Can you imagine breaking your arm and your doctor saying, “I think we can squeeze you in, in a month or two?” It’s unimaginable.
Now, close your eyes. Picture someone close to you, such as a close friend or family member, or maybe even yourself, feeling deeply depressed. This person might be experiencing a high level of anxiety, or worse, suicidal thoughts. You call up Kaiser Permanente, your health care provider, and you’re told the same — “I think we can squeeze you in, in a month or two.” Unfortunately, that scenario doesn’t have to be imagined. For thousands of people seeking mental health care at Kaiser, it’s the reality.
The delay of mental health care is not acceptable. It’s a gross disservice to those who pay for it. The denial of timely mental health care is immoral and unethical, and it’s precisely the reason why therapists, psychologists, social workers and chemical dependency counselors employed by the health maintenance organization, or HMO, Kaiser are on strike.
Roughly 2,000 members of the National Union of Healthcare Workers have been striking since Aug. 15 in the Bay Area, northern California and the Central Valley. This strike is not about worker wages or benefits. The union members want California’s largest HMO to wake up and confront the mental health crisis surging in our state and across the nation. They want Kaiser to create parity with medical services, and they fundamentally desire better care access for Kaiser patients in need.
In late July, John Oliver pointed out on his HBO program Last Week Tonight with John Oliver that about four in 10 adults in the United States have exhibited symptoms of anxiety or depressive disorder during the pandemic. He further explained more than half of those who need mental health services don’t receive it, with even higher rates in minority populations.
“If we want to be a society that truly respects and values mental health,” Oliver said during his July 31 program, “we have to respect and value mental health care, and that means supporting the people who deliver it.”
Oliver nailed it.
Many insurance companies and health care providers across the country routinely violate federal and state parity rules. In the case of Kaiser, records of delays and denials of mental health care to subscribers predates the pandemic.
The HMO has been fined by state regulators for denying members timely access to care and sued by local prosecutors. As of May of this year, Kaiser is facing a state investigation following a sharp rise in patient complaints last year. Another new state investigation was announced only last week.
In response to concerns from Kaiser psychologists, the American Psychological Association told California state regulators Kaiser’s appointment wait times for mental health services were “egregious” and the worst it had ever seen.
Kaiser staffs only one full-time equivalent mental health therapist for every 2,600 members in northern California. Patients are routinely forced to wait four to eight weeks between therapy appointments. This is in violation of a new state law that requires follow-up appointments be provided within 10 business days.
It doesn’t have to be this way. Kaiser certainly has the money to beef up services. California’s largest HMO reported $54 billion in cash and investments and earned more than $8 billion in income last year.
Kaiser claims that it has trouble hiring therapists. Probably true. But it might have less trouble if it would invest in mental health, follow laws on the books, hire more staff to work the phones, improve working conditions in general and provide more training. Taking these actions also would bring an end to the strike.
Medical care and mental health care are both health care — there shouldn’t be a double standard. Mental health shouldn’t be treated as an afterthought. In response to a shortage of physicians and an increased need for more medical doctors, Kaiser started its own medical school. When it had a surge in demand for mental health services, it did next to nothing.
“Strike or no strike, as the regulator, we are going to hold them accountable for following the law,” Mary Watanabe, director of the California Department of Managed Health Care, told state senators during a hearing earlier in August.
State regulators are saying all of the right things. But, they need to do more. Much more. Kaiser has time and time again thumbed its nose at state laws requiring timely treatment. It is time to hold it accountable.
Gov. Gavin Newsom appeared in Fresno two weeks ago to promote a $4.7 billion investment in universal screening and support for children’s mental health. That’s great, but the governor also needs to make sure the bills related to mental health that he has already signed into law are enforced.
The state government has been very good to Kaiser. The Newsom administration recently offered Kaiser a no-bid contract for Medi-Cal services, a huge reward. The state has shown that it knows how to give gifts. Let’s see how it does at enforcing discipline. Your mental health may depend on it.