of them for $10.
The Plan has more than 5 million members, so I assume their buying power is huge, so they have some heft with the drug companies.
So, that's the background of the unhappy events of last year. This is one American Health System at work.
Gwen had been ailing and was in bed. Daughter Wendy had come down from Seattle for a couple of days. We don't know why. She was lying on the bed talking to Gwen, when her mother went into a seizure. We didn't know it, but she had contracted double pneumonia. Someone dialed 911 and some 4-5 minutes later a large fire-engine came into the canyon, followed by an ambulance.
(For Keith's benefit, our paramedics are attached to the local fire stations.)
They grabbed Gwen and did emergency stuff, then took her away. The local emergency hospital - Verdugo Hills - is private and very good. (I noticed a poster in the Emergency Waiting Room, with something like: "No one will be turned away. If someone in labor arrives, she will have her baby with us.")
The doctor told us a "platoon of nurses" were around her. Apparently it worked. She was X-Rayed, cat-scanned, attached to a variety of inputs and stabilized before being sent up to Intensive Care. Two days later she recovered consciousness. They had saved her life.
But it took two tubes into her lungs and stomach to keep her alive. She couldn't speak and was in considerable distress.
I noted there were 7 intensive care rooms at Verdugo. My sister-in-law was taken into hospital in Windsor in the UK. She occupied one of 4 intensive care beds (one unused because of staff shortage). Her husband told me these were the only IC beds in the county of Berkshire. I hope he was mistaken.
Each Verdugo nurse handled two patients only - which was also true in the Kaiser hospital. In the ordinary wards at Kaiser, each nurse had a maximum of 6 patients.
Verdugo Hills is an expensive hospital. Kaiser had to pay. So the sooner they can transfer her to their own hospitals the better. Yet all the Kaiser Intensive Care rooms were taken. So, Gwen stayed at Verdugo for most of four days. The bill for those days was $28,000 (not counting the platoon of doctors and specialists who handled her.) Eventually, an ambulance took her to the Hollywood Kaiser Hospital. I found that there is a special "intensive care" ambulance for such transfers and it comes with a doctor.
After a few days in intensive care, she was transferred to a two bed ordinary hospital room. After several days, the floor doctor released her to come home. My impression was that the doctor had other patients that needed the bed more than did Gwen.
When she arrived home, a hospital bed was delivered for her (supplied free). We also got her an inflatable mattress (about $120, of which we paid $22).
A nurse came in 2-3 times a week. Also, a physical therapist to help her get on to her feet.
Two or three weeks went by when she suddenly stopped breathing. She had contracted another dose of pneumonia. She started breathing again, but we dialed 911. We went through the same procedure. The paramedics arrived very quickly, Gwen went into Verdugo emergency, but once she was stabilized she went off to our local Kaiser hospital.
Her pulmonary specialist told us she was on the "final cycle" - that even if they managed to bring her up - the same thing would keep happening. The kids and I decided that if she got home, we would not put her thorough the same agony again. We would let her die.
But after a few days in IC during which time she couldn't eat, she succumbed.
Short of being in the Gates or Trump families, I doubt she could have received better care.
Oh, that $28,000 bill was paid for me by insurance, as were dozens of other bills that arrived, ranging from ambulance cost to specialists' fees. The 'in house' Kaiser treatment wasn't billed.
I've described Kaiser as the best private National Health Service there is. It's a non-profit that is essentially run by doctors. As costs have risen, they have recovered revenue by raising the monthly fee a little, charging $10 for us and now $20 for new members for a doctor visit. I suppose this also cuts down a little on less important demands on a doctors time.
Doctors are seen by appointment, so they are busy throughout the day. They also can be found on hospital duty. All services are in the hospital. A doctor can get lab tests, XRays, etc. done on the spot. I had a suspicious sore. I called on Wednesday afternoon, my doctor saw me Thursday morning and sent me immediately to a specialist. He and a couple of surgeons examined me. I went through the pre-operation procedure in the afternoon. (I walked around the hospital meeting various specialists who explained everything to me along with giving me reassurance.) Monday morning the sore was removed. It was cancerous.)
The five million membership of Kaiser gives it a lot of clout with such outside people as the drug companies. I would think that the NHS and the Canadian Health Service would enjoy similar clout.
Kaiser has a reputation for conservatism. It is slow to try the latest miracle. I asked a specialist on one occasion whether they would adopt a new procedure. She said: "It doesn't have enough history."
Kaiser covers most of California and much of Oregon and Washington. But, you'll find it in Hawaii, Georgia, DC, Maryland, Ohio, Colorado, and Virginia. How extensive it is in these States I don't know.
So, perhaps, this is the future of Health Services. I'm sure there are people who will criticize, or even condemn Kaiser. Everyone cannot be satisfied. Insured medical service anywhere faces something no-one talks about - rationing. Triage in the afternoon. If little can be done, a patient must be allowed to die.
I'm sure that too much was done for Gwen, but it happened. I know she would hope that no-one else was harmed by her two sojourns in hospital.
Harry
****************************** Harry Pollard Henry George School of LA Box 655 Tujunga CA 91042 [EMAIL PROTECTED] Tel: (818) 352-4141 Fax: (818) 353-2242 *******************************
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