Gail Saivar is feeling a little sheepish these days about the answer she gave to a local newspaper doing a feel-good Thanksgiving story last month. Asked what she is thankful for, Gail, not exactly gushing but nevertheless feeling a holiday glow, said "Kaiser Permanente."

Two days later, Gail received her Kaiser notice for coverage in the upcoming year. As soon as she saw the envelope, her warm fuzzy feeling melted like snow on the sun, replaced by an icy chill slithering down her spine. So sure was she that the news was bad, she waited a couple of days before opening it. "I didn’t want to ruin my weekend," she says.

The damage was extensive: her monthly premium shot from $295 to $493. Her hospitalization costs went from nothing to $200 a day, and her co-pay increased. "I was stunned," she says. "Shocked. I thought, this has to be a mistake."

It was no mistake, however. Gail, like so any Kaiser members, is receiving double digit increases in health premiums. Some subscribers have seen their rates double in two years.

Many Kaiser victims are long-time Kaiser subscribers. Others, like Gail, have signed on in the past decade. A native of St. Paul, Gail came to California in 1970. For the next couple of decades, health care was not a major concern, and she handled her coverage routinely and without incident.

In 1998 Gail signed on to a Kaiser personal plan. When she turned 50 later that year, "my rates went way up." She was appalled that her girlfriend, who joined at the same time, had much lower rates because she was under 50. Still, Gail was able to handle it, and didn’t feel unhappy with her coverage.

Since then, however, her rosy words on Thanksgiving notwithstanding, each year has brought a jump in Gail’s Kaiser rates, culminating in this year’s mega-boost. It is getting to be too onerous a burden for Gail, a self-employed contractor who owns an advertising business.

"I’ll somehow manage," Gail says, but she admits she is worried. Business has slid the past three or four years. The uncertainty brings great stress and anxiety. "I’ll panic. If it’s this bad now, what’s it going to be in three to four years? What am I going to do (then)?"

She already has put off home repairs because of the increase she just received. She was about to take out a home equity loan to hire a landscaper, but as soon as she saw Kaiser‘s Christmas premium, she called the landscaper to tell her it was off.

Gail, with her hard-working mid-western values and existing business, has the toughness and resources to muddle through. But she worries about others less well off. "What about people who make a hell of a lot less than I do?" she asks.

She thinks it’s no accident that premiums get less affordable as people grow older. Like many HMO patients, she believes Kaiser would like to jettison its older patients, no matter how long they have been with the health care giant. There is no such thing as customer loyalty when money is involved, and keeping aging patients could mean more payout for coverage. "As we get older our bodies start to fall apart. Of course they don’t want us," Gail says.

She adds that Kaiser is wreaking havoc on employers as well with exorbitant increases. "My biggest client has Kaiser, and they’re freaking out," she says.

Gail is angry now, and wants to know what people can do. "Are there no restrictions placed on these HMOs at all? How is an ordinary person supposed to pay these outrageous fees?"

She is writing letters to legislators. But she wishes the people of California would arouse themselves and take political action. "Should we get a bunch of people to picket?" she asks. But she adds, "we’re so apathetic about everything."

Gail would like to see the state step in and freeze rate increases. She would like to see management salaries published. She realizes that calls for such reforms will invite accusations that she is pushing for "socialized medicine." But so what, she asks.

"England and Canada rave about their systems," she says, despite efforts by the U.S. mainstream media to denigrate universal health care. "I’m seriously thinking about moving to Canada."

But Gail is baffled and angry that her own country, her own state can’t fix this problem and provide its citizens with one of the most basic services any government ought to provide: health care.

"What is the problem?" Gail asks. "It’s corporateering. Why is it so difficult for the greatest nation on earth to get this right?"