Can anyone tell me if this suit is still active, and how to get involved. I have a 11 year old with HFA / Aspergers, and Kaiser will do nothing except offer Prozac. No social skills, no art, no talk therapy, nothing but drugs. My son’s anxiety is so high we had to take him our of public school (no services in Berkeley Public either) and homeschool.

At the autism “seminar,” the woman suggested that if enough people were interested (I think all of us signed up), a support group could be organized in a month or two. Well, we called back, received no response. Called again, received no response. Left a more angray message the next time, and eventually got a callback saying that she was no longer working as a “specialist.” I asked who my new advocate was, and was told she was not being replaced, and that we should call San Jose. Further inquiries did not result in any plausible explanation, or treatment (there is none, they said) and my only conclusion was that Kaiser is a heartless and cruel organization that exists only to make a buck. Last I heard, they were closing the San Jose facility altogether, and no one seems to have a reason for it. Kaiser’s prescription: Thrive!

Let’s all sue Kaiser!!!!!!!!!

Single Payer is the only way. Take away the profit motive, kick these thugs out of the health farce industry, and make healthcare a right, not a priviledge in this country! (Protest June 10 in San Francisco)

If any of you live on the SF Peninsula, we should organize and help each other out.

Good Luck to Us All,
Mike

It’s all crap. Medica hot potatoe.

First paragraph:

“At Kaiser Permanente, our top priority is to provide our patients with the most appropriate care to manage their medical needs. However, many conditions also require work with experts in areas other than medicine, such as education.”

Translation: “It’s an educational issue.” Note lack of support for this claim. “Work with”, OK, fine. “Completely abdicate responsibility to”, not OK.

“Kaiser Permanente pediatricians in Southern California, for example, look for a constellation of symptoms and behaviors that might lead to a diagnosis of autism along a wide spectrum. The course of medical treatment is based on the individual and unique needs of each child.”

Translation: “PLEASE don’t certify the class action.”

“Kaiser Permanente Southern California has teams of autism experts that include developmental pediatricians, child psychiatrists, child neurologists, and speech therapists, that work together to provide and coordinate the care for the children and their families.”

Translation: “We diagnose, then ‘coordinate’ the care provided by others. This means we tell parents to go to the schools or Regional Centers. Heck, we’ll even have our case managers attend their IPP’s or IEP’s with them to try to get those other entities to provide service, so the parents won’t pester us for that costly treatment.”

“In California, the many services needed to support those diagnosed with autism are provided by a combination of government-sponsored Regional Centers, our public schools, health care providers, social service agencies, and other public and private programs.”

Translation: “We haven’t had to do it before now – other folks have done that for us. Can’t we keep it that way?”

“As a health care provider, our goal at Kaiser Permanente always has been to treat the medical needs of people diagnosed with autism.”

Translation: “It’s, uhm, not a medical need [cough], it’s an educational need. Really. Honest.”

“This five-year research study, called the Study to Explore Early Development, will involve 2,700 children and their parents from six areas around the nation, including Santa Clara and Alameda counties in the San Francisco Bay Area. Factors that will be studied include family medical history, genetics, socio-demographic, lifestyle and environmental factors. All of these illustrate the complex constellation of impacts and services required to treat this disease.”

Translation: “PLEASE don’t certify the class action. Pretty please?”

“Kaiser Permanente thinks the best approach is for all providers of autism-related services (family members, educators, social services, and medical professionals) to work together to help children with autism.”

Translation: “Did we mention that we haven’t had to provide treatment before now, since everyone else has done that for us? We’d like to keep it that way please. It’s really expensive. It would really eat into our revenue if someone made us treat this medical [ACHOO] — ahem, strike that – educational condition.”

“Purchasers of private health insurance cannot bear the full costs of addressing all the emotional, developmental and social needs of children with Autism Spectrum Disorder.”

This is an ABSOLUTELY FASCINATING comment! Purchasers? They can mean only one of two possible things here. The first is what they actually wrote: “Purchasers” – in which case they are admitting that people paying their premiums (“purchasers of private health insureance”) aren’t getting treatment and are bearing the cost themselves. The second is precisely the OPPOSITE of what they wrote – “Providers” (i.e., Kaiser) – in which case they mean that it’s way too expensive for them to bear the cost that they contracted (and took insurance premiums) to bear, and that their obligation should therefore be shouldered by families, schools and the public. Incidental is the implied confession, by substitution of “provider” with “purchaser”, that they can’t even bring themselves to say this straight out! Simply FASCINATING!

“Our view is that ABA therapy is primarily used to change behavior to achieve educational objectives, rather than to address clinical problems.”

STUNNING! This goes against ALL the research regarding plasticity of the brain, developing neural pathways, and overwhelming evidence that such therapies actually heal. Behavioral issues only affect educational objectives? Have these folks actually ever met an autistic child? What about after school? Weekends? Adult autism? Autism behaviors are not Clinical?!?!?! This comment is so insupportable it takes my breath away!

“[ABA] is not required to be provided by people with clinical training or a clinical license and is best provided in a home or school setting rather than a medical setting.”

Translation: “Any old yahoo can do that for you! You don’t need us! Oh, and it needs to be done at home. That would be REALLY expensive, so it must not be our responsibility. We don’t make house calls, so its isn’t covered. Ipso Facto. That’s Latin. It means we’re right. So just agree, OK?”

“This view has been upheld in a number of cases which have been reviewed by the California Department of Managed Health Care and the DMHC’s independent medical review process.”

Translation: “We’ve lost some, but we’ve won a few too. (Heck, ya gotta expect that, right? We’ve got more money and resources than you.) We like to focus on the ones we’ve won, and pretend that the ones we’ve lost don’t really count. Will you please cooperate and join us in our myopia?”

“[The cases we’ve lost] have prompted us to look more closely at our overall system of care for autistic children.”

Translation: “We’re looking closely to see if chinks are showing up in our armor, and considering if we need to revise our strategies of denying care.”

“For example, a clinical report in November 2007 from the American Academy of Pediatrics listed ABA therapy under Educational Interventions along with speech and occupational therapy. They were not listed in the section on Medical Management. *Management of Children with Autism Spectrum Disorders, Pediatrics Vol. 120 No.5 November 2007.”

Translation: “We found one report in which doctors happened to include it in an educational category. Lawyers would call that dicta (or, “not the point”), but heck, we’re not lawyers. (We use a lot of ‘em, but that’s a different story.) Anyway, we found it, so we’re seeing if it’s strong enough to hang our hat on. Also, it dovetails nicely with our theory that since we haven’t had to provide treatment before now, we must not be obligated to. Logicians would call that “begging the question.” Ordinary people would call it “bootstrapping.” But since we’re not logicians or ordinary people, we don’t see it that way. And we hope you simply won’t notice.”

“We are reviewing our current practices to look for potential opportunities for improvement.”

Translation: “If we’re losing some ground here, we’re looking hard for the next fall back position, and ways of limiting coverage and minimizing costs to the extent possible.”

“we are interested in soliciting feedback from parents of autistic children as to how we might improve the coordination of services and care that children with autism receive.”

Translation: “Did we mention before that we only want to coordinate care provided by others? Yes, that’s what we’d like your feedback on – how we are doing in that area. We’d love your suggestions on how we can improve our ability to get others to provide the services. Please don’t give us any feedback on how we are doing actually PROVIDING services. WE don’t want to generate any print on that subject. If we say “coordinate” enough, you may come to believe that’s all we’re required to do.”

“This will take efforts from lawmakers, parents, health plans, physicians, advocacy groups, educators and therapists”

Translation: “Lest there be any doubt, rest assured that given the enormous cost, we will not change the way we do business unless we are absolutely forced to.”

Read the whole Kaiser response here:

http://xnet.kp.org/newscenter/stories/nat/2008-07-06.html