CNN Article - Psychologists to Strike

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Joined
Dec 8, 2014
Messages
1,182
Reaction score
1,822
Saw this on CNN:


Members don't see this ad.
 
Last edited:
  • Like
Reactions: 4 users
This is great. Unions, though often problematic are so necessary. I really hope they are successful.
 
  • Like
Reactions: 6 users
Sending big solidarity forever vibes to any SDNers joining them on the picket line!
 
  • Like
Reactions: 8 users
Members don't see this ad :)
Conversation with my husband this morning:

Husband (reading the news): Some therapists are going on strike.
Me: Kaiser?
Husband: Yup.

It's so sad that they continue to struggle with all of this, especially the ridiculously large panel sizes.
 
  • Like
Reactions: 4 users
Conversation with my husband this morning:

Husband (reading the news): Some therapists are going on strike.
Me: Kaiser?
Husband: Yup.

It's so sad that they continue to struggle with all of this, especially the ridiculously large panel sizes.

Yeah, when I saw the title of the thread, I immediately thought Kaiser before even opening the link.
 
Kaiser has quite a reputation for not providing therapy in a timely or regular manner, and for using psychologists as workhorses. VIa word of mouth, I've heard of someone who works there writing notes after hours and on weekends because they see clients back to back all day. No admin time. Waitlists are ridiculously long to get into see therapists for individual therapy, and appointments are spaced out 3-4 weeks, sometimes more.

Also, a non-profit reporting over $8 billion net income in a year? Where does that excess go when you're a non-profit?

My best wishes to all the psychologists at Kaiser striking--I hope they get everything that their union is advocating for. The irony of Kaiser's rep saying the union is using "unethical" means by striking and not providing needed mental health services when the psychologists are striking unethical conditions by Kaiser--such manipulative language.
 
Last edited:
  • Like
Reactions: 7 users
Kaiser has quite a reputation for not providing therapy in a timely or regular manner, and for using psychologists as workhorses. VIa word of mouth, I've heard of someone who works there writing notes after hours and on weekends because they see clients back to back all day. No admin time. Waitlists are ridiculously long to get into see therapists for individual therapy, and appointments are spaced out 3-4 weeks, sometimes more.

Also, a non-profit reporting over $8 billion net income in a year? Where does that excess go when you're a non-profit?

My best wishes to all the psychologists at Kaiser striking--I hope they get everything that their union is advocating for. The irony of Kaiser's rep saying the union is using "unethical" means by striking and not providing needed mental health services when the psychologists are striking unethical conditions by Kaiser--such manipulative language.

Non-profit does not mean no profit. It does mean no income taxes. As to where all the money goes, that is a good question. I usually like to start at the top and see how fat those bank accounts are. I can tell the CEO was the highest paid non-profit in the country a few years ago at 18 million in compensation.
 
  • Like
Reactions: 6 users
Members don't see this ad :)
The NASW code of ethics has an explicit clause about social workers going on strike, not surprisingly APA offers absolutely nothing to guide our ethical decision making in the case of labor disputes. I've always thought this would be a good thing for us to have for this exact reason. A ****ty employer could try and accuse a psychologist of patient abandonment or something for going on a strike and we wouldn't have our code to back us up...
Kaiser has quite a reputation for not providing therapy in a timely or regular manner, and for using psychologists as workhorses. VIa word of mouth, I've heard of someone who works there writing notes after hours and on weekends because they see clients back to back all day. No admin time. Waitlists are ridiculously long to get into see therapists for individual therapy, and appointments are spaced out 3-4 weeks, sometimes more.

Also, a non-profit reporting over $8 billion net income in a year? Where does that excess go when you're a non-profit?

My best wishes to all the psychologists at Kaiser striking--I hope they get everything that their union is advocating for. The irony of Kaiser's rep saying the union is using "unethical" means by striking and not providing needed mental health services when the psychologists are striking unethical conditions by Kaiser--such manipulative language.
 
  • Like
Reactions: 5 users
Non-profit does not mean no profit. It does mean no income taxes. As to where all the money goes, that is a good question. I usually like to start at the top and see how fat those bank accounts are. I can tell the CEO was the highest paid non-profit in the country a few years ago at 18 million in compensation.

Profit-wise, it means that that don't have shareholders that they distribute profits/dividends to. But that doesn't mean that they don't have highly paid executives. Also, as long as the excess profit goes to the "organization's purpose" it's ok. "Purpose" being a vague notion.
 
  • Like
Reactions: 3 users
The psychologists are devaluing themselves by uniting with lesser trained, lower scope of practice professionals. CA allows psychologists to admit to hospital.
 
  • Like
  • Angry
Reactions: 4 users
The psychologists are devaluing themselves by uniting with lesser trained, lower scope of practice professionals. CA allows psychologists to admit to hospital.
I was thinking something along the same lines; however, increasing the value and compensation of the midlevels should increase ours. As doctoral professionals, our professional organization should be working on this stuff so that we can support the midlevels, but we should remain separate.
 
  • Like
Reactions: 7 users
Unfortunately, I am sure that the APA won’t say anything about it or if they do it will be some weak statement which is one reason I left the APA. They don’t seem that interested in advocating for our profession or our field.
 
  • Like
Reactions: 1 users
Unfortunately, I am sure that the APA won’t say anything about it or if they do it will be some weak statement which is one reason I left the APA. They don’t seem that interested in advocating for our profession or our field.
APA as a whole maybe not (although maybe it's been improving recently), but APAPO is definitely more active on that front. I stay in APA because I strongly feel psychologists need a single, national "voice," and the APA is the best we've got; and also to continue supporting the Practice Organization and their advocacy.
 
  • Like
Reactions: 2 users
Yeah, I was part of the AFM union for musicians back in my day as a pro musician. I decided to never again be part of a union after that experience.

Like most things, there are good and bad. My graduate student union was hugely beneficial and successful, before the state government went on a union busting run. Definitely some bad apples when it comes to unions, but I do think by and large they've been more or a boon to workers than a hindrance in the aggregate.
 
  • Like
Reactions: 7 users
Like most things, there are good and bad. My graduate student union was hugely beneficial and successful, before the state government went on a union busting run. Definitely some bad apples when it comes to unions, but I do think by and large they've been more or a boon to workers than a hindrance in the aggregate.

Perhaps - I still opt to not get involved for the time being.
 
Like most things, there are good and bad. My graduate student union was hugely beneficial and successful, before the state government went on a union busting run. Definitely some bad apples when it comes to unions, but I do think by and large they've been more or a boon to workers than a hindrance in the aggregate.
I had a horrible union in an old job and couldn’t opt out of paying them a lot of money every year. Definitely gave me a negative view of unions but I do see how they can be valuable, but mine was every negative stereotype you’ve heard.
 
  • Like
Reactions: 1 users
I had a horrible union in an old job and couldn’t opt out of paying them a lot of money every year. Definitely gave me a negative view of unions but I do see how they can be valuable, but mine was every negative stereotype you’ve heard.

I don't doubt it, definitely some shady unions out there. And, I say that coming from a UAW family ;) Some do a pretty good job at finding that middle ground. And, the numbers for union involvement are fairly consistent regarding increased wages. But yes, they do need appropriate checks and balances.
 
  • Like
Reactions: 2 users
In California, Kaiser is like the shady used car dealer of health care. They will sell you a health insurance plan that is a bit cheaper than that of the competition, and that doesn't work well. This is especially true when it comes to mental health care which they essentially refuse to provide in an adequate way. They have a long and ugly history of this.

Kaiser is currently canceling therapy appointments for thousands of patients (regardless of the severity of their conditions) in anticipation of the strike, and in violation of state law. The Kaiser clinician managers who are implementing this are acting illegally and unethically:


Kaiser is doing this because referring patients to alternate sources of outside care (as is legally required) is deemed too expensive and will cut into their billions of dollars in profits.
 
Last edited:
  • Wow
  • Like
Reactions: 6 users
In California, Kaiser is like the shady used car dealer of health care. They will sell you a health insurance plan that is a bit cheaper than that of the competition, and that doesn't work well. This is especially true when it comes to mental health care which they essentially refuse to provide in an adequate way. They have a long and ugly history of this.

Kaiser is currently canceling therapy appointments for thousands of patients (regardless of the severity of their conditions) in anticipation of the strike, and in violation of state law. The Kaiser clinician managers who are implementing this are acting illegally and unethically:


Kaiser is doing this because referring patients to alternate sources of outside care (as is legally required) is deemed too expensive and will cut into their billions of dollars in profits.
Not sure why kaiser should be on the hook to pay for out of network care for these patients. When nurses go on strike this doesn't happen, just the department is shut down.
 
Not sure why kaiser should be on the hook to pay for out of network care for these patients. When nurses go on strike this doesn't happen, just the department is shut down.
Just my guess--maybe because the insurance requires they go to a Kaiser facility, but Kaiser facilities now can't reasonably provide the service? Sort of like if a VA shutdown because people went on strike, I suspect VA would be financially obligated to pay for care for the patients at outside facilities. I have no experience or familiarity with Kaiser insurance but wonder if it's a similar situation/setup.

Something like that.
 
  • Like
Reactions: 3 users
Just my guess--maybe because the insurance requires they go to a Kaiser facility, but Kaiser facilities now can't reasonably provide the service? Sort of like if a VA shutdown because people went on strike, I suspect VA would be financially obligated to pay for care for the patients at outside facilities. I have no experience or familiarity with Kaiser insurance but wonder if it's a similar situation/setup.

Something like that.

There is something here like this as well. One of the larger healthcare systems created their own insurance network, of which most of it's providers are the preferred in-network providers for the plan. They have to provide necessary care in a "reasonable" time frame. If they cannot provide this, that may have to reimburse the out of network providers at no extra cost to the insured patient.
 
  • Like
Reactions: 2 users
Not sure why kaiser should be on the hook to pay for out of network care for these patients. When nurses go on strike this doesn't happen, just the department is shut down.

Because Kaiser is 3 entities:

1) A health insurance
2) A hospital group
3) A medical clinic group


Insurance companies have legal requirements to pay for care, with additional requirements that something like 80% of revenue must be used to pay for healthcare. Kaiser, the health insurance, acting like an HMO, has created rules that incentivize subscribers to go to Kaiser brand medical groups. That does not excuse them from paying that 80% of revenue. The medical Group is stating they are understaffed. That is not a legal excuse for the health insurance. The avoidance of using the required percentage for healthcare makes it look like the insurance company is acting like a revenue generating department. There are HUGE legal consequences for when an insurance company's claims department acts as a revenue generating department (e.g., State Farm).
 
Last edited:
  • Like
Reactions: 6 users
Not sure why kaiser should be on the hook to pay for out of network care for these patients. When nurses go on strike this doesn't happen, just the department is shut down.

New California state law also requires a first visit within 10 business days and follow up visits within 10 business days, unless deemed not detrimental to the patient to wait longer. These are mental health specific laws.

This is on their public union website:
 
  • Wow
Reactions: 1 users
F/u visits within 10 days?? How the heck do they manage that?
 
  • Like
Reactions: 1 user
F/u visits within 10 days?? How the heck do they manage that?
Welp... they're not. Huge shortage of providers in their outside network, too.

Kaiser striking is nothing new. This has been going on for years. I know plenty of people who like it on the medical side - like for OBGYN. Abhorrent on the MH side for both staff and patients.
 
Not sure why kaiser should be on the hook to pay for out of network care for these patients. When nurses go on strike this doesn't happen, just the department is shut down.
Do your patients commit suicide or require hospitalization when they can't get appointments because Kaiser is too cheap to hire providers or pay them decently? Ours do. That is why poor Kaiser needs to pay for out-of-network care or fix the problems.
 
  • Like
Reactions: 3 users
New California state law also requires a first visit within 10 business days and follow up visits within 10 business days, unless deemed not detrimental to the patient to wait longer. These are mental health specific laws.

This is on their public union website:

New state law...blah, blah. How does this work??? New "state law" starting.....when? Grace period? Or they think this just should be "happens" because they say so? We give big industry and Oil 5-10 and 20 years for goals, don't we? "New California state law" means very little in and of itself to me.
 
Last edited:
  • Like
Reactions: 1 user
New state law...blah, blah. How does this work??? New "state law" starting.....when? Grace period? Or they think this just should happens because they say so? We give big industry and Oil 5-10 and 20 years for goals, don't we?
Big oil and industry don't directly involve life and death. Mental health does.
 
  • Like
Reactions: 1 user
In 2015 Kaiser was on strike for the same reasons they are again today. Nothing is better.
 
  • Like
Reactions: 1 user
Because Kaiser is 3 entities:

1) A health insurance
2) A hospital group
3) A medical clinic group


Insurance companies have legal requirements to pay for care, with additional requirements that something like 80% of revenue must be used to pay for healthcare. Kaiser, the health insurance, acting like an HMO, has created rules that incentivize subscribers to go to Kaiser brand medical groups. That does not excuse them from paying that 80% of revenue. The medical Group is stating they are understaffed. That is not a legal excuse for the health insurance. The avoidance of using the required percentage for healthcare makes it look like the insurance company is acting like a revenue generating department. There are HUGE legal consequences for when an insurance company's claims department acts as a revenue generating department (e.g., State Farm).
I've seen insurance deny many things. They just have the patient pay for it and absolve themselves. I do prior authorization all the time that is denied
 
Laws have changed - something may happen this time.
 
New state law...blah, blah. How does this work??? New "state law" starting.....when? Grace period? Or they think this just should be "happens" because they say so? We give big industry and Oil 5-10 and 20 years for goals, don't we? "New California state law" means very little in and of itself to me.

How do laws work?

It said it started in July on that webpage. It also looks like the state is doing some kind of monitoring:

 
I've seen insurance deny many things. They just have the patient pay for it and absolve themselves. I do prior authorization all the time that is denied
People that have Kaiser cannot generally afford to pay for anything else.
 
Maybe they are but Kaiser is politically very powerful.

Seems to be.

Now I'm going down a rabbit hole online. Should be interesting few weeks ahead.

It looks like a number of state and local government officials are making their positions known:

"This strike is a long time coming," said state Sen. Scott Wiener, D-San Francisco, among a growing number of state legislative leaders backing the workers. "There have been major issues at Kaiser in terms of providing people with timely access or any access to mental health and addiction treatment and the workers have been advocating for years to have more staffing and compliance with the law and that hasn’t happened."

"Oakland City Councilmember Dan Kalb, who joined Oakland staffers on the picket line on Tuesday, said mental health care has been undervalued for far too long."

 
Doesn't matter. Medicaid denies claims too.

Have you read through the the policy statements regarding what you are asking for a prior auth for? These are usually pretty straightforward and the biggest reason for denials is people being completely unaware of existing guidelines. Also, do you have an office assistant or something? You seem to have a difficult time navigating different aspects of healthcare, and a dedicated staff person may decrease your time on unreimbursed activity.
 
Doesn't matter. Medicaid denies claims too.
All of this is really NOT about denial of claims, although that certainly does happen in various contexts. It is more about the delay of service and overwork of providers.
 
I've seen insurance deny many things. They just have the patient pay for it and absolve themselves. I do prior authorization all the time that is denied
So what? That’s not what I said. Are you misreading my statement or arguing in bad faith?

The health insurance must pay 80% of premiums towards healthcare. It is illegal for a claims department to serve as a revenue generating department. Those are two separate and established legal standards. You asked why they should have to pay. That’s your answer. They are legally obligated to pay.
 
  • Like
Reactions: 1 user
Welp... they're not. Huge shortage of providers in their outside network, too.

Kaiser striking is nothing new. This has been going on for years. I know plenty of people who like it on the medical side - like for OBGYN. Abhorrent on the MH side for both staff and patients.

I know that Kaiser is terrible, but I don't know how many clinics could manage consistent 10 day initial access AND f/u. The VA certainly can't

Edit: Oh, this is for HMOs. I admit I don't know much about HMOs.
 
Last edited:
  • Like
Reactions: 1 users
Top