APS and new healthcare provider

[Anonymous]

Kaiser just voted to strike on Monday. Look at the reasons why, this company is in trouble.

https://www.wusa9.com/amp/article/news/health/dmv-health-care-workers-approve-strike-at-kaiser-permanente/65-f276e0ae-d25c-4f7d-81b2-9c0b94caaf87

[Anonymous]

There is a fundamental lack of understanding from APS staff about how healthcare contracts and bidding works. And it isn’t my job or APS’s job to tell them that APS wouldnt be allowed to tell employees in February that Kaiser didn’t bid. And it couldn’t tell them with certainty in July who would be the new provider. Remember when Obama said you could keep your doctor and then we all realized that wasn’t true. Different insurance companies. Different doctors. Some overlap. Some don’t. But I don’t think APS staff is wise acting like this is some monumental deal that they can’t educate kids. That they need more leave to deal with it. I’ve been through this a number of times. It sucks. But I also don’t know on any scale how one can say Kaiser is better is BCBS.

[Anonymous]

Anonymous wrote:There is a fundamental lack of understanding from APS staff about how healthcare contracts and bidding works. And it isn’t my job or APS’s job to tell them that APS wouldnt be allowed to tell employees in February that Kaiser didn’t bid. And it couldn’t tell them with certainty in July who would be the new provider. Remember when Obama said you could keep your doctor and then we all realized that wasn’t true. Different insurance companies. Different doctors. Some overlap. Some don’t. But I don’t think APS staff is wise acting like this is some monumental deal that they can’t educate kids. That they need more leave to deal with it. I’ve been through this a number of times. It sucks. But I also don’t know on any scale how one can say Kaiser is better is BCBS.

+1

The people at the school board meeting comment period sounded completely uninformed about the realities of procurement, contracting, and healthcare. Which - fine - they don't need to be experts on any of those subjects. But the hyper emotional reactions to a set of fairly straightforward facts about how this situation came to be was concerning from a judgement perspective.

[Anonymous]

People are complaining about...escaping Kaiser? And getting BCBS? What is this, opposite day?

[Anonymous]

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Anonymous wrote:I sympathize with you, APS teachers on Kaiser. It is not easy to find new doctors right now, but they’re out there. Good news is that this is likely a one time switch- most practices around here participate in many of the big plans.

As hard as this is, you not winning any supporters with this. Stop trying to get the parents to do your bidding for you. It’s unprofessional. The Board has a fiduciary duty to the taxpayers to ensure that the benefits that are being provided to you are being obtained at a reasonable cost commensurate with market rates. Insurance plans cost a whole lot more than the small fraction you individually pay.

Additionally - All of us in corporate land have been through insurer changes, along with massive YoY increases in premiums or deductibles, and limits on service. You are being offered what appears to be a great plan at a competitive cost. Stop threatening to quit or call out for days on end unless you’d like to come experience employer coverage out here in the wild.

Or maybe, just maybe we CARE about the kids we teach and feel bad that we will have to take days off because we know it sucks, but it is also the only way we are given. It isn’t a threat, just the reality of what we are facing.

This has nothing to do with insurance plans changing. I know some people are asking for more days off to "look for more doctors" That's nonsense. Most of this can be done online at any time of day. Even if not, our contract hours allow for phone calls.

No, my kid needs to be brought to a doctor so her multiple therapies can be approved. I need to take medicine for a chronic condition. I suppose after being in Kaiser for 20 years, I could be out of it, but I doubt a doctor will just approve and write a prescription without ever seeing me. I can pick a doctor out online, in fact I already have on the BCBS website. That doesn’t mean I can get him to prescribe meds sight unseen. We have to SEE the doctor and that can’t be done outside of contract hours.

Ok, so two new appointments (one for you and one for your daughter) doesn’t seem like that big of a deal.

You’re acting like you’re going to have thousands of appointments. A bit melodramatic.

(Your daughter may have multiple therapy appointments, but wouldn’t that also be the case if you still had Kaiser?)

Each therapist usually needs an intake appointment which is at a weird time so they can “test” your kid in whatever they deem necessary and get to know history and your kid then you can set appointments on a regular basis. Keep in mind we can only take half days from 9-12 or 12-4 so if you get a 10:30-1:00 appointment it turns into the whole day because the first time you go to a doctor you don’t know if it is the kind of office that is always running late. So it usually ends up being a whole day or else you don’t have coverage. That is up to 4 days for my kid (one general doc and each therapist) and 1 for me, of course I will try my best to take half days, but if Kaiser was still going, it would be zero because we wouldn’t need all the intake appointments.

Sorry, if it is “melodramatic” but yeah that is a lot of time off during a testing month Dibels and pals.

So take the days off. The world is full of cemeteries the world couldn’t do without.

It’s not that hard finding an appointment that’s not at 10:30.

Good lord, what a drama llama. Welcome to life! Most of us have to figure out how to balance careers, family demands, health issues, etc. You aren't special or more put upon than anyone else.

[Anonymous]

Anonymous wrote:People are complaining about...escaping Kaiser? And getting BCBS? What is this, opposite day?

I will say that Kaiser is easier to navigate in many ways. Your lab, doctor, pharmacy, sometimes specialists, MRI etc are all in one building and there’s no worrying about if things are covered. Surgeries are usually cheap. I’ve paid $20 each for a tonsillectomy
and gallbladder removal. On other insurance carriers I’ve had lots of surprise bills/driving from place to place

[Anonymous]

Anonymous wrote:People are complaining about...escaping Kaiser? And getting BCBS? What is this, opposite day?

Losing family therapists and finding new ones is a stressful long process. But the fact is Kaiser did not bid. Teachers threatening to leave mid year now. That’s not what’s best for our kids. They need to calm down and look at facts.

[Anonymous]

It’s not about whether Kaiser is better than BCBS - it’s about people mid-treatment. You don’t have to emphasize or even sympathize but to tell staff it’s NBD is cold. Y’all think you’re rational and calm people. I can bet you’ve flipped out over less.

[Anonymous]

BCBS is even giving 90 days in 2024 for transition. Will cover Kaiser doctors til end of March. Get over yourselves.

[Anonymous]

Anonymous wrote:BCBS is even giving 90 days in 2024 for transition. Will cover Kaiser doctors til end of March. Get over yourselves.

Read the fine print.

[Anonymous]

Anonymous wrote:It’s not about whether Kaiser is better than BCBS - it’s about people mid-treatment. You don’t have to emphasize or even sympathize but to tell staff it’s NBD is cold. Y’all think you’re rational and calm people. I can bet you’ve flipped out over less.

We have over 90 days to find new coverage and an additional 90 days if certain conditions apply

[Anonymous]

I talked to colleagues and don’t think this is so much about having to switch providers. that’s inconvenient but it is one more issue to contend with on top of everything that central office is throwing at us. We don’t trust them.

[Anonymous]

Even if they told teachers earlier, like this summer, it's not like you can begin searching for new doctors 6 mos in advance. Going from being beholden to only using Kaiser doctors to having to go to other offices may seem like a lot of work, but it's also a chore that all adults have to do. We all have to take time off for doctor's appointments (most DMV doctors offices are open on all federal holidays, it's when a lot of us schedule our appts). Pull our kids out for doctor's appointments. Take our kids into ped's offices (though I call shenanigans on there still be toys in most ped's offices in a pandemic world - wear a mask, take sanitizer along, wash everyone's hands after that ped's appt). Having had an insurance switch literally the day before scheduled, life changing, life saving surgery, yes I know it's scary. The whole way that we tie health insurance to work is scary. But truly it's life, teachers. It really is. There are so many things that parents will support you on: hiring, pay retention, sub pay, reducing syphax numbers, the calendar, heck we'll even listen to ventilation lady if you need us to, but the insurance thing really is the way it works.

[Anonymous]

I don’t understand how quitting APS would help you keep Kaiser, unless you can quickly find another job that uses Kaiser. That seems non-sensical.

[Anonymous]

Anonymous wrote:I don’t understand how quitting APS would help you keep Kaiser, unless you can quickly find another job that uses Kaiser. That seems non-sensical.

Someone said that ACPS and FCPS have Kaiser, so it may not be that hard if there are openings.

I'm not APS, but have had Kaiser for 10 years through my employer. I really like it and would be miffed to lose the pediatrician, primary and ob/gyn we've used since before kids. We have good relationships and it's great to have that continuity. That said, stuff happens and you have to roll with it.

I wonder if there's help that can be provided to help connect folks with new in network HCPs. I wouldn't even know where to look after 10 years with Kaiser.