Opinion: Staying with a proven benefit as ACA deadline looms

By Donna Smith

It wasn’t an easy decision to make.  Many people urged me to choose a cheaper plan, and some even thought I should select the cheapest plan available on the Connect for Health Colorado health insurance exchange.  But I didn’t do that.  I looked at several factors, and I decided even if it is marginally more expensive to choose the Kaiser Permanente gold plan that I did, it is the right fit for me.

 Donna Smith doesn’t want to suffer through bankruptcy again. Photo courtesy of Donna Smith.

So, what would make me — a 60-year-old, working-class, cancer survivor on a tight budget — choose to keep a Kaiser plan and even upgrade it to a more expensive one? It really came down to how well Kaiser was able to provide for me as a patient and deliver what I felt was the best care I have had in years in spite of several administrative challenges that have made it a difficult year. It is critical to me to have continuity of care and high quality care, and the Kaiser model provides that for me.

2014 began with a serious illness for me, and even though Kaiser was having trouble getting all the new enrollment data from the exchange, I was treated well and even ended up as an in-patient in the hospital after only a week as a Kaiser patient. Throughout the rest of the year, the doctor I chose as my primary care doctor was attentive and thorough, and these are qualities I respect and want. The rest of the Kaiser staff also seemed genuinely concerned about providing high-quality services (with a few small exceptions that might be expected anywhere).

Even as I complained publicly about the pharmacy stresses as they brought their new computer system up, it seemed that Kaiser kept right on trying to make things better. It has clearly experienced some growing pains this year, and the staff probably could have managed some of that better — but my care was never at risk, and that means a lot to me.

I did note that some plans on the exchange for next year cost significantly less than my Kaiser plan — especially the Colorado HealthOp‘s plans that have been reported on so widely. Along with being more than annoyed by the damage the undercutting of premium costs by HealthOp did to my subsidy amount for next year, I just wasn’t willing to give up the quality of care I have experienced this year as a Kaiser patient. I didn’t trust that a company that acts as HealthOp did without much regard for the damage done to tens of thousands of Coloradans who also lost their subsidies would be any better about its treatment of me if I were one of their insureds. And I was able to contrast that with decades of being insured by many other kinds of plans.  Overall, I found the coordination of care and the one-stop-shop set-up of Kaiser was much more in tune with my desire for continuity of care and better use of on-line notifications of test results, doctors’ messages and other services.

Anyone who knows me knows all too well that I support a much broader, much more comprehensive health system through an improved and expanded Medicare for all for life system. That has not and will not change until we win the day. But for now, I am going to manage my health with the plan and the providers that have answered my needs most closely.

One more thing. No one at Kaiser has ever called me a consumer. Ever. I am a patient. Often at Kaiser they call me a member. But I am not a consumer to them. That matters, because the provision of health care is not the same as selling widgets. I know, I know. Kaiser’s insurance arm is a business too, and they want to make money. But I appreciate not having that pointed out to me by being called a consumer as HealthOp and so many others do routinely. I’d rather be viewed as a patient. I think Kaiser gets that. Lots of other insurance companies do not, and even if some would argue that it’s all semantics, words matter. How a company frames the language about those it serves says a lot about its motivations.

Health care is a human right to me, and the Kaiser model comes closer to what I hope to see and experience when the U.S. finally joins the rest of the civilized world in providing that right to all.

Donna Smith is executive director of Health Care for All Colorado. A former award-winning journalist, Smith has co-chaired the Progressive Democrats of America’s national “Healthcare Not Warfare” campaign since 2007. Smith also was featured in Michael Moore’s 2007 documentary, “SiCKO,” after she and her husband both became ill, lost their home to bankruptcy and had to move in with one of their six children even though Smith had health insurance at the time. Moore took Smith to Cuba to receive free care through the country’s universal health system.


Opinions expressed in Health News Colorado represent the view of individual authors.


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