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New 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.
New Thank you for being here
Your viewpoint is always welcome.

Aka: Todd's back, yay!
New 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.

New 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.

It's mourning in America again.
New Nice ..but ugly, clarification.
New Holy geez
Hi Todd. Good to see you again.
     When it rains it pours - (drook) - (31)
         any idea of the cause? -NT - (boxley) - (10)
             It just keeps getting better - (drook) - (9)
                 your foot not the parents :-) -NT - (boxley) - (2)
                     Thought I said ... Yeah, I did - (drook) - (1)
                         ok missed that, ouch! -NT - (boxley)
                 Most sorry to hear of so narsty a convergence as seems near enough ... Diabolical. - (Ashton) - (5)
                     Yup, convergence seems to be going around. - (Andrew Grygus) - (4)
                         Ummmm.. - (Ashton) - (3)
                             Oh, I've bailed her out of one disaster . . . - (Andrew Grygus) - (2)
                                 Ahh.. Understood (!) to a fare-thee-well. :-) - (Ashton) - (1)
                                     Translation: - (Andrew Grygus)
         Well, shit - (pwhysall) - (16)
             Truth - (drook) - (15)
                 You're not getting surgery out of state are you? - (crazy) - (1)
                     That's what I need the consult for - (drook)
                 Re: Truth - (TB D)
                 Are none of these weird "networks" nation-wide? If not, why not? - (CRConrad) - (11)
                     Individual states are responsible for issuing insurance licenses. -NT - (mmoffitt) - (3)
                         Yeah, so? If you're MegaInsurance Corp, you just get licenses from many/all of them, no? -NT - (CRConrad) - (2)
                             It's not cut and dried. - (mmoffitt) - (1)
                                 (That this mode has been perpetual: defines the *Shame* of USian ongoing, fecklessness): Duh! -NT - (Ashton)
                     Re: Are none of these weird "networks" nation-wide? If not, why not? - (TB D) - (5)
                         Thank you for being here - (crazy)
                         Preach It! Brother; that's Best short-summary yet peeped; we suck so hard: it's a [-]-vacuum Bizness - (Ashton)
                         Exactly. - (mmoffitt) - (1)
                             Nice ..but ugly, clarification. -NT - (Ashton)
                         Holy geez - (jake123)
                     as usual it depends is the answer, I work for a large multinational comany - (boxley)
         Holy wow, Drew. Best of luck for all of that -NT - (malraux) - (1)
             Amen to that! -NT - (a6l6e6x)
         Ouch. - (jake123)

We need to drill for VASELINE in ALASKA!
95 ms