Truth

Post #434,893 by drook 6/29/20 3:44:37 AM 6/29/20 3:44:37 AM Reply	Truth I'm out of state, so anything that happens here is out of network. -- Drew
Post #434,895 by crazy 6/29/20 8:17:02 AM 6/29/20 8:17:02 AM Reply	You're not getting surgery out of state are you? I assume whatever you doing now was diagnosis and then get you back home for the follow up, right? Or is there a time constraint?
Post #434,897 by drook 6/29/20 8:23:30 AM 6/29/20 8:23:30 AM Reply	That's what I need the consult for Do I need surgery; and if so, how long can I defer it? -- Drew
Post #434,899 by TB D 6/29/20 11:47:46 AM 6/29/20 11:47:46 AM Reply	Re: Truth Sorry to hear that. Medical networks are bullshit. We should have national health care by now. Hope things start looking up. Crazy times.
Post #434,931 by CRConrad 6/30/20 10:50:03 AM 6/30/20 10:50:03 AM Reply	Are none of these weird "networks" nation-wide? If not, why not? It's not as if the insurance companies behind them are all tiny just-one-state outfits, is it? And: People travelling between states, is that a shockingly new development that has only started after the Corona pandemic, or WTF?!? I really don't get your fucking system. The USA spent the 20th century basking in the admiration of the world, for being some kind of "Mecka of modernism" -- but when one looks closer at it, a lot of the country is run on much more 19th-century principles than the rest of the world. (Like, banking: Sending paper checks around in the post... Sheesh!) -- Christian R. Conrad The Man Who (used to think he) Knows Fucking Everything Mail: Same username as at the top left of this post, at iki.fi
Post #434,932 by mmoffitt 6/30/20 11:23:37 AM 6/30/20 11:23:37 AM Reply	Individual states are responsible for issuing insurance licenses. bcnu, Mikem It's mourning in America again.
Post #434,940 by CRConrad 6/30/20 3:56:43 PM 6/30/20 3:56:43 PM Reply	Yeah, so? If you're MegaInsurance Corp, you just get licenses from many/all of them, no?
Post #434,966 by mmoffitt 7/1/20 9:59:52 AM 7/1/20 9:59:52 AM Reply	It's not cut and dried. Todd below described what networks are, but the nut of it is that before you go into a state to sell your health insurance, you better be sure you can get enough business in that state to have the numbers of insured high enough that you can negotiate reasonable (read: profitable) fees with that state's healthcare providers. Simply put, you've got to be sure you can make money in the state first. You can't look at our system with the belief that our health insurance industry is designed to provide health care for our population. It isn't. Our health insurance industry is designed (like everything else) to bring value to the shareholders. Having to pay for somebody's actual health care is just "a cost of doing business" that is avoided wherever possible. Our health insurance industry is in the business of collecting premiums, not paying claims. bcnu, Mikem It's mourning in America again.
Post #435,022 by Ashton 7/4/20 4:15:44 PM 7/4/20 4:15:44 PM Reply	(That this mode has been perpetual: defines the Shame of USian ongoing, fecklessness): Duh!
Post #434,937 by TB D 6/30/20 12:50:51 PM 6/30/20 12:50:51 PM Reply	Re: Are none of these weird "networks" nation-wide? If not, why not? 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. ----- USA is a shit hole country.
Post #434,952 by crazy 6/30/20 7:01:38 PM 6/30/20 7:01:38 PM Reply	Thank you for being here Your viewpoint is always welcome. Aka: Todd's back, yay!
Post #434,956 by Ashton 6/30/20 7:26:34 PM 6/30/20 7:26:34 PM Reply	Preach It! Brother; that's Best short-summary yet peeped; we suck so hard: it's a [-]-vacuum Bizness Appreciations from moi: As a privileged-White-person, one also with the (rare-as-hens'-teeth) de-$$Bizness-icated Retirement coverage: I daily count [those 'blessings' things]. Gloating?--not a fucking-Bit: know too many who are among the Majority-totally-Fucked by the disgusting root-cause of most every absurdity we might care to analyze: 'Murican Vulture Kapitalismo is the root-Cause of this Failed-'state's predicament as-we-speak. It cossets the very-Ethics-free tiny minority as have pillaged this banana-'republic' throughout my lifetime /from the 'Tipping-Point' of sentience arriving in my jelloware. (Much of our National Clusterfuck derives IME from the 'accident' that: in Males, testosterone enables/intesifies! the Violence-tic) ... from the pig-ignorance folkways-growing-up on to --> the totally Ethics-free daily habits [some %Huge] of virtually every 'Bizness': management and daily-operation [Daily-Lying] takes its toll in destroying Conscience. Add-in the Rebel-flag-masturbating masses and ya gets: Just What you so ably ..just wrote. (I feel privileged too, that IWE--even exists) as the rarest kinda tribes. This amidst the so-many-wannabes' Hangouts, where maudlin-BS is the general level of such time-filler spots ..at grammar-school vocabulary-levels [emulating too often that deranged Man-child-in-Chief]. Etc. So.. Thanks Todd [Et Alia!]. Competence!, especially within a Clusterfuck Collection to End-all-clusterfucks: proves to be in shorter supply as the stakes climb ^Upwards^ via the anti-gravitas of the Fascists' chosen form of Non-governance. Circus of the Macabre.. ..we gets to Examine it, whether wanting-to or not. 40
Post #434,964 by mmoffitt 7/1/20 9:47:12 AM 7/1/20 9:47:12 AM Reply	Exactly. One thing of note, California has, for example, stricter labor laws than most states. It makes sense for Aetna to carve their California business out separately. They sure don't want their Indiana office to be subject to the sort of employee protection laws that are present in California. It's a minor contributing factor to why the umbrella company carves themselves into smaller bits, but its contribution is non-zero. Also, in those negotiations you mentioned, Aetna lumping together the members they have in Michigan, Illinois or New York doesn't help them in California. No provider (physician, lab, hospital, etc.) cares how many non-California members a company has and so there's no incentive for Aetna to have everyone lumped together. bcnu, Mikem It's mourning in America again.
Post #434,994 by Ashton 7/2/20 2:53:46 PM 7/2/20 2:53:46 PM Reply	Nice ..but ugly, clarification.
Post #435,035 by jake123 7/5/20 11:36:07 PM 7/5/20 11:36:07 PM Reply	Holy geez Hi Todd. Good to see you again.
Post #434,974 by boxley 7/1/20 1:15:38 PM 7/1/20 1:15:38 PM Reply	as usual it depends is the answer, I work for a large multinational comany US side we have presence in many states so the company rents an insurance company to process claims for the cheapest cost possible. The one they rent has mostly nationwide coverage so If I travel I can usually find a provider that is under their umbrella. "Science is the belief in the ignorance of the experts" – Richard Feynman

Welcome to IWETHEY!