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I have a choice and elected to pay the extra money to be in a PPO, rather than an HMO, in California. and generally do not have to wait--except in ER's which can be unbelievable.  though I must admit they do a good job of triaging and handling the most critical cases.

California would be a great example though of what you are talking about.  Doctors are being squeezed by California Medicaid, Medicare, etc.  In fact my urologist just moved back east because he felt the financial situation for him personally is just out of control.  I wouldn't want to defend this statement right now (because I'm hoping to write a diary with a friend on this issue soon), but HMO's have a lot of the practices of a nationalized health care system.  So you may be getting a glimpse of socialized medicine.

Just to finish on this California point however.  The extreme tightening of healthcare mayments by the government, the very cost competitive nature of HMO's in California, are IMO driving down the quality of healthcare for all--even myself as a PPO.  I have an unusual work and travel schedule now, and am able to choose where to have my doctors and main care (obviously not emergency care) and I've moved our doctors and main care providers to Illinois, where personally I've found the care far better.  I know this is an extremely unusual situation (and for me too)--but just mention it because, once again IMHO, I don't think Americans understand the lower quality of care in socialized medicine than they are used too--and HMO's are a glimpse at that care.

IMHO, and obviously all our financial situations are different, but I would recommend people sacrifice on some other area of their spending, and pay the extra for a PPO.  

by wchurchill on Thu Oct 13th, 2005 at 09:02:05 PM EST
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