Kaiser Foundation brought HMOs to the US through their relentless lobbying efforts.
You know the Health Maintenance Act of 1974 was horrible just by the fact that it was bipartisan. Nixon and Ted Kennedy pushed hard to get it passed.
Why did it take a federal law to make HMOs legal in the US? Because prior to the Act became law, it was illegal in every state for a doctor to accept payment for withholding treatment.
California, dominated by Kaiser, is effectively a German-style health system. The hospitals, clinics, and diagnostic facilities are owned by Kaiser and the doctors are employed by Kaiser.
This might not affect your health if you have, at worst, a chronic condition like Type 2 diabetes which is treatable with generic medications. It’s not so good if you want a new treatment or off-label usage of a drug. Want a second opinion? Sure, my colleague, also employed by Kaiser, will be happy to provide one.
Doctor shopping for HCQ isn’t likely to work at Kaiser if that’s what you’re getting at.