The Context of American Healthcare
Most countries consider preventative medicine to be the most important element of a stable society that treats its citizens like they matter and are important. Here in America, profits tend to be more important than people. As a result, the connective tissue of our medical system is not preventative care and ensuring that people live lives that prevent them from getting sick, instead, we are mostly focused on making sure that everyone has health insurance and health insurance companies are duly compensated for their service.
As a result, it is critical to ensure that you are making the right decision for yourself when you are thinking of what type of health care plan to choose. In most countries, if you are giving birth to a baby, you go to the hospital, give birth, and then go home. There is no cost attached to giving birth in almost every country in the world except the United States of America. In this country, it costs at least $10,000 to give birth. Yes, you read that correctly: Americans are paying tens of thousands of dollars to give birth at the bare minimum. You can click here to learn more about the costs of giving birth in America.
Most people end up indebted to the hospital just because they chose to bring a life into this world. In a country that is attempting to ban abortion right now, we do not have the social safety nets that would make it easier for women to actually become mothers. We want pregnant people to give birth, but we do not even consider the fact that we charge people for doing so. We also have a massive baby formula shortage and many Republican politicians voted against it, arguing that people should “just breast feed” as though they took no scientific knowledge into account when making these decisions.
Therefore, when it comes to deciding what type of life you want to live, you have to consider what type of health insurance you want. And it can be incredibly daunting to people who are not accustomed to this system or who are joining it for the first time. You can pay your insurance bill on time every single month without fail and still discover that you still owe money on your deductible, your co-pay and the many other steps that American health insurance companies take to make sure that they do not actually have to pay for your health care, despite the fact that you are paying them to do exactly that.
For example, until President Barack Obama passed the Affordable Healthcare Act, it was legal for American insurance companies to refuse service to people who were paying them for help due to “pre-existing conditions”. Meaning that if you were sick or hurt in any way before you got health insurance, the health insurance company had the right to refuse you coverage. Does that sound deeply unethical and disgusting? Yes, you would be right because that is exactly what it is. Jumping through hoops to survive is the American way, because in the United States, the needs and wants of massive corporations will always be more important than the needs and wants of ordinary people.
Which Plan Should You Choose?
When considering Medicare HMO vs PPO, you have to do a considerable amount of research before making your decision. This is a fairly difficult decision because many people cannot even determine the difference between those two plans. PPO is a Preferred Provider Organization while an HMO is a Health Maintenance Organization. The fundamental difference between these two is the concept of a Network. In the United States, medical facilities exist in Networks that are linked to insurance companies.
You have to pay a fair amount of money out of pocket until the deductible is met. The deductible is the amount you have to pay in addition to your monthly fee before the health insurance company will put any money towards the costs of your care. So if you have not made it to your deductible, you will continue to pay full price for many of the services that you think the health insurance company should cover. However, if you select an HMO plan, you are more likely to pay less in deductibles if at all. Additionally, you may not have coinsurance payments or copays for medicine.
Under a PPO insurance plan, you will not select your own primary care provider. One will be provided for you by the PPO Network, because again, you must remain in-network to be seen by someone. In a PPO Network, you simply do not have to receive a referral to see a specialist of your choice. Do you need to see a dermatologist? You can simply go see one that is in your Network without getting, in essence, a permission slip from your primary care provider, which would cost you another visit.
Under a PPO plan, you also can see doctors that are out of Network in case of emergencies and your Medicare (https://www.kff.org/interactive/medicare-spending/) plan will cover those costs. Was that complicated to think about? That is by design because American healthcare is tricky on purpose. Instead of thinking of preventative care, the United States is focused on making money. This is why you need to think carefully before making these decisions and you should carefully research before choosing.