The Media
and Medical Mistakes
By Sharon Rushford 
Over thirty years ago Kaiser “horror
stories” had faded from the news, so when it came time to
pick our medical provider
when we first started our lives together, my husband and I picked
Kaiser. We figured since so many people had Kaiser and you really
didn’t hear much anymore about the “horror
stories” that they must have really cleaned up their act and
were now providing good healthcare.
What I have come to learn is that just because you
don’t hear about something in the news doesn’t mean
that it’s not happening. Medical mistakes and malpractice
being a prime example. There are thousands of malpractice complaints
filed every year. If jetliners were crashing several times a year,
killing and maiming the same number of people, the media would be
having a field day reporting it.
What is it about a death caused by malpractice that
isn’t newsworthy? What is it about medical care being
withheld causing horrible physical pain and damage that fails to
interest the media.
One answer is that it’s too complicated
to report. A plane crash is simple. It’s either pilot error
or something else went wrong. Maybe the weather, maybe a malfunction,
maybe the mechanic forgot to bolt down some insignificant item whose
failure caused the death of hundreds of people. Simple for gathering
facts. Simple to report.
But a story of medical malpractice is complicated
and involved. It is usually the culmination of several events that went
wrong which can be as hard to prove as the existence of God.
The media does not report the everyday instances of
medical errors that only moms know about because they have insisted
there is something wrong with their child. The mistakes that only the
children of elderly parents know about because they see it first hand
and their complaints go unheeded. The mistakes that are there everyday
for the doctors and nurses to see but cover it up as best they can so
they don’t “get sued” and lose their jobs.
Kaiser’s Thrive campaign spends about $40
million. Who do they pay some of that money to? Newspapers and TV
stations. The media. Do the papers and TV stations want to upset their
major sponsors with negative news coverage? I don’t think so.
So the mistakes and malpractice that actually make
it to the media arena are few and far between. That being said, take
heed, not all major stories makes the daily news including medical
mistakes and malpractice.
I challenge you all to not know
one person who has had an experience of malpractice or medical
mistakes, either for themselves or someone they know. I
have regrettably not met one yet. Sharon
Rushford may be contacted at: sharon [at] rushfordfiles.com Meeting with DMHC in Sacramentoby Hillarie Levy  On November 27th I met with DMHC's Deputy Director Ed Heidig as well
as Marcy Gallagher, DMHC's Chief of Plan Surveys. Ms. Gallagher was
responsible for the investigation leading to the $3 million Kaiser fine. Our
discussion focused on Kaiser Hospitalist Shahab Attarchi's violation of the
probate Codes, which include ignoring my daughter Robyn's Medical
Directive instructions to not be an organ donor along with requesting
Robyn's corneas from an unauthorized person, and failing to follow the Organ
Procurement Organization (OPO), One
Legacy's protocols.
I had been corresponding to Kaiser executives in regards to this
issue in an attempt understand their position. It should also be
noted, Kaiser CEO George Halvorson refused to meet with me. According to
So. Cal. Patient Liaison April Richards, Mr. Halvorson refuses to meet with
all Kaiser patients! Although I was unsuccessful in obtaining those
answers, it was quite beneficial when those five letters were
presented at the meeting. A DMHC law states that Kaiser is to respond to
all grievances in a "clear and concise" manner. Has anyone ever received
such a response? I know I haven't.
The DMHC meeting ended with an understanding of the need to
resolve Kaiser's probate code violations correct patient grievance
responses and ensure OPO protocols are followed, along with an invitation
to a future meeting with Kaiser and DMHC.
The only problem, according to DMHC, is their inability to be
involved with actual violations of state laws, which falls under the
purview of Superior court. DMHC is researching this issue and if this is
in fact the case, I will present this problem to a Legislator for
changes. No Californian should be forced to pay thousands in court costs
to resolve a DMHC issue. DMHC must oversee any violations of state and
federal laws if it involves and HMO, even if all they can do is report it to the
state or federal agency. Kaiser clearly figured out that loophole!
Kaiser's policy of requesting corneas from ineligible cancer patients also
violates state and federal laws!
Critical American Issues
by Dina Padilla
Dina Padilla's Statement on the 3rd
Congressional District -
I,
Dina Padilla will be running as the The Peace and Freedom Party candidate for the 3rd
Congressional District seat of the State of California. The following
are the most immediate critical issues I see facing Americans today and
that serious correction is needed now.
1. That there be an immediate
pullout of all American troops from Iraq, the immediate end of the war
in Iraq, to not escalate wars in the mideast or anywhere else in the
world.
The current administration started a false war for imperialistic control of Iraq's resources-OIL.
This
has caused severe loss of life, loss of limbs and mental status for
both Americans and Iraqi's, with grave financial burden laid upon all
Americans. Due to the current administration lies used to go into Iraq,
this has greatly damaged the reputation of the United States of America
around the world as a civil, humane, peaceful and democratic society. We are looking no different than countries who have
complete disregard for human life.
2. That
there be healthcare for all with accountability unlike what we have
today with insurance companies/HMO's like Kaiser who are in complete
control of healthcare via legislators. That insurance companies-HMO's
and any other profit health care provider who profit off of the most
vulnerable will no longer be in control of healthcare but will be directed
and operated by individuals with real compassion and expertise for the
sick and the dying. That no profit will be made off of the sick or
dying patients.
3. That there be investigations into insurance
companies/HMO's who have denied medical care, eked out medical care and
committed egregious malpractice, including the maimings and deaths of untold
numbers of citizens, all for evil profit and that all health care
providers be held accountable for all medical malpractice with no
limits. That there be enforcement of the law by law and order-justice and not by enforcement of state and federal agencies like
the Dept. of Health and Human Services which allows the maiming and
killing to go on of patients.
4. That
injured workers receive all their due medical care and compensation
that they have horrendously been denied for decades via illegal and
wrongful enacted legislation such as SB899 signed by California Governor
Arnold Schwarzenegger that has negatively impacted public policy and
the state and federal treasury.
5. That there be investigations and
accountability into all state and federal agencies that have been
fraudulently receiving American taxpayer money and criminally not
providing the services to American citizens, resulting in the
monumental fraudulent cost shifting to the American taxpayers such as
Medicare and social security.
6. That there be congressional hearings
concerning the fact that patients, employees, and citizens have been
denied their constitutional, civil and human rights such as due process,
rightful compensation in all health related issues such as workers
compensation, medical care, vocational rehabilitation, causing
destitution, the theft of personal property by all involved including
insurance companies, corporations and government officials, maiming and
death.
7.
That
there be congressional hearings as to why labor laws have not been
enforced and no wage increases to the level of the prevailing wage.
That there be congressional investigations as to why people's pensions
cannot be collected and or have been allowed to be stolen and have not
been given back to the workers.
8. That we need to increase our
employment rolls for our nation's educational system, infrastructure,
and the need for real security for WE the American
people and OUR nation.
Sincerely, Dina Padilla Peace and Freedom Party Candidate
Dina Padilla may be reached at:
dina [at] comcast.net
The Misuse of Evidence-Based Medicine By Chuck Phillips, MD, FACEP
"Evidence Based Medicine" was the original dream of an accountant in
England named Archie Cochrane. He decided that if all of the medical
articles in the world could be synthesized into  pure knowledge - and weighted
toward levels of certainty - then out would come a central logic of what to do
in most or all situations. And so the Cochrane Collection was created
and is ongoing on the Internet. To itself it is fairly pure and unbiased -
like a glacier on the top of the mountain.
England was the first to try to manipulate the collection to the
government's supposed benefit and decided that at York there would be
clinical testing or validation of the Cochrane evidence. They immediately
picked out those topics where they might save money - so that less care could be
given if possible to so prove. Pure knowledge is budget neutral - creating
more care for some problems and less for others. But to no one's surprise
the government paid for and got back what it wanted - minimalist
care.
The actual term "Evidenced Based Medicine" or EBM was dreamed up in the
Family Practice Department of McGill University. They have conceded that
what they really wanted to create is "Expert Absent Medicine." Clearly it
would be cheaper to punch up the computer than asking real experts.
Instead, the practicing physician was to become dependent on reviews of
reviews. The physician - burdened by medical school to be free thinking
and challenging to the changing world of science - could now simply leave the
thinking to others. In fact, there is even a bizarre approach to give
every symptom a diagnostic weight so in combination the physician analysis is no
longer needed.
The rivalry between narrative medicine (the careful interview of the
patient and building up of diagnostic clues) is still championed by Harrison's
Textbook of Medicine. The rival Cecil and Loebe has allowed its diagnostic
chapter to be written in the EBM style of weighing symptoms computer
style. Harrison acknowledges the advances of evidence but still finds the
most complex of medical skills - a good interview - to be best governed by and
then taught by experts. In terms of our glacier, we are starting to work
our way down to the forest of animals and their discharges into the mountain
streams.
HMOs decided that EBV if yoked to their goals of "the less we do the more
money we make" (Kaiser CEO to Nixon summary in SICKO), then the public
would have no legal defense against being victimized by disease. It goes
along with illness being life style created so being sick is about the same as
being bad. Thriving is something joggers do each morning, not really a
promise of a prepaid health plan. Experts - on the Kaiser Website - were
once pictured as old men with simply the halos of balding hair. After I
pointed that out, the Website morphed.
To see the "malignant heart" approach used by HMOs in blocking care, one
needs to hold side by side the original evidence against the "evidence" within
the secret Guidelines and Pathways of the HMO. The American Diabetes
Association, for example,states that all couch potato types need to be tested
for diabetes rather than waiting until a few show up suddenly needing
dialysis. Kaiser carefully changed this recommendation so that such folks
would not be tested in a chart that almost matches but has been fudged toward
less care. At the same time the for profit Permanente physicians carefully
invested in dialysis ventures.
Yet, for Kaiser - on their Permanente Medicine Map - the only way to the
"Sustainable Future" for the fleet of Permanente (pictured as a group of
ships) is through the straights of EBM. This is the pathway for each
partner physician to end up with a millionaire's pension, e.g. $15,000 a month
plus social security. But the partners can never tell the above tale
because the pension is all potentially gone if the same physicians do not
support the HMO and its expansion (yes - in writing). This is the great
"gag" clause.
Like all good ideas that get translated into profit, evidence based
medicine is now so contaminated with disinformation that it is dangerous.
With EBM nurses will hold out in HMOs to be practitioners - though only RNs with
no diagnostic training - and withhold antibiotics from all but those yelling for
them. And since it is "evidence," it does not matter if it is given out by
the least qualified. The patient history - 90% of diagnosis - is tossed
out the window as time consuming. After all patients are simply "the
worried well" using up health dollars instead of eating broccoli. Judges will
find themselves weighing competing "evidence" journals - medical experts no
longer needed in court.
I sound like the near extinct physician eagle flying over the
canyons of the past. But then I am comforted to know that ER
physicians in general have remained skeptical about this new panacea of
information. In fact, the lead ER journal noted that by the time
"evidence" has gone from the source to the frontline it has passed
through 11 prisms of value judgment. The "retrospectoscope" is not as clear as we had hoped.
When I get sick, I will look for an expert. That expert will be able
to quote all the current lead articles but will also bring to bear
experience. And, yes, his or her white coat will really stand for the oath
of patient loyalty. For that moment in time, I will be the north star
around which the medical world revolves. I will have a champion willing to
take on the dragon of disease. I will not be a stepping stone to the
expert's retirement plan.
Sorry, Archie. You had a good idea. We need to perfect the
collection and selection of knowledge. But there are white coats and green
coats. Until it becomes profitable to give superior care, "evidence" is
often just the pathway to doing nothing.
Chuck Phillips, MD, FACEP Dr.
Phillips may be reached via e-mail at:
CPhil49401 [at] aol.com
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Serendipity by Jupirena Stein:
Stein v. Kaiser went into arbitration in 2001.
Not
everything about Kaiser Permanente’s Mandatory Binding
Arbitration System turned out to be BAD!!! (at least in my case)
Kaiser’s
Mandatory Binding Arbitration System (medical malpractice); instead of
promoting the legal truth and justice by preventing the guilty one from
committing corruption and fraud against the injured patient, has rather
an open door that welcomes them.
This
is certainly the case of retired Judge Rebecca Westerfield. She knew
(or should have known) that by staying silent when my attorney’s
asked for future medical care, the future costs would forcibly be
shifted from Kaiser to Medicare.
There is no doubt about this.
Now, what does SERENDIPITY have to do with my lawsuit(Stein v. Kaiser) and retired Judge Rebecca Westerfield?
EVERYTHING! I will explain.
On November 21st, 2001, retired Judge Rebecca Westerfield ( www.jams.org) signed her final award/decision against Kaiser and in my favor.
She
carefully and in great detail responded (as it is mandatory) to all
items that my attorney had claimed against Kaiser but, with one
exception.
Here is what my attorney asked for:
a
- That Kaiser’s doctors Dr. Robert Wolgat and Dr. Timothy Wilfred
Wild be held responsible for the severing of my 11th right cranial
nerve ( Spinal Accessory nerve. )(today I know this nerve was never
severed)
b
- That I should be compensated for future employment because the
severing of my right spinal accessory nerve has caused the atrophy of
muscles (right sternocleiomastoid and trapezius) and I have lost
forward and upwards movement of my right arm.
c
- and that I should be financially compensated for my future medical
care related to this severing of my right spinal accessory nerve.
Oh,
.... hum...SERENDIPITY? Here it is.
Here’s
an important phrase of Judge Westerfield’s final award.
“
Although purportedly released from her disability by her treating
physician, she had not sought work nor discontinued receipt of
disability benefits.”
This phrase stayed
in my mind as if it was carved in it.
What did she
mean by that? I felt degraded, betrayed, sad and very concerned about
her words.
For the next several months I could not
understand the meaning of her conclusions.
Besides
the inaccuracy of her words, feeling sick, not knowing what was really
happening to my body and being tossed from one to another doctor,
retired Judge Rebecca Westerfield’s words were certainly
offensive to me and I simply could not handle it.
Now...,
all that I had done to fight a post traumatic stress disorder, (after 2
life threatening incidents in a 2 week period of time,) went out of the
window, - for now I was facing serious physical disability.
I
spend the next few months crying, angry, hating both the judge for
implying in writing that I was possibly committing Medicare fraud and
because Mr. Bailey refused to show me how he had explained to the judge
what really was happening with my health.
Right
there and then, I began to understand that the mandatory binding
arbitration system was just a game and its final results were
previously decided among the judge and the attorneys on both sides
against the victim.
In this case, -me.
Mr.
Bailey said to me. “ Judge Westerfield admits in writing that
“...the injury has exacerbated
Stein’s pre-existing psychiatric disability and her pain
syndrome.” (pain syndrome? ) and at the same time she states
that:
“ She can not have it both ways. He
said. She can not say that you are now “more
disabled” and in the same breath state that you were
considered able.
After things settle down a bit, I
decided to find out what had happened.
What were
the reasons behind retired judge Rebecca Westerfield implying that I
could possibly be committing some kind of fraud against the federal
government?
So... after going through months of the
critical process of grieving I decided to open my own investigation.
For the next 7 years I investigated Stein v. Kaiser in great detail. I
slept and dreamed of this case. I thought about it every minute, of
every day, of every year, after year, after year.
I
was able to get documents from Kaiser Permanente‘s medical
records department (with great difficulty) that proved that what my
attorney had explained to Judge Westerfield that I was taking disabling
medications and still receiving treatment for post traumatic stress
disorder just before my parotidectomy surgery was schedule for November
19th, 1999.
But SERENDIPITY as it was the case, came
into play.
In fact, the reason why I saw Dr. Hoffman
on June/July 1999, at Kaiser Permanente Redwood City California, was
because I had decided on my own to stop taking all the psychotropic
medications all one time, ( do not do this, it can be very dangerous)
and my body was reacting negatively because of chemical deprivation
and medication withdraw reactions.
Dr. Hoffman
during examination, (he is a GP) felt a tiny little ball on my right
neck. He told me this was a lymph node reacting from a cold, a tooth
infection, or something like that, but he was going to send me to Dr.
Robert Wolgat anyway. ... and the rest is history.
It
is amazing how SERENDIPITY happens.
If retired Judge
Rebecca Westerfield had not forced me into an investigation looking for
answers to her unjust words, I would have never discovered what had
really happened to me as I slept under general anesthetic, without my
knowledge, without my families’ knowledge, without medical
need and without a bit of concern and respect to my body, to my health
and to my life.
My right spinal accessory nerve (was
never severed) is now very thin and holds little life for it has
suffered serious ischemic atrophy.
Dr. Timothy
Wilfred Wild, did not directly injure this nerve in my right neck.
He
caused this nerve and several others, to suffer ischemic atrophy
(atrophy of nerves and muscles because of lack of blood supply) by
going to my vascular system without medical need.
Without
medical need to me that is!
Dr.
Wild severed my right Great Auricular nerve needlessly.
Dr.
Wild dissected my perfectly healthy right sternocleiomastoid muscle,he
sutured shut my external carotid artery. He placed a surgical clip on
my right internal jugular vein and if this not enough, he inserted a
small PTFE tube (polytetrafluorethylene) inside my right internal
carotid artery.
This was a serious criminal act.
Just
imagine my lawsuit Stein v. Kaiser without Judge Rebecca Westerfield.
She
is the one who helped me; by forcing me to investigate my case against
Kaiser therefore, finding out it was really NOTHING as it appeared to
be.
It was not about medical malpractice, it was all
about medical crime.
Within the next few days I will
be releasing to the world a video made specially for Ms. Mary Parks,
KP’s Management personnel Liability for Kaiser’s
Northern California doctors (she was the attorney responsible for Stein
v. Kaiser) and to Dr. Timothy Wilfred Wild's criminal behavior against my
health, committed during surgery.
But, until then...
Thank
you Judge Rebecca Westerfield. Your actions against me became my
Serendipity.
Jupirena Stein
"Evil
prevails when the good people are silent or take no action."
The
contents of this material are based on my own opinion, my notes, my
attorneys notes, my recollection of facts and literally hundreds of
pages of my medical records from Kaiser Permanente Redwood City,
California and other doctors medical records.Jupirena Stein
may be contacted via e-mail at:
j_u_stein [at] yahoo.com
What about this George Halvorson guy? by Vickie Travis This
month the KaiserPapers Newsletter has a variety of topics but one
central theme and that is you, as patients, cannot blindly trust the
non profit Kaiser and/or any for profit Permanente personnel.
Their corporate financial incentives are such that it could be harmful
to your health. Certainly it has been harmful to the health of
many thousands of patients already in this country and the business
practices have been harmful to the treasury departments at every level
of our government. When deceit is financially rewarding
and the employees knowing full well that they are participating in such
deceit to continue receiving their paychecks, we all suffer. This month we placed online a report from the State of Minnesota Attorney General ( http://kaiserpapers.info/minnesota.html ) which
includes five volumes of information on George Halvorson, the current
CEO of Kaiser Permanente. In the next two weeks we shall also
have the exhibits to this report online which entail many
documents. In fact, this material entails five reams of paper or
around 13 pounds of paper. If you thought that you had read
about greed and gluttony of non profit corporate executives before you
were wrong. When the heat was turned up during this investigation
Mr. Halvorson took the job at Kaiser and the man from Kaiser that was
originally scheduled to get the CEO position, Dick Pettingill took a
job in Minnesota for a company that was already part of a major HMO
investigation by the Attorney General's Office there. The
I.R.S. became involved at the request of the Attorney General because
the investigators had done a great job of ferreting out the burying of
money to avoid paying taxes and to make sure the public would never
find out. (Yes that is actually in the report.) Mr. Halvorson
who appears today as he did then to not make as much money as other
insurance company CEO's actually was found to be making quite a bit of
money and leading a pretty posh lifestyle. This report
from the State of Minnesota was released a year after Halvorson came
out to California. I suppose that there was little mention of it
in the California press because by that time he had been working at
Kaiser for about a year and either they didn't know the contents of the
report or didn't care. They should have cared because things have
only gotten worse. The bottom line is that the executives bottom
lines took money away from patients that needed medical care while the
corporation kept increasing patient premiums. Here is a little more insight to the systemic, incestuous corporate situation: "Both companies have worked closely on health care policy issues. Kaiser put out feelers a few years ago to absorb HealthPartners into the Kaiser organization."
"We went through an examination of that at that time," Halvorson said. "We decided it was something we didn't need to do."
Halvorson
said that he doesn't intend to reopen discussions on a merger in his
new role at Kaiser, but he said opportunities do exist for partnership
between the two companies, such as working together to serve national
accounts." "I am delighted with the selection," said Lawrence, who said he has known Halvorson for at least 10 years."
- Star Tribune: Newspaper of the Twin Cities (Minneapolis March 8, 2002
Author: Glenn Howatt; Staff WriterThere
is a great deal more in the report; implications of secret deals with
people that didn't want to be known as doing business with them, or at
least is how it looks. I wonder if some of those positioning in
secret meetings (for which there are high priced expense reports), have
something to do with a news report similar to what came out today -
November 29, 2007, where insurance companies contracting with the
Federal Government are receiving many millions of dollars to track the
public's use of prescription drugs. See: http://www.bizjournals.com/sacramento/stories/2007/11/26/daily35.htmlSame
explanation for this contract as always - It's for our own good. They
may even be able to justify this by believing that they are doing us a
favor. After all that the insurance industry has already shown
that it will not do to help the public, after the number of fines,
penalties and sanctions that came about because people got hurt or
killed by insurance business practices we are now expected to blindly
trust them again. You could say that this business logic is
similar to what would happen if the former head of Enron were to be put
in charge of the Treasury Department. Someone awarding the job to
him would justify it to the press and, get away with it by saying
- "After all he already knows how to handle money." Vickie
Travis may be contacted via e-mail at:
vickie [at] kaiserpapers.info
Kaiser, Lyme Disease & the Connecticut Attorney General
by Miguel Perez-Lizano For those unfamiliar with Lyme disease, it is a serious bacterial
infection epidemic in Kaiser market areas, the West Coast in particular where
Kaiser has 80% of their business. It can take many different presentations and
be easily subject to misdiagnoses. Some of the more common diagnoses that can be
due to Lyme disease are chronic fatigue, fibromyalgia, MS, Lou Gehrig’s, early
Alzheimers, rheumatoid arthritis and lupus. In children, autism has been linked
with undiagnosed or inadequately treated Lyme disease. Kaiser prefers to
diagnose members with Lyme disease with syndromes that do not involve
substantial expense or simply declare the patient a psychiatric case.
Kaiser would prefer that this disease not be diagnosed at all. It can be
expensive to treat and may be incurable when it reaches a late-stage. There is
also the issue of liability regarding failure to diagnose and medical
incompetence. Lyme disease and other tick borne coinfections can be completely
debilitating and fatal. To our knowledge, Kaiser has no clinicians experienced
in tick borne diseases.
Kaiser has gone on record that they use the Lyme disease guidelines
issued by the Infectious Diseases Society of America (IDSA). Strict adherence to
these flawed and biased guidelines is how Kaiser has managed to escape
culpability. We have heard many stories of Kaiser doctors being reprimanded for
diagnosing Lyme disease, of strict limits of treatment to those few who have
been diagnosed, and of abuse to and abandonment of Kaiser members with Lyme
disease. We have also heard of favored treatment to Kaiser doctors and their
families with disregard to the limitations imposed by the IDSA
guidelines.
Kaiser’s first line of defense against Lyme disease is to use lousy
tests. The Elisa test recommended by IDSA guidelines for screening purposes has
very poor sensitivity, in the order of 50% under the best of conditions. This
standardized test uses a strain of East Coast Lyme disease heavily linked with
Lyme arthritis. Neurological Lyme cases will have poor, if any, response to this
test. In addition, there are many more (and different) West Coast strains of
Lyme disease than there are on the East Coast. There are very poor odds, perhaps
in the order of 5% or less, that a West Coast Kaiser member will show a positive
result on an Elisa test. The second stage test, the Western Blot, Kaiser will
only give on the unlikely result of a positive Elisa. The laboratories that
Kaiser uses do not test for some responsive bands that are highly specific for
Lyme disease. The test is also highly dependent on competent personnel to
execute and interpret. Kaiser labs and the labs they use do not
qualify.
The IDSA is now under antitrust investigation by the Attorney General of
the State of Connecticut. The investigation
has been ongoing for about a year. While the IDSA itself has been cooperating
with the investigation, the authors of the Lyme guidelines have not. These
authors and a select group of about 50 doctors and scientists comprise what has
been referred to as the Lyme cabal. They have garnered the bulk of the federal
research dollars for this disease and have manipulated the disease for their
gain and for the financial benefit of ethically-challenged healthcare providers
such as Kaiser. They also have an undue influence on the Centers for Disease
Control since some members of the Lyme cabal were former CDC
employees.
The International Lyme and Associated Diseases Society (ILADS) is a
professional organization composed of doctors who specialize in treating Lyme
patients. Many are leading clinicians known worldwide. ILADS has issued another
set of Lyme disease guidelines. They are based on more inclusive science than
the IDSA guidelines. The IDSA guidelines used an absurd 40% or more of their
references from articles written by the IDSA authors themselves and excluded
medical research that did not support their position. Kaiser has totally ignored
the ILADS guidelines and does not give the patient this medical
option.
Lorraine Johnson of the California Lyme Disease Association offered the
following insight in an interview…
"What's
the CDC's rationale for publishing IDSA's guidelines while ignoring the ILADS
guidelines? I sense that the CDC policy on chronic Lyme could be linked to some
underlying, general policy issue."
"The CDC
emphasized the need to involve Medicare--the nation's largest insurer--in the
resolution of Lyme disease treatment issues," she said, "suggesting that the
patient's ability to obtain treatment might be linked to Medicare cost
containment issues--and perhaps more broadly to cost containment issues implicit
in any move toward universal health
coverage."
I
pursued the issue of cost containment. "Could one reasonably interpret the
connection you're making to mean that the CDC favors the IDSA guidelines because
these place severe limits on which expenditures are allowable and reimbursable
in diagnosing and treating Lyme?
"I
think," Lorraine Johnson answered, "that it is important to separate the right
of a patient to obtain treatment (and the right of physicians to provide that
treatment) from cost issues. The first issue should always be whether the
treatment improves the patient's quality of life. The second issue should be to
decide who is going to pay for that treatment. When cost issues frame treatment
options, the result may be a total denial of care regardless of who bears the
cost."
It is notable that in the recent press IDSA
has backed off enforcing their guidelines stating that they are recommendations
and the treating physician is free to follow what he/she deems best for the
patient. Kaiser apparently has not heard of
this.
The Connecticut Attorney
General’s antitrust investigation could result in a beneficial change in the way
Kaiser conducts its Lyme (non)business. The New York Attorney General has either
joined this antitrust investigation or has been contemplating joining. Once the
investigation is further along and results in a legal case, it is very possible
that the Attorney’s General of other states, including
California, Oregon and Washington, will join. Hopefully, one way or another, Kaiser will be
forced to recognize and treat their members with Lyme disease and other tick
borne diseases.
Miguel Perez-Lizano may be reached at: mikijean [at] pacifier.com ©
Kaiser Papers November2007.html
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