Quote:
Originally posted by Sidd Finch
Is that because people chose to move from plan to plan? Or is it because they had to -- either because they changed jobs, their employers changed providers, or (as has happened to me countless times) mergers among HMOs led to the plan effectively being changed on them?
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I think it was a lot of things. I think especially that Americans are spoiled about going to the physician of their choice and don't like to be limited by the plan's rules and regs. So they didn't
like the gatekeeper model which assumed some basic competence in a lot of fields by PCPs.
Members wanted to skip the (less expensive) GP appointment and go straight to the (more expensive) cardiologist, orthopedist, allergist, etc. and get lots of tests because, of course, American consumers know more about healthcare than their physicians do. Sometimes that's the case, a lot of times it's not.
As people started not liking the concept's limitations, the plans started changing until pretty much they're less HMOs and more PPOs with exclusive contracting for in network physicians and hospitals.
I've been on a Blue Cross PPO for years, and I'm pretty happy with it. Of course, it's only paid for my nurse practitioner visit once a year and birth control prescriptions, so I'm printing money for them.
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