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When I found myself between jobs last year, I knew I would go through rough times taking care of my health needs until I found a new employer. Nevertheless, I thought I could handle it, for a while at least.

Today I can only look back in wonder and anger at how naive I was and how ruthless Kaiser Permanente is. I am now paying far more for health care than I thought possible. Meanwhile, the level of services has gone down.
I am not alone.

I left a full-time job in March of 2002. My former company had taken care of my health care needs, through Kaiser. I was receiving decent care, especially during the last few years, when I found a doctor who was both competent and caring. I had dental, vision, and prescription drugs covered, and a reasonable co-pay for doctors' visits.

Under COBRA, which I subscribed to when I left the job, I continued the same level of coverage, paying a bit more each month. Six months went by. As October loomed, so did a $400 monthly COBRA premium. I had no full-time work yet, so I opted out of COBRA and looked for a Kaiser plan I could afford.

The least expensive left me with no dental, vision or prescription coverage, and a $20 co-pay for doctors' visits. Nevertheless, at $239 a month it was all I could handle. So I signed on, beginning October 1. I figured if I was careful I could avoid the dentist and the optometrist for a few months until I had a regular job. I began to brush and floss my teeth with a new vigor, and stocked up on carrots.

Imagine my surprise when I received a letter in December telling me my premium would go up to $345 a month on January 1, 2003 - a 44 percent increase.

After enduring a typical HMO runaround I learned that my costs had gone up for two reasons. The first was because I had turned 60 in 2002. At particular ages, Kaiser figures you are a bigger risk and arbitrarily charges you more.

Kaiser's minions had neglected to mention this age problem to me when I signed up for their supposed $239 a month plan in September, even though I already was a sexagenarian at the time: my birthday was in July.

It probably slipped their minds.

The second reason was a simple cost-of-living increase or, as I like to think of it, a make-the-customer-pay-for-the-drubbing-we-took-in-the-stock-market increase.
Again, nobody had breathed a word about this in September.

So, there I was, paying more money for less coverage and more or less locked in. I couldn't realistically think of going elsewhere because I have a pre-existing condition.

Besides, I didn't really want to leave my current doctor. Finding a trustworthy doctor in today's health care system has become harder than finding a good auto mechanic, and the customer's feeling about it is similar: this took me years, you think; I'm not changing.

So I'm stuck until I can find an employer who has a health plan and will hire me full-time.

The situation is perilous financially, and affects all my health care decisions. The annual dental checkup is out; so is the vision exam: I simply can't afford them. I won't go to the doctor unless I absolutely have to. I have expunged the phrase "preventive medicine' from my lexicon unless by preventive you mean don't get sick. My anxiety level has jumped (I could see a Kaiser shrink, but the co-pay is now $20 a visit; better to bite my nails.)

Ironically, as I look for regular work, I have landed some free-lance jobs that have me interviewing other victims of the health insurance industry. Most of them feel betrayed and jerked around, as I do. Many of them are in far worse straits.

There is little question in my mind that the health care delivery system in California is putrid and decayed. It is sucking the life out of patients.

Maybe when the state does its job and regulates this, health care will finally serve patients.