4 ms·

Not OP, but switching providers could mean one actually provides coverage and the other regularly denies it. I have upgraded health plans in the past, only to

Not OP, but switching providers could mean one actually provides coverage and the other regularly denies it. I have upgraded health plans in the past, only to discover I spent more time fighting my insurance company because they just refused to honor the coverage. I actually had to get a lawyer involved at my own expense. I find it bizarre how many people just trust that insurance companies will actually honor their contracts. In my experience, they likely won't. This is just my anecdote.

shoemakersteve 5y ago
As a non-American, that sounds pretty fucked.
- lotsofpulp 5y ago
  It is not as bad as it sounds. There is an appeals process: https://www.healthcare.gov/appeal-insurance-company-decision/appeals/ https://www.healthcare.gov/appeal-insurance-company-decision... And in general, anything the insurance company might not want to pay for required a “prior authorization”, which usually happens if the insurance company’s doctors think there is another option for treatment or the proposed option does not have sufficient evidence. I imagine there is similar processes in taxpayer funded healthcare systems too to properly allocate resources. Although, I am sure there are many cases of problems caused by insurance companies in the US, due to the bureaucracy.
  - ThePowerOfFuet 5y ago
    It really is as bad as it sounds. >I imagine there is similar processes in taxpayer funded healthcare systems too to properly allocate resources. What the doctor orders is what you get. You can typically choose your doctor, as well as get a second opinion. The doctors are generally paid the same.
    - lotsofpulp 5y ago
      These are some pharmacists talking about prior authorizations for medicine, and they seem to exist in Canada, UK, AUS, and NZ. https://www.reddit.com/r/pharmacy/comments/oekhrp/curious_about_retail_pharmacy_outside_of_the_us/ https://www.reddit.com/r/pharmacy/comments/oekhrp/curious_ab... I would be surprised if any country gave doctors blank checks for everything since no one has unlimited resources. There most likely is a system for figuring out where waste is happening and avoiding it.
      - ThePowerOfFuet 5y ago
        I can't speak for all of Canada since health care is handled at he provincial level, but I think most provinces don't cover prescriptions except for the young and elderly, and even then prices are capped anyway.
      - lazyasciiart 5y ago
        Yes, but it's generally done on a national level. The waste in the American system is the requirement for an extra 73 rounds of paperwork for every interaction with the medical system.
- sdenton4 5y ago
  The American healthcare system is quite fucked. Proponents are typically profiting from it directly, have no idea what things are like in other places, or suffering Stockholm syndrome (and lack access to medical care to treat it).

shoemakersteve 5y ago

As a non-American, that sounds pretty fucked.

lotsofpulp 5y ago
It is not as bad as it sounds. There is an appeals process: https://www.healthcare.gov/appeal-insurance-company-decision/appeals/ https://www.healthcare.gov/appeal-insurance-company-decision... And in general, anything the insurance company might not want to pay for required a “prior authorization”, which usually happens if the insurance company’s doctors think there is another option for treatment or the proposed option does not have sufficient evidence. I imagine there is similar processes in taxpayer funded healthcare systems too to properly allocate resources. Although, I am sure there are many cases of problems caused by insurance companies in the US, due to the bureaucracy.
- ThePowerOfFuet 5y ago
  It really is as bad as it sounds. >I imagine there is similar processes in taxpayer funded healthcare systems too to properly allocate resources. What the doctor orders is what you get. You can typically choose your doctor, as well as get a second opinion. The doctors are generally paid the same.
  - lotsofpulp 5y ago
    These are some pharmacists talking about prior authorizations for medicine, and they seem to exist in Canada, UK, AUS, and NZ. https://www.reddit.com/r/pharmacy/comments/oekhrp/curious_about_retail_pharmacy_outside_of_the_us/ https://www.reddit.com/r/pharmacy/comments/oekhrp/curious_ab... I would be surprised if any country gave doctors blank checks for everything since no one has unlimited resources. There most likely is a system for figuring out where waste is happening and avoiding it.
    - ThePowerOfFuet 5y ago
      I can't speak for all of Canada since health care is handled at he provincial level, but I think most provinces don't cover prescriptions except for the young and elderly, and even then prices are capped anyway.
    - lazyasciiart 5y ago
      Yes, but it's generally done on a national level. The waste in the American system is the requirement for an extra 73 rounds of paperwork for every interaction with the medical system.
sdenton4 5y ago
The American healthcare system is quite fucked. Proponents are typically profiting from it directly, have no idea what things are like in other places, or suffering Stockholm syndrome (and lack access to medical care to treat it).