Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
Newsday - July 12, 1988
Laurie Garrett
According to the report commissioned by the Office of Technology Assessment, the cost of treatment for only 940 AIDS patients since 1981 is potentially threatening the finances of Kaiser Permanente, the nation's second-largest prepaid group health plan. This is despite the fact that Kaiser is providing care at a cost lower than many other organizations.
Kaiser Permanente reported spending an average of about $35,000 to treat AIDS patients in Northern California from the time of diagnosis until death. This is less than previous studies have reported for other health-care providers in New York and Boston.
The report, which Kaiser researchers prepared, indicated that part of the savings were achieved by establishing an elaborate system of providing care on an outpatient basis, rather than providing it in the hospital. The study concentrated on Northern California, the area with the second-largest reported AIDS population in the world, and headquarters of Kaiser. This may only be possible, however, in an area such as San Francisco, where most acquired immune deficiency syndrome patients are middle class, have established support systems and have homes in which they can be treated. In Eastern urban centers an ever-growing number of AIDS patients are poor and 15 percent of New York City's AIDS patients are homeless. Thus they frequently end up being treated in hospitals at a far higher cost.
Nevertheless, Jill Eden, project director of the OTA study, said, "there are lessons to be learned from the Kaiser situation that pertain to everybody." The major one, she said, is that the epidemic is hitting the health-care system in a disproportionate manner, hardest in New York and San Francisco. In those areas, she said, even an extraordinarily frugal provider, such as Kaiser, is financially threatened.
"In terms of solutions," says Eden, "I think that locales . . . that are disproportionately hurt ought to get some kind of federal support. Systems like Kaiser shouldn't be allowed to fall to unexpected epidemics."
According to the report, Kaiser Permanente has not been testing prospective enrollees for exposure to AIDS or attempting in any other way to screen for potential AIDS cases. Because other insurers have been doing these things, the report said, Kaiser may lose its ability to compete financially.
Kaiser said it does not plan to screen potential patients and that federal financial assistance is needed to help treat AIDS patients.
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