Re: Health insurance for contractors

[M Silverspring <vetalidevi -at- yahoo -dot- com>]

If you need insurance and you live in California,
consider Kaiser.

I've been an RN for 18 years and a Kaiser member for
>20. I've even worked there from time to time. I've
seen all the private, PPO, HMO, and other plans in
action. And yes, I've heard the Kaiser horror stories.
Why do I recommend Kaiser?

1. They've been doing the HMO thing longer than
anyone. 
2. They have improved greatly over the years, while
other plans have gotten shabbier and more desperate.

3. Doctors, RNs, & co. who work there are there by
choice. They applied for their jobs. They aren't in an
HMO under duress, like providers who must accept Aetna
or Health-Not (sorry, I meant Health-Net) to survive.

4. Providers who work for Kaiser get their same
salary, whether they see your for 5 minutes or 30.
Yes, they are expected to see as many people as
quickly as possible, but they don't lose money if they
order extensive tests or procedures. The other plans
penalize providers who spend a lot of time or order
expensive tests.

5. You don't have to deal with insurance forms,
deductibles, or calling insurance reps to argue about
whether or not you need that MRI for your brain. If
your doctor orders it, you go and schedule it, and no
one makes you jump through hoops.

6. If you are out of state and need emergency care,
you go to the nearest hospital, and Kaiser pays. No
questions. This has happened to me twice in the last
20 years, and each time, Kaiser didn't blink.

7. Kaiser does offer acupuncture under some
circumstances, and has excellent drug coverage.

Having said all that, let me also say that if you have
a condition for which there is a new and experimental
treatment, Kaiser may not go for that. They prefer to
pay for treatments that have been proven. For example,
they did not pay for bone marrow transplants for women
with breast cancer. This was a very popular treatment
among women and one that many of my patients screamed
for (altho having treated many bone marrow
transplants, I shuddered when they asked for it). But
the treatment was eventually proven to be not
beneficial. Kaiser is conservative that way. In the
long run, and spread out over large groups of people,
this is a wise policy. But in the individual case, it
can seem impersonal. 

And... Keep in mind that ALL emergency rooms suck
these days, and almost all hospitals are scary as
hell. So it no longer matters how much money you have
for blue chip insurance, unless you have enough money
to hire a private RN to sit by your hospital bed to
help the harried RN covering 10 people on the unit.

The nursing shortage is real. Our average age is 47,
and girls aren't going into nursing anymore. I love
it, but it's a calling. 

Later
Martha Silverspring

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