ABSTRACT
In the mid-1990s, the big health conglomerate Kaiser Permanente was looking for cost-cutting measures. Managed care had begun in earnest, and any big insurer had not only to pay medical staff, facilities and equipment costs, but the health dollar had to cover more administrative expenses, executive salaries, and shareholder profits, as well. The designers knew that a major drawback of obesity clinics in the past had been the high drop-out rate. The model clinic began operation, but to the company’s dismay, it was soon evident that the drop-out rate was almost as high as for other obesity clinics. Childhood abuse and childhood neglect are bad. Worse even than we thought, because of their ability to increase the risk for virtually all mental illness and many chronic, debilitating, and deadly physical ills decades after its occurrence.
