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Comment by Der_Einzige | Hacker News Reader

Integrated providers, such as Kaiser Permanente, have far fewer issues related to the problems brought up in this article compared to most others.

Nothing like this would ever happen in a Kaiser hospital.

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> Nothing like this would ever happen in a Kaiser hospital.

Kaiser’s mental health services were so bad that their providers went on strike a couple years ago. They’re paid a fraction of what they could make in private practice.

https://www.healthcaredive.com/news/kaiser-strike-mental-hea...

What barriers prevent them from working in private practice?

As a non-American I assume that Kaiser implements some sort of barriers to stop smaller competitors from rising up?

Yes, the healthcare industry is one of the main reasons FTC is trying to go after non-compete clauses.

That plus as the insurers vertically integrate all the way down to care providers, they’re making it harder and harder for external providers to join their insurance network.

Capitalism doing capitalism things, and we have enough rightwingers to neuter any possible intervention.

Uh oh, downvotes from people who don't want to talk about actually solving this problem because it requires outing a particular group of people who want it to remain unsolved!

FTC's attention on non-competes in healthcare:

* https://www.sheppardhealthlaw.com/2024/04/articles/antitrust...

* https://gi.org/2024/05/03/ftc-finalizes-ban-on-non-competes/

For vertically integrated payer-providers pushing non-owned physicians out of their insurance networks, you need only read the quarterly filings or listen to investor calls for any of these entities. They brag about it as an efficiency gain.

Regarding rightwingers neutering interventions:

* The FTC vote on non-competes was precisely on party lines

* Obviously the Trump admin would not allow FTC (or anyone else) to go after vertical integration + expansive, market-degrading non-competes in healthcare

* There is no GOP proposal anywhere to solve this, nor is it mentioned in the GOP platform whatsoever

* Project 2025 explicitly says the FTC should have no authority to analyze vertical integration as an enforceable anti-competitive behavior

They primarily went on strike to address access-to-care issues, not to increase pay. Maybe they are paid a lot less too, but I’m not sure what that had to do with the strike.

FWIW, Kaiser isn’t cheap for employers or individuals but it offers a no BS system for claims and great care.

I don't think you know Kaiser very well. Kaiser's vertical integration is really good at some things, but the other edge of this sword is that if you need treatment in a specialty they're bad at, you're fucked: there's nowhere else to go because getting out-of-network care with Kaiser is nigh-impossible. And mental health is infamously one of the things Kaiser is very bad at. Their mental health coverage is so inadequate that if I was choosing between insurance providers I'd pick a different one for that reason alone.

By "nothing", are you referring to the incident in Santa Rosa in 2015?

https://nuhw.org/therapists-demand-action-in-response-to-tra...

Or the one in San Diego in 2021.

https://www.sandiegouniontribune.com/2021/03/31/kaiser-patie... (https://archive.is/wF1bD)

Or maybe you're referring to the incident in Santa Clara in 2022.

https://www.medpagetoday.com/nursing/nursing/98534

Of course, those incidents aren't like the one mentioned in the article. The ones I linked are just a gross failure of Kaiser's mental health resources leading to three people's deaths instead. At least they didn't have to deal with a ghost insurance network though!

Kaiser had its own very sordid history of denying people mental healthcare which has led to deaths, fines by the state of California, and new legislation.

My family has gone through three generations of Kaiser in California and it has its own tradeoffs I promise you and mental health is one of it’s most frequent complaints.

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