[Moses]

The problem with Kaiser has nothing to do with the quality of the physicians. The doctors are fine, but they are bound by treatment protocols based on cost, not safety.

Kaiser is fine until you have a real problem. Ill give you an example in the field of obstetrics; if a pregnant woman at full term breaks her water and does not go into labor, the fetal mortality rate is four times higher if she is left at home to await the onset of labor. Every private practice physician I know will admit these patients to the hospital and induce labor. It is expensive, but absolutely the safest course. At Kaiser, they let them stay home. Every year this policy will lose a few babies, but the cost is minimal compared to the cost of the safest treatment. (Remember, Kaiser patients must sign a malpractice waiver in favor of arbitration.) Private practice physicians rarely care what the cost of our treatment is because if something goes wrong, our ass is on the line. No arbitration agreement backed by a huge healthcare monolith, just a little doc vs. an injured plaintiff and his hungry attorney. Think that makes us more careful? Hell, yes.

The example I cited is duplicated in every specialty I know of in Kaiser. In Kaiser, you will be sicker before you get the "expensive" medicine. You will be more disabled before you get a hip replacement, men will get fewer colonoscopys and women will get fewer mammograms. It's just the way the system works.

Kaiser. Good people, good medicine...good luck.