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Kaiser Kidney Fiasco | The Nation

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Kaiser Kidney Fiasco

If the confusion and miserable performance that has resulted from the Republicans' Prescription Drug giveaway to the HMO's and insurance companies wasn't enough to demonstrate the private sector's incapacity to meet our medical needs, then check out this horrifying investigative report by the Los Angeles Times.

Kaiser Permanente forced more than 1500 patients awaiting kidney transplants to transfer "to a new transplant center run by Kaiser itself -- the first ever opened by the nation's largest HMO."

The patients were moved from established programs into its "fledgling program" in San Francisco with "a waiting list [that] ranked among the longest in the country…. The patients didn't know it, but their odds of getting a kidney had plummeted."

The numbers tell much of the story: in the first year, "Kaiser performed only 56 transplants, while twice that many people on the waiting list died…. In each of the two years before Kaiser opened its program, UC San Francisco and UC Davis medical centers together performed at least 168 transplants on Kaiser patients."

In hundreds of cases Kaiser neglected to record the amount of time patients had already spent on waiting lists at other hospitals. Consequently, many were wrongly placed at the bottom of the new waiting list – even if a patient was close to receiving a transplant at a previous hospital.

Dr. Stephen Tomlanovich, medical director of UC San Francisco's renal transplant service, has tried repeatedly--"by phone, fax and e-mail"--to contact Kaiser about 220 patients who have not been credited with time already spent on its waiting list. He also noted that Kaiser representatives denied 25 patients "the chance for new kidneys that were nearly perfectly matched" because the company would not authorize UC San Francisco to do the transplants. To make matters worse, Kaiser failed to do the paperwork necessary to transfer those same patients into its own program--the patients were "stranded."

67 patients formerly treated by UC Davis inherited another setback due to the transfer: organs are allocated regionally, and the waiting time in the concentrated San Francisco area is nearly double that of the Sacramento area.

The financial motive for Kaiser's decision is readily apparent. "The San Francisco hospital's open-heart surgery program was shrinking as less-invasive procedures became more popular. Kaiser was left with unused beds and operating rooms."

"The timing was perfect," according to Dr. Bruce Blumberg, the chief physician at Kaiser's main San Francisco hospital.

Aside from the statistics on patient care, the personnel records are also revealing: "10 permanent employees have quit or been fired out of a staff of 22."

In January--prior to being placed on administrative leave--kidney specialist Dr. W. James Chon wrote, "On the outside, the program seems to have settled into a reasonably functioning unit. However, a closer look at the program will show that it is suffering from very serious and potentially explosive problems."

Indeed, it is explosive problems such as these that have led an overwhelming majority of Americans to support national health care, as well as The Nation and columnists like Paul Krugman who called for Medicare for all Americans in his Death By Insurance op-ed this week.

The 2006 and 2008 elections must be defined by three issues: The Constitution--DEFEND it; the war in Iraq--END IT; and national health care--PASS IT. The Kaiser kidney fiasco reemphasizes the urgency of taking health care out of the hands of private companies concerned first and foremost with profits not people.

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