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bulletFrom Dr. Charles Phillips, to President & Mrs. Bush re the HMO menace to the public health


bullet3/17/04 Letter to Insurance Commissioner J.P. Schmidt in response to 2004 Kaiser premium increase




From Dr. Charles Phillips, to President & Mrs. Bush re the HMO menace to the public health

Dear George and Laura,


Thank you for the invitation that you sent for the President's Dinner on July 21st in Washington, D.C. And while I don't have the $5000 for two tickets, I did appreciate being found so as to receive such a letter and a personalized style that made me feel momentarily acknowledged. As an Independent, I get less mail than most who are more formally aligned. You're probably picking up my name from a past registration. I am a Jeffersonian in search of government for the people.


Now that our dialogue is open though, I do have to tell you that I am a fan of some of the things you are doing. Saddam targeted 24 SCUD missiles - each on a separate night at about 3 AM - into Riyadh when I was trying to run the ER of the leading hospital - the King Faisal Specialist Hospital and Research Center. First the TV report out of Colorado that missiles were on the way, then the choice of city next became clear on the screen, then the popping off of two Patriots, then the boom of the poorly aimed SCUD in most cases, etc. And I became the hospital's canary (yellow suit and duck tape) to test the air after each such explosion - sarin, mustard, etc. As a non-Moslem I was expendable.


Saddam is forever thinking of mass destruction capacities. Mass graves of political opponents is a clue to this. He needed to be replaced by someone who can help deliver a Bill of Rights for citizens of Iraq. (Freedom of speech - like this letter to you is important in the Middle East - enshalla.) Ten years from now we will find out whether more of the chemical weapons were stored in Syria or Iran; our delays in trying to wake up the UN allowed Iraq camel time for transfer of materials out of Iraq or burying the same far below the sand. Don't stop looking. Check unused waddis, they have softer soil; and look below each palace (the elevators also go down).


So you have done all right in this area. But in the health area of government you have been a complete disaster! HMOs are abusing and killing seniors night and day. Your efforts with Senator Frist (a physician morphed into a stock laden business man) and others to force more seniors in the HMO direction is either deeply misguided or just premeditated evil. Rather that YOU go in without ID sometimes and be a recipient of an HMO, as did Saudi Arabia's favorite King in one hospital. (Heads did not roll, but visas did.) See if you feel like a sub-speciated "external customer" when you finally get seen - going home with your chest pain unresolved.


Your version of the Patient Bill of Rights is so awful that it is better nothing has yet passed out of the Joint Conference Committee; patty cake penalties are a catalyst not a deterrent to greed. And why can't someone remind the people that all these "rights" were once theirs and simply removed by the Kaiser-drafted HMO Act of 1973. So the debate is about restoring rights. Jefferson noted that if politicians screw up enough government dissolves back to the people who always really have the rights - push come to shove. And since you and the rest of the 1/3 of the country with a shoe string connection to government can sue for wrong care, this is really a class question - potentate to peon. As a peon and a country doctor, I object and thought I viewed my last caste system when I visited India. Do you see any parallel to the Sunni minority ruling the Shiite majority in this health matter? You don't want to be the ace of spades on the health care deck of cards.


It is really very simple. Patients who are run over by an HMO have must have the same rights to sue as drivers who roll over in poorly designed Broncos. They also need the right to have a concurrent, duplicate of their own records for instant second opinion, and the right to jump to another health plan when the first one forgets to test or treat. Your own responsibility to keep HMO advertising honest through HHS, then CMS, then Medicare Plus Choice, then Senior Advantage, and the desk of the person pre-approving those same ads is clear - the buck for false advertising stops on the oval desk. Kaiser Permanente, for example, is FOR PROFIT - the partner docs getting over $100,000 in kickbacks each on a yearly basis for under-testing and under-treating; the ads you approve say the opposite.


Since I can't come to your Presidential (kickoff campaign) Dinner for $5000, I thought I would invite you free to my house for dinner a week before or after. I'm thinking of a cross cultural menu like lumpia and fries. We could call it a business dinner so you could deduct Air Force One. I would invite Betty who lost her husband, Gary who lost his leg, his wife Sharon who had to watch it and ran for Governor, Pat who lost her mother, Peter who lost his child, Sandy who lost her near term fetus, Miguel whose Lyme Disease was missed, Vickie who lost her father, Jupe whose cranial nerve was cut by an eager resident, Grant who was told he was terminal when he wasn't, the family of the postman who died of Anthrax, Jerry's family who grieve for a man who couldn't get a GI appointment for 8 months until death did him depart, etc. You get the idea - extra chairs and all; gotta move the couch.


And you can't send any substitute - like Cheney to Reagan's funeral. Health is a big part of your discretionary budget so big screw-ups are presidential in scope. Edwards and McCain had the right bill on patient rights, so I'll check with them if you can't make it. Or we'll leave a chair for you and the light on. Turn left on Chance Avenue - like take a chance on learning something new. (Kerry won't be invited unless he learns the difference between an abrasion and a war wound.)


Funny thing is, all these hurt patients and families want more than anything to make it better for the future for others. So you won't need Zoloft after meeting them. Just be ready for a Saul to Paul epiphany experience - translate that trans-culturally as needed. Then you better head back to the Beltway, our air in Fresno is full of the smoke from San Francisco Restaurants (the Blue Fox and others) and cars chugging up the seven hills only for the fun of going down the other side.


So, I'll keep working on the menu while I wait to hear from you. Sign a few non-health bills, and then lets talk.


Charles Phillips, MD - country doc




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Letter to Insurance Commissioner J.P. Schmidt in response to 2004 Kaiser premium increase

March 17, 2004


Mr. J. P. Schmidt
Insurance Commissioner
State of Hawaii, Insurance Division
PO Box 3614
Honolulu, Hawaii 96811


Dear Mr. Schmidt:


Although Kaiser's requested 14.5% rate hike was denied, according to newspaper reports they will be getting between an 11.5% and 11.7% increase. Kristen Sawada of Pacific Business News reports: "After investments and other gains, the state's largest HMO posted $10.8 million in net income -- or 1.6 percent of revenue in 2003 -- reversing a $2.8 million net loss in 2002." In an age when more and more Americans are unable to afford health insurance at all, it is abhorrent that Kaiser Hawaii should be granted a 20%+ increase in two years! Remember, not everyone in Hawaii is covered under an employer-paid group plan. You must know that the number of uninsured in our state has doubled in recent years, and you must also know all of the reasons why.


As an attorney you are fully aware that just because Kaiser Permanente wears its "non-profit" status like a badge of honor, by no means does this mean no one is profiting. Not even close. Their most egregious and underhanded ploy is to hide behind their contracts with the FOR PROFIT corporations, also Kaiser entities, which employ their physicians and run their clinics. In Hawaii this entity is known as the Hawaii Permanente Medical Group, and its shareholders are profiting all over the place. The California Nurses Association has done an excellent job of explaining Kaiser's questionable money trail in their attached publication "Kaiser Corporate Healthcare- For Profit, Not for Profit, or Not for Patients: Kaiser Permanente."


Even more disturbing is how Kaiser has been spending premium dollars to defeat consumer protection laws in California. In just one example, Kaiser spent $40,000 this past year to defeat the Voluntary Health Plan Arbitration Act of 2004, which would have given consumers a choice about how to resolve disputes with HMOs. Binding arbitration clauses were created with the specific purpose of benefiting the HMOs to the detriment of the patient. Now Kaiser has made sure it will stay that way, and with OUR MONEY.


More recently, according to a press release from ElectionWatchdog.org (attached), Kaiser contributed $100,000 in support of a November 2004 ballot initiative to amend California's Unfair Business Competition Law, which would "take away the legal rights of individuals, communities and public interest groups to stop unfair business practices-such as false advertising, polluting, and deceptive labeling." Kaiser was sued in 2002 for false advertising. If this initiative is successful it could set a dangerous precedent that will jeopardize unfair business practice laws in all states.


It is common for Kaiser Hawaii officials to try to distance themselves from goings on in California, but another thing most of our citizens don't know is that Kaiser Hawaii and Kaiser California are one and the same. The attached letter from Donald A. Ruhl, Kaiser's National Tax Director, confirms this fact. Kaiser Foundation Health Plan of Hawaii is NOT a separate corporate entity.


So not only is Kaiser committing the unconscionable act of using our premium dollars to fight against patient rights, but the State of Hawaii Division of Insurance will be awarding them 11.5% or more to do it with. There is something very wrong with this picture!


My question for you is when will it end? Thousands of people in Hawaii are already uninsured because they are employed part-time or are self-employed. Children are going without coverage because their parents make too much money to qualify for Quest, but they don't come even close to being able to afford the outrageous premiums for family coverage offered through their employer group plans. Small businesses are struggling to pay insurance costs that are rising annually at over three times the rate of inflation. Hawaii's supposedly excellent insurance laws have backfired for many, including my family and me, and every time you approve a new rate hike you put another nail in our coffins.





Voice your concerns to the insurance commissioner:


Mr. J. P. Schmidt
Insurance Commissioner
State of Hawaii, Insurance Division
PO Box 3614
Honolulu, Hawaii   96811
Phone: (808) 586-2790
Fax (808) 586-2806


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