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Kaiser is among the first HMOs to make the latest genetic test, for the breast orlistat be gene, available to enrollees. It's so new that other large plans don't cover it orlistat be, a spokesman says.

Girding for a "flood" of demand for the costly test, this summer Kaiser will release guidelines for its appropriate use, says Ronald Bachman, M. Because Kaiser wants to tap company pfizer consumers' knowledge of their own healthcare needs, the guidelines were developed with advice from breast cancer advocacy groups, he said.

Despite these accomplishments, Kaiser has recently become one of the most maligned HMOs. Reports in the media suggest Kaiser's vaunted system-based on an exclusive partnership with physicians-is unraveling under pressures to compete with for-profit plans. Recent reports describe a powerful player fighting to suppress negative information and scrambling to correct problems in two California hospitals where patients died after long stays in emergency rooms and transport delays.

On top of that, the California Supreme Court found that Orlistat be arbitration system orlistat be be fraudulently tilted in its favor. Although few problems in healthcare can be framed in simple black and white terms, that often happens with Kaiser's.

The California Nurses Association, which is fighting for wages and jobs, and Consumers for Quality Care, a Los Angeles-based group orlistat be to many HMO practices, generate a blizzard of commentary condemning Kaiser. Orlistat be California Nurses refused to join the landmark Kaiser labor pact.

Quality of care is deteriorating at Kaiser, the CNA charges, and joining the pact-which would be dominated by Kaiser-would create a conflict of interest with nurses' role as patient advocates. Last month, the San Francisco Chronicle quoted a nurse practitioner and union leader at Kaiser's Oakland medical center saying Kaiser has a "vague overall plan.

Orlistat be Enthoven, a Stanford professor and managed-competition pioneer who is a consultant to Kaiser, says casual Kaiser bashing is "dreadful. I wish it were as easy as fast food. Managing medical care is an extremely complex matter. Kaiser's size, she says, makes it a target for critics. They offer a comprehensive set of services at a reasonable cost. They are publicly oriented and provide a lot of community support.

I don't think they are getting credit for that. Kaiser biggest won a restraining order keeping secret a negative state insurance department report on its operations.

Texas, famous for its resistance to HMOs, was "a political hothouse" last orlistat be and spring, says David O'Grady, a plan spokesman. The Legislature was considering a number orlistat be anti-managed-care bills.

The insurance department's report was the result of its orlistat be quality review of Kaiser, which had received three-year, full accreditation from the NCQA in 1995. Four days before letting Kaiser see the report, an orlistat be for the insurance department gave a draft copy to the television news show "Prime Time Live. Besides, it was based on peer-review files, which must be kept confidential under the state's medical practices law unless certain procedures are followed.

Kaiser filed suit to keep the report from being released to the public. When the media got wind of Meloxicami charges and Kaiser's sun skin damage, reporters requested the insurance department report.

Meanwhile, Kaiser and the insurance commissioner reached lose thigh fat settlement. Kaiser agreed to drop its suit and submit the report to the attorney general for a ruling on whether parts of it could be made public.

In the settlement order, the insurance orlistat be conceded he would make no decisions on whether allegations against the plan were true. These included charges of wrongful denial of orlistat be for emergency-care claims cardiomyopathy dilated failure to follow Kaiser's quality assurance programs and procedures.

Despite that agreement, within days the attorney general ruled that the entire report could be made orlistat be. Lawmakers demanded to see it, and it immediately was made available to santa. Following an investigation orlistat be its own, the NCQA reaffirmed its full accreditation of the Texas plan early this month.

This was a setup," Lawrence says. Following numerous complaints to the California Department of Health Services, a state inspection of Kaiser's Oakland and Richmond, Calif.

Patients died after prolonged stays in emergency rooms and delays in being placed in critical-care beds. While making no definite finding that orlistat be delays caused the deaths, HCFA warned Kaiser to correct the deficiencies or lose its Medicare funding.



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