In Copyright Since September 11, 2000. This web site isn't affiliated with, and doesn't rep­re­sent, any Kaiser entity, including but not limited to Permanente. This is instead a public interest nom­in­a­tive use site. Permission is granted to mirror this web site under Creative Commons CC BY-NC-SA 4.0. Please acknowledge where material was obtained.

What is this site for?

This site is here to fill a gap related to tooth­less enforce­ment of the laws by regulatory agencies and limited coverage by news media of stories that may offend in­flu­en­tial organ­i­za­tions.

The absence of consequences:

In theory, State and Fed­er­al regulatory depart­ments are there to protect the public from mis­con­duct by entities such as Kaiser. In practice, it isn't that simple and often doesn't work out that way.

In fact, agents at both levels, State and Fed­er­al, will often go out of their way to find a way to bury com­plaints and to let large entities off of the hook.

There are mul­ti­ple reasons for this but the take-away is that it's a fact of life.

The position of this site is that those that stand back and simply watch as mis­con­duct occurs are as guilty as those engaged in the mis­con­duct. This said, what can be done about it?

In the context of any entity that is powerful and con­nect­ed to the interests of the wealthy, the media is seldom able to pursue invest­i­ga­tion of spe­ci­fic nega­tive matters.

If a story breaks and gains traction, and there is no risk, a news­paper or TV net­work may jump on the bandwagon. That is the primary excep­tion to the rule that the wealthy may do as they please.

A news organ­i­za­tion that is the first to take the plunge on a story which offends wealthy interests may be sued, may lose adver­tis­ing revenue, or may face retal­i­a­tion in other contexts such as a powerful entity seek­ing to muzzle the news through legis­la­tion.

Readers in 2024 will be able to think of current exam­ples such as the threats that Elon Musk makes so publicly. But the cover-up process is usual­ly more subtle.

Profit vs. patient care:

Kaiser Permanente is intrin­sic­al­ly flawed due to its structure. The issues are rarely covered in depth, but it's not sur­pri­sing that they exist.

When any HMO grants a monopoly on payment for medical services exclusive­ly to one medical group as Kaiser does, health care personnel must give priority to bureau­cra­tic over patient needs if they'd like to be paid.

This makes an insurance company, rather than the doctor, patient or his family, re­spon­si­ble for health care - and the insurance company is the one that decides who lives and who dies. The end result is sometimes ghastly.

That is how Kaiser is run.

Kaiser claims that medical care, what medi­ca­tions are pres­crib­ed, etc., are decided by doctors and not by bean counters. That is a half truth. The full truth is that there is a conflict of interest inherent in the system. One that can be dangerous to the well-being of patients.

To explain further:

Kaiser Permanente is an integrated healthcare system that combines health insurance with healthcare delivery. It operates on a model where phy­si­cians are employed by the organ­i­za­tion rather than working independently or in private practice. This structure allows for a more coordinated approach to patient care.

However, this model inevitably leads to a conflict of interest.

In Kaiser Permanente, phy­si­cians often have dual roles. They not only provide medical care to patients but they also participate in administrative decisions related to resource allocation, budgeting, and financial man­age­ment within the organ­i­za­tion.

This can include involvement in clinical guidelines that affect treatment protocols and cost man­age­ment strategies aimed at improving efficiency and reducing unnecessary expenditures.

Somebody who's trying to maximize profit interprets the word "unnecessary" differently.

Phy­si­cians may be implicitly or explicitly incentivized to go along with cost-saving measures and processes. This can complicate their ability to prioritize patient care over financial considerations.

There is an inherent tension between maintaining the quality of care and limiting costs effectively. In the end, limiting costs is going to win.

Kaiser Permanente's response is that it has processes in place to minimize conflicts of interest. Evidence-based clinical guidelines are one example.

However, the reality is that these processes are for show. The processes that matter ensure that profits are maximized and that mis­con­duct is covered up.

Cover-up is, for such an organ­i­za­tion, the rule and the priority.

Add dif­fus­ion of re­spon­si­bil­ity to the mix and it's obvious that Kaiser Permanente, as an organ­i­za­tion, is going to lie, cheat, and kill people.

Few indi­vid­uals in an organ­i­za­tion wish to think of them­selves in this light. However, with the right processes in place, nobody needs to do so.

So, we've got what amounts to a de facto criminal organ­i­za­tion, argu­ab­ly falling into the RICO category, government depart­ments that trip over them­selves in the rush to protect the organ­i­za­tion, and timid news media that is reluctant to go out on a limb.

Mission statement:

This site is needed, taking the largely tooth­less nature of government and news media watchdogs — actually, watch-poodles — into account, to inform, to educate and to preserve content that may have been taken down elsewhere due to threats by Kaiser or that may be of interest to consumers.

As a related note, in due course, this revived version of the Kaiser Papers will go onto flash sticks that will be given away. The flash sticks will work offline even without the Internet. It isn't possible to take-down material that is already offline and is being passed around in this form.

Our advice, and another way to put the mission statement, is as follows: Educate yourself. Protect yourself. Education is protection.

No government agency is truly there to help you if there are problems. Learn how to avoid the pitfalls that others have had to go through in order.