Kaiser Permanente, meet Autism.
Or: The ludicrous story of how I tried to get Kaiser to get me to stop using the telephone.
I’ve lived in the US for going on ten years now, but in some ways, I’m extremely European. Any interaction I have with the American healthcare system makes that all the more obvious. I chose Kaiser Permanente as my healthcare provider, because, at least in theory, being both a healthcare insurer and a provider, means it has the incentives in place to ensure that the care delivered is adequate, and that the cost is kept down. Makes moderate amounts of sense: In the lap of late-stage capitalism, I’d assume that you wouldn’t want one side of the business trying to rip off the other side. (I have no proof, and little evidence, as to how this actually plays out, but there we go).
One thing I like about Kaiser is that it has an app, and in theory you can use that to conduct your medical business. In practice, however, things aren’t quite this easy. Rather more often than I’d like, I get phone calls out of the blue from Kaiser (which causes 10/10 levels of anxiety), and to resolve things, I have to call them (7/10 levels of anxiety).
I’ve been struggling with my mental health for a while, and Kaiser did approve for me to see an external therapist (yay!) but something went wrong with the referral, and since February I’ve been staring at my phone. I know I’m probably 3–4 phone calls away from getting a new therapist, and I just can’t face doing that.
So, instead, I figured perhaps it would be a good idea to send a note to Kaiser, requesting that they wouldn’t ask me to call them, or vice versa.
Requesting help
So, I sent a short note to member services:
I am autistic, and having to use the telephone to access services is causing me incredible amounts of anxiety. I have several messages from Kaiser in my inbox (one from my doctor, one from mental health services) that I need to deal with. I have tried many times to call, but I just can’t do it.
Is it possible to add a note to my account that I can’t use the phone? I’m happy to use chat, or email, or the messaging system you have.
Is this an accommodation you’re able to make? How do you handle members who are deaf, for example?
Thank you,
I thought that was a rather reasonable request. What happened next was sort of astonishing.
Within 24 hours, I got a letter from them. (Which involves logging into my account, and clicking ‘view letter,’ which is a 12-page PDF. It turns out Kaiser read my message as a formal complaint, and is treating it as one:
We are writing to let you know we received your grievance on April 26, 2024. We are reviewing it now. Thank you for contacting us to share your experience.
The other 11.5 pages of the letter? My rights, non-discrimination notices, additional information about grievances, and more information in 17 or so languages. I suppose it’s encouraging that they sent it to me as a PDF rather than killing half a forest to inform me that they’d received my note.
Not gonna lie, I’m confused why this went to the California Grievance and Appeals Operations. In an ideal world, they’d have gone “oh, you don’t want phone calls? No problem, we’ll help you out via our messaging system.” and that would have been the end of it. Instead, it took another three weeks to get a response to my ‘grievance,’ which… wasn’t.
The reply
The reply from Kaiser was another PDF — titled ‘Notice of Resolution.’ Which, right of the bat, was curious. Was this resolved? I have no idea, but the headline of the letter made it pretty clear that this was the end of a conversation, not the end of one.
Anyway, this was an 18-page document that had my eyes doing backflips with anxiety, rage, and confusion.
To Kaiser’s credit, the first 3 paragraphs of the letter were fine:
It pulls a great trick of communication: It explains how my communication was received and summarizes the case. The summary is pretty decent, although I’m still confused why this was treated as a grievance.
The next paragraph had me deeply frustrated though:
My perception of events? You’re joking, right? Even if this were a grievance (which it wasn’t), that’s the laziest, most useless apology I’ve seen in a hot minute. It’s worse, even, than “We apologize if you were hurt.” Anyway, I wrote a whole separate post about what it means to apologize for things as a corporation, so if you want to go down that rabbit hole, go ham:
It gets better before it gets far worse.
The rest of the letter is actually pretty good. The case manager tells me that the various service managers have been notified with the request to ‘further review or action as appropriate’ and said that they are happy to accommodate my needs. “We have removed your phone number from your account; please know that you can contact us via email and that we can also respond using our KP.org messaging system.”
So that’s a win, right?
Not so fast. The very to next lines are these:
“Our intention is that you receive excellent service (…) if you have further questions or concerns, [call us]”
Followed by:
Basically: “We’ve closed your case, if you have questions, call me on xxx”
You literally can’t make this shit up.
On the bright side, the next 14 pages of the PDF include a complaint form and information about how to escalate this matter. Which, I guess, I’ll need to do, because it’s been a hot minute since I’ve had someone take 3 weeks to so spectacularly miss the point.
Kaiser, when I notify you that I am terminating my relationship with you, I will include a link to this blog post. Hopefully you can learn something along the way.
