Healthcare is in crisis in the US, though thankfully it hasn’t affected my family – at least as far as I know. Too many people don’t have insurance (about 28 million as of 2026!), and even the ones who do have trouble getting proper care. Here’s a plug for Kaiser Permanente’s healthcare delivery model as the way to get the US out of crisis mode.

Access and affordability – those are the problems. Healthcare is expensive, and even when you’ve got insurance coverage it can be tough to get proper care approved by insurance. Kaiser solves both those problems and does it with an efficient, friendly, non-nonsense delivery process.

Kaiser is unique in that it is BOTH an insurance company and a healthcare delivery system. It manages the conflict/tension between cost of care (insurance) and quality of care (doctors and nurses) internally, where patients don’t see it. In fact they encourage tons of preventative care, as their studies show that preventing diabetes/obesity/infection/cancer/etc is so much cheaper than treating it once the disease becomes acute. Kaiser wants the same thing you do – to be healthy and feel good. Makes sense, right? Align the incentives.

I just got back from a visit to a KP primary care doc to get a spot of actinic keratosis (sun damage) on my hand frozen and dealt with. It was soooo easy. Online scheduling with a primary care MD, an appointment in 3-4 days, a 5-minute wait with cell phone checkin, a 15 minute consult and procedure. Absolutely zero problems and zero extra cost. With Medicare Advantage coverage of about $400/month (I think that’s affordable), I pay NOTHING for prescription drugs, no copays, nothing for MD visits, nothing for hospital visits.

And I had a stellar experience at KP with the only two serious med problems of my adult life – kidney problems leading to sepsis, and a knee replacement. In both cases I paid nothing extra and received incredibly good care. The Kaiser hospital room I stayed in for sepsis (6 days!) was a private room as nice as any hotel I’ve been in. So yeah, I’m a huge Kaiser fan.

Kaiser Permanente covers about 13 million people across CA, Colorado, Georgia, Hawaii, Washington, Oregon, Virginia, Maryland, and the District of Columbia. We need about 20 regional copies of their system to do the job for everyone else. This isn’t socialism – KP makes a shit ton of money – it’s just common sense. Get rid of the conflict between insurance and care, and the system works.