We don't have a system.
We have a bunch of "things" for different classes of people. FWIW, a "network" is a collection of service providers (doctors, hospitals, labs, etc...) for which an insurance company has negotiated "special rates" in exchange for exclusive access to their subscribers. Every insurance company has its own rate card, which is why you can't get a handle on what a "typical price" is for anything. It is absolutely insane. Also, insurers are regulated by the state so while we might have a big company like Aetna as an umbrella company, I end up with Aetna CA - California specific version whose network only exists in CA. The existence of networks is part of why our stuff is screwed up. The other part is that only employers can afford to buy insurance so it gets tied to your job and ifyou're unemployed, you're uninsured. Of course the "cash" rate card is the most expensive one.
This is a great article on four models of health care systems in use around the world. And then it explains how the US has elements of all but no coherent system.
From the fine article:
These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we’re Britain or Cuba. For Americans over the age of 65 on Medicare, we’re Canada. For working Americans who get insurance on the job, we’re Germany.
For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you’re sick enough to be admitted to the emergency ward at the public hospital.
The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it’s fairer and cheaper, too.
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USA is a shit hole country.
We have a bunch of "things" for different classes of people. FWIW, a "network" is a collection of service providers (doctors, hospitals, labs, etc...) for which an insurance company has negotiated "special rates" in exchange for exclusive access to their subscribers. Every insurance company has its own rate card, which is why you can't get a handle on what a "typical price" is for anything. It is absolutely insane. Also, insurers are regulated by the state so while we might have a big company like Aetna as an umbrella company, I end up with Aetna CA - California specific version whose network only exists in CA. The existence of networks is part of why our stuff is screwed up. The other part is that only employers can afford to buy insurance so it gets tied to your job and ifyou're unemployed, you're uninsured. Of course the "cash" rate card is the most expensive one.
This is a great article on four models of health care systems in use around the world. And then it explains how the US has elements of all but no coherent system.
From the fine article:
These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we’re Britain or Cuba. For Americans over the age of 65 on Medicare, we’re Canada. For working Americans who get insurance on the job, we’re Germany.
For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you’re sick enough to be admitted to the emergency ward at the public hospital.
The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it’s fairer and cheaper, too.
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USA is a shit hole country.