I'd be curious to see what the numbers are at Kaiser and other HMOs. No incentive for treatment there, either.
I'll attest to that. I have a friend who was dx a year ago with Kaiser. He's a gleason 3+4=7with a slow rising pSA about
6.2 I think it was 5.5 6 months ago and they are fine with his doing AS for awhile. But they are also telling him he's not eligible for seeds because his prostate is too big Although they haven't told him how big it was at the biopsy and not a word about
possibly shrinking it with drugs which is SOP many other places before biopsies at times and treatments. He also has no idea the percentage of his positive cores. They seem to be pushing the multi visit IMRT because he's rejected radical surgery. That had nothing to do with me. I think he should find out if they even offer seeds and go that route with medicare. I volunteered to go with him but his girlfriend didn't want me there so fine they both went there clueless and let themselves be persuaded and bullcrapted IMHO. He's just turned 65 and is at the stage that maybe he'll do nothing. Brings back memories when I had Kaiser in the 1980s. I remember for about
2 years I never used my healthcare much but when I did I only talked to a nurse or a physician's assistant. When a few month later I'm taking my dog to the Vet it dawns upon me my dog always got to see a medical doctor but I never did. I switched my healthcare away from Kaiser next
open period and never dealt with them again.Not completely sure what your point was, Zig, I just thought it might be instructive to compare systems with and without incentives for more treatment. I don't want to start a pro-and-con Kaiser thread here, but my experience with them has been nothing like you describe. I see doctors for a problem, not nurses or PAs. In 2+ years, I have never detected a hint of limiting treatment for the purpose of cutting costs. The urologists all recommended surgery but also referred me to both Brachy and radiation specialists. Kaiser's new Mid-Atlantic megafacilities are spectacular, and they get the absolute best ratings for all national health care providers from Consumers Reports. You can look that up. For a self-employed guy like me, having navigated the health care nightmare in this country for 50 years, I'm thrilled to be under their umbrella and have few complaints.As far as I know they are about
the only HMO left of at least a national size. My story of not seeing actual doctors was years ago and really not relevant . But the recent experience of my friend with PCa is. At least you were offered Brachy he wasn't and I wonder if it's the fact Kaiser may not have it locally. The excuse is his prostate is too big without bringing up it's size and/or why it can't be shrunk with drugs which is common, raises doubts in me. Kaiser may be like the VA where it's great treatment in one city for a specific disease and awful somewhere else. All I know for sure I was sure glad I didn't have kaiser for they would have never approved my TFT and paid for the hospital I had it done at. That's enough for me to never recommend them to anyone I know.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A
2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study
4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal
7/30/08 - Psa: .32
11/10/08 - Psa.62 -
April 2009 12 of 12 Negative Biopsy
2/16/10 12 of 12 Negative Biopsy