Posted on 06/24/2017 4:14:38 PM PDT by Kaslin
But we would sell a &*^% load of tennis shoes and televisions for that first 10 years......
No, actually trauma care, the broken leg, the asthma attack, and most other trauma required services, are on the healthcare plans under two main, and one other little used plan.
The following is off the Blue Cross and Humana pages:
PPO stands for Preferred Provider Organization. A PPO health insurance plan allows for more flexibility and more choices when it comes to your healthcare. A PPO plan offers a network of healthcare providers to choose from, and you have the freedom to receive care from any in- or out-of-network doctor, specialist or hospital without a referral. This is the more expensive of the plans with higher cost shares and co-pays.
Where as an HMO stands for Health Maintenance Organization. With an HMO plan, you must choose a Primary Care Physician (PCP) from a network of local healthcare providers who will refer you to in-network specialists or hospitals when necessary. All your care is coordinated through that PCP.
The basic single payer we are stuck with today is the Affordable Health Care Act. Under ObamaCare most plans are either HMOs or PPOs. There is also an EPO but it is little used as it offers no out of network benefit.
Most HMOs or PPOs are geared to cover ER visits. But its important to know that your coverage for your emergency room visit ends when you are admitted to the hospital. You need to contact your PCM making sure that it is in your network and/or referred by your PCM. If it isnt, and in theory, you would be on the hook for the entire cost from the time you walked into the ER to include even if the hospital accepts your plan.
The only other plan that most get into and off the above is with medicare. But most purchase a supplement to assist the costs there. And you pay for medicare for emergency room visits under part B. Co-pays also.
The point of the original article was to indicate just how far off the California government was in their assumption of the implementation and use of a single payer product. In the mid 80s my spouse was the second benefit service rep ever hired by tricare, the government program. The startup costs to create the system of either the rules, or the physical costs of just normal operations, were astronomical. But uncle sugar had the never ending checkbook, and paid for it. (No one knows how much or is willing to admit it)
That program, which has morphed a number of times and changed controlling companies a number of times in all three regions, is still in effect today. The active duty do not pay for it, the retirees do up to 65 years. At 65 they transfer to tricare for life, which is at no cost and limits the use of federal hospitals but opens up the outside providers as a secondary to medicare. I supplement with it, medicare my main.
But California has run into a cash flow problem and cant use the fed checkbook for their product. And many people, to include illegals, are just walking into ERs and sitting until the doctors Hippocratic oath forces care and then walking out without any payment. Is it legal? Not really but theres nothing they can do to them. They dont even have to give their name Is it moral? Not when you force people that have nothing to do with you to absorb costs you create. So this big boast by Gov. Moonbeam was full of it from the start.
rwood
Ah, the wages of “Embracing Diversity.””
They'll just claim residency in another State and say that Hollywood is really their winter home.
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