[kaiserthrive.org editor’s note: After six years of investigating and documenting the heinous medical crime committed against her by a Kaiser surgeon — and related Medicare fraud — Kaiser victim Jupirena Stein is challenging George Halvorson to put his money where his mouth is. For the last few months George has been squawking to anyone who will listen about fake health care reform, but the one question he pointedly refuses to answer is the one most relevant to Kaiser members and its victims, past and future: How dare you hold yourself up as an expert in health health care reform when you can’t even reform your own murdering organization? Please George, tell us, we would really like to know.
Despite failing health (thanks to Kaiser), Ms. Stein has never given up, and she has chosen to help others by becoming a patient advocate. When asked if there was anything she would like readers of this open letter to know, Ms. Stein repeated her favorite saying: “Evil prevails when the good people are silent or take no action.” We couldn’t agree more, and we believe she deserves an answer to her questions.]
Friday, August 24th, 2007
Mr. George C. Halvorson
Chairman and Executive Officer
Kaiser Foundation Health Plan, Inc.
1 Kaiser Plz. Ste. 2600
Oakland, California 94612
RE: Medical Crime, Dr. Timothy W. Wild, DDS, MD, ENT — Surgeon, Kaiser Permanente Redwood City, Ca. (1999) and Medicare Fraud; Mr. George E. Clause Kaiser Permanente’s defense attorney (2001)
Dear Mr. George C. Halvorson:
My name is Jupirena Stein, and I am a former patient at Kaiser Permanente Redwood City, California. I am writing this open letter and demanding your response. Please tell me if you are aware of the crime and Medicare fraud mentioned above on this letter RE. Before you took office on March 2002, I took my suspicions about these facts to the attention of Mr. David Lawrence. He ignored its importance. It is now your turn.
Medical Crime:
On November 19th, 1999, Dr. Timothy Wilfred Wild (unbeknown to me at that time) performed a needless Parotidectomy surgery and an invasive, life threatening vascular surgery on several of my right cervical vessels for his own gain, without medical need, without my knowledge and without my permission. I became severely ill. I saw 8 medical specialists at KP Redwood City, California, but none of them “were able to figure out” what was wrong with my health. Why didn’t they just simply asked Dr. Wild, “What have you done to this patient?” But instead, these physicians simply chose to cover up his crime against my health. Even I, think they can’t be that incompetent! Subsequently, I filed a lawsuit; Stein vs. Kaiser.
Medicare Fraud:
KP was represented by Mr. George E. Clause, a partner at Ropers, Majeski, Kohn & Bentley, in San Jose, California. Mr. Clause claims in his Law Firm’s website that he is an experienced Health Care attorney, a member of many reputable legal institutions and that he have represented KP on medical malpractice cases. Because of this public information, one would think that Mr. Clause clearly, wouldn’t have to seek to the use of Medicare fraud when defending Kaiser Permanente in matters involving Medicare and medical malpractice health insurance legal liability. But in my case, he chose to. By doing so, he saved KP money by reversing future medical legal liability from Kaiser to our Federally Funded Health Care System, Medicare.
Of course, Mr. George E. Clause can not claim this illegal shifting of the burden of ALL my future medical care from Kaiser’s future liability to our tax payers, – an act of his own. Mr. Bruce Albion Bailey (my representing attorney cooperated with him by choosing not to correct Mr. Clause’s Legal Brief fraudulent information about my health insurance coverage legality to retired judge Rebecca Westerfield from JAMS San Francisco, Ca. (“…who is known for her ability to grasp legal and factual issues quickly,”) cooperated with Mr. George E. Clause by choosing to stay silent about the subject of future medical care, when signing her final award.
And finally the involvement of the Department of Managed Health Care (DMHC) through Mr. Lewis Chartrand’s Legal Department and his illegal destruction of my files, when I asked them for help in these matters. I often ask myself if Ms. Lucinda Ehnes, DMHC Director (she will receive a copy of this letter) is aware of KP’s involvement in medical crime and fraud, in my case or in any other. It seems to me that neither Kaiser nor the DMHC worry about whose credibility is in danger to be damaged.
Medicare as a secondary payer is protected by federal laws and must ALWAYS be properly observed in cases such as mine, and be considered as such. Section 1862(b) of the Social Security Act 42 USC Section 1395Y(b)(5) Applicable regulations found at 42 CFR part 411 (1990).
Retired judge Rebecca Westerfield, the attorneys Mr. Bailey and Mr. Clause chose not enforce federal laws, as well as neglect KP’s rules and regulations contents found in Kaiser’s Evidence of Coverage Book pertaining to Medicare health care coverage liability of patients such as myself.
In my opinion, Kaiser Permanente could never be successful in such matters, (fraud and crime) if they would handle things on their own. Kaiser had to have the complete cooperation and the blind loyalty of all these professionals mentioned in this letter. Without this kind of cooperation and loyalty, this HMO could be considered safe for ALL their patients.
Mr. Halverson, you may whish to clear these facts with me by using our legal system. I invite you to do that. After all, my claims of medical crime of this serious nature and of Medicare fraud, are NOT something Kaiser Permanente nor the DMHC should take lightly. I know, I don’t.
Dr. Wild has the mental and physical capability plus he has the medical knowledge to commit such a horrendous crime, and he is willing to take chances with his medical license and with his Board Certification. Dr. Wild, should NOT be permitted to perform surgery. Watch my words: chances are, – he will do it again (if I am indeed the first one).
No wonder Kaiser and their attorney Mr. Clause, couldn’t find Dr. Wild for his deposition, even though he was still working at KP. As a resident, (physician in training) he would have never been allowed to operate without supervision (as per court documentation.) Much less, become board certified after committing a crime against my health and for that, he would not qualify to work for the Permanente.
These serious matters involving Dr. Wild showing his clear intentions other than helping me with my health, and Kaiser Permanente Mandatory Binding Arbitration System involvement (in my case, through their defense attorney) in Medicare fraud, is, as you receive this letter, being announced to the world.
If you chose to stay silent as KP’s executive officer, and chose NOT take a position of ethics and legality, I will take it as your public admission of guilt and as reckless disregard to protect Kaiser Permanente’s patients health and safety.
“Evil prevails when the good people are silent, or take no action.”
Regards,
Jupirena Stein
j_u_stein@yahoo.com
www.kaiserpapers.org
CC: Open letter
“Evil prevails when the good people are silent, or take no action.”
Why is it that Kaiser seems to be above the law in ALL matters?
Reform your organization FIRST before “claiming” to be spearheading
a healthcare reform campaign. Kaiser is the opposite of good, despite
what rubbish we hear in the media. We all know the truth of what kaiser is
and we stand behind it.
Mr. Halvorson, all Kaiser Victims everywhere deserve a response.
We are eagerly awaiting your response.
I would like to add my own challenge to Mr. Halvorson and Kaiser Permanente.
It is well-known within Kaiser that I have SERIOUS (and I do mean serious) issues with Health Connect.
The methodological problems (and “attitude”) at Kaiser is one reason why I quit my job there (in addition to the primary reason–allowing our beautiful daughter to die and then hiding or misrepresenting critical medical records for Beth and our baby) and it is also why I went public with my concerns back in February in the Los Angeles Times. I have been told, as a result of my little speech in the newspaper, that at Kaiser “my name is mud”.
Of course, I haven’t read Halvorson’s book (although I did read some excerpts from it which, at a high level, I am in agreement with) but it seems to me (at least in what I have seen so far in the excerpts) as if what he is saying is very generic and there are no concrete plans that I see as to the actual implementation of his vision–a theme perhaps I have seen somewhere before, methinks.
I realize that I have only seen a small portion of his book but, in the part that I read, I saw nothing of any substance as to the hows and whys of “practically” implementing this plan.
He speaks about the need for “data” which of course I agree with. This is absolutely critical and a correct assumption.
But what he fails to mention is the need also for business rules for organizing and cataloging that data, as well as concrete procedural imperatives defined both within the context of the business itself and the full analytics for specific constraints of the application (as well as any feeder/legacy systems that may be tied to the application) in order for the associative properties of the data to be fully realized, within the context of defined clinical necessities.
Data means nothing without a fully and properly defined contextual framework.
As to the fiction that Health Connect is a “successful” implementation, as the wonderful words of praise for him and his book suggest, I beg to differ–unless he did two successful implementations somewhere else BEFORE KPHC.
In fact, I would be happy to debate Halvorson or anyone else from KPHC–anywhere, anytime– about the REAL untold story of Health Connect.
I have seen it myself, up close, too close, and of course I have my own opinions as to what is likely to happen–which I imagine is much different than the corporate spin.
Also, one side note. Halvorson mentions market incentives as a successful driver of reform. I could not agree more.
However, the current MICRA caps serve to encourage mediocrity and lack of quality care as there are no financial incentives for providing “good’ service as opposed to mediocre service since there are no effective deterrents (penalties are also “incentives” driving quality assurance standards) in place driving compliance standards in a meaningful way.
In other words, the penalties are not big enough to worry about and until they are it is unlikely that much will change–to the betterment of Kaiser’s balance sheet and the detriment of many Kaiser members seeking quality health care.
Let me just say this one more time. I challenge anyone from Kaiser (and I do mean anyone) to debate me in a public forum about methodology and controls and what normally happens with a software implementation and what actually happened within KPHC.
Anyone. Anytime.
MediCARE doesn’t CARE when they pay criminal doctors for their services. This is so sad. We can only hope that perhaps with the coming change in the current corrupt U.S. administration that lawmakers will begin to see what is going on underneath their noses.
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I have recently attempted to get a response from Mr. Halverson regarding the poor care Kaiser is giving to patients with neuroendocrine carcinoma and carcinoid. This is a life threatening rare disease and the oncologists in Kaiser see very few cases, so they don’t know much about it and how to treat it. But they attempt to treat it anyway, when they should be referring patients to specialists who see many patients and are knowledgeable about appropriate diagnostic procedures, and treatment options. I have made numerous recommendations and cited many examples of the poor care given. But I have been totally stonewalled by Mr. Halverson, and responses from the Chairmen of the Northern California Kaiser oncology chiefs and the head of Kaiser Permanente in Northern California have essentially denied there is any problem and refuse to make any efforts to even look into it.
I have emails from other Kaiser patients with this devastating disease that support my contention and I am looking for more patients with similar stories. Any Kaiser patient with neuroendocrine carcinoma or carcinoid or friend or family member reading this comment please contact me at robstieg@Comcast.net so I can gather further evidence of Kaisers poor care.