<p>I’m from the west coast. I have no idea which way the New York Post leans. So is it untrue? And if a biased publication reports a story, is it always untrue? Maybe sometimes, I suppose. But is this story not truthful, or is it purely suspect because of the source?</p>
<p>And I don’t want to upset the order of things, texas, I really don’t know. Don’t want to post anything biased, but this is what I googled when I was looking for info for my friend. I just want to know if this is accurate.</p>
<p>Is your friend in NY? otherwise it won’t make a difference since ACA plans are mostly within state and everything else is considered out of network.</p>
<p>Southbel is having a similar issue. You should probably follow her posts and responses.</p>
<p>When I google which networks Sloan Kettering covered in Washington, I didn’t get anything useful. Plus, earlier links didn’t give me that information either. I don’t know if they are covered in our state. I really do think maybe the best bet for my friend is to just get the minimum required, and go out of network for all specialists. At least the plans pay a little (50%, I think)?</p>
<p>My friend is in Washington state, texas. I’ll go back and look at Southbels posts, but I think she wasn’t having any luck with out of state plans. My friend probably should just accept that if something serious happens, she’ll just need to go out of network if she decides it’s best.</p>
<p>Are there Sloans outside of New York, in Washington? No plan in Washington would cover Sloan except as out of network.</p>
<p>GP has been complaining about the plans for a couple of months. I have offered to help him relocate to Houston where the best hospitals are on the multitude of plans. </p>
<p>Does your friend want to move to Houston. :p</p>
<p>We all are concerned with costs, but the bottom line will be - for many - where they can get care, if they really need it. </p>
<p>You can get your arm set anywhere, but if you have a brain tumor, or need a transplant or a cancer scare, where can you get good coverage? </p>
<p>It is interesting, because most of us never really think about it, till we are in the situation where we have to figure it out and things are scary. </p>
<p>We all are focused on price of plan, but the big picture will be important, too. Not just monthly premiums, but what happens if something BAD happens and you do need to hit your max that year and find out who will help you? </p>
<p>When we were shopping on private market a few years ago, concern was with costs and care. Knew there was a good chance we would need one surgery, and heard good things about the doctors. Chose that plan, because of it. I have no idea how this company fares on things like cancer treatment or heart attacks or anything else. </p>
<p>Yet, my H and I are getting older, and that is a concern.</p>
<p>I actually have no idea, but I’m sure she’s talking about Sloan Kettering in NY. Actually, I hadn’t realized that the rules for new individual plan must comply with ACA rules…ie, not just minimum coverage for certain issues, but who they allow companies to consider in network. She’s not talking about an ACA plan, but are they now all the same plans offered as private plans? Is it correct that not only are there now new minimums, but plans are only allowed to offer certain providers as in-network?</p>
What part of the word “OPINION” posted prominently at the top of an article don’t you understand?</p>
<p>
Op eds in any publication, biased or not, are not “reporting a story.” That’s why they are labeled “opinion” – it is the publication’s way of telling you that they are not representing anything in the article as “fact.”</p>
<p>I know a number of people with cancer. Everyone who could afford it, tried to at least get a second opinion on Sloan and/or MD Anderson. Even though we have a cancer center at UofM and Mayo clinic.</p>
<p>"Your friend lives in Washington and she is worried about a hospital in NY?</p>
<p>Your initial post read weird, Busdriver11. A Colbert skit?"</p>
<p>Ha, ha, no! Just got off a phone call…don’t know if I got it right. But it does make sense. If you are a well off person, with an alarming family history, and you are a physician with strong opinions about hospitals and doctors…you might want access to the best specialists in the world, just in case. Doesn’t sound too weird to me, really.</p>
<p>“What part of the word “OPINION” posted prominently at the top of an article don’t you understand?”</p>
<p>That’s kind of snarly, calmom. I guess it didn’t register to me that since it said “opinion” that therefore it must be untrue. In fact, I didn’t even notice that it said “opinion”, but it seemed to match with what my friend said.</p>
<p>But, in your opinion, is this true? Or is it false? What do you think?</p>
<p>I think a second opinion may be warranted. That isnt necessarily expensive. I thnk there are other places beside Sloan and MD Anderson that are pretty good. We have Stanford and UCSF around here. For rare cancers, there are other good places below the radar.</p>
<p>Busdriver11, what is wrong with the Seattle Cancer Care Alliance?</p>
<p>ACA doesn’t tell the insurance companies who to include in their network, other than mandating coverage for the listed essential benefits. (That is, presumably they will need to include obstetricians and psychiatrists in their networks to meet the requirement that they provide maternity and mental health coverage). </p>
<p>There is no legal difference between a pre-ACA or a post-ACA plan related to who they include in their networks. PPO’s, EPO’s, and HMO’s are and have always been a matter of the insurance companies contractual relationships with various providers.</p>
<p>It’s obvious rhetoric, not even intended to be taken seriously: “To keep costs down, the White House designed ObamaCare plans as cut-rate HMOs.” The White House had direct role in designing ACA plans or telling insurers what to charge or who to include in networks. So right there you know that the article is not fact-based. (The opinion that the plans are “designed” to be cut-rate HMO’s is based on the reference to “low profit margins” in the following sentence: the opinion writer is framing an argument that the 80%/20% rule makes it so unprofitable for insurance companies that they are forced to restrict their networks to providers willing to discount their services.)</p>
<p>The Mayo Clinic is low cost relative to comparable high-end specialty care facilities on the East Coast and in California. It is high cost relative to everything else in Minnesota. </p>
<p>I think the problem is that in addition to functioning as a high-end specialty care system serving a national and international clientele, the Mayo Clinic is also pretty much the only game in town for routine medical care in and around Rochester, MN, and it charges much higher prices for those basic services than any other health care provider in the state. So in a sense local residents who rely on Mayo for routine care may be subsidizing the high-end, high-need patients who jet in for boutique care.</p>
<p>Of course, when Joe Doaks from Rochester, MN needs to have his broken arm set, he’s proud to tell his friends and relatives he had it done at the world famous Mayo Clinic. So that’s worth something, I guess. Though folks in Rochester don’t seem very happy to be paying the highest insurance premiums in the state.</p>
<p>"I think a second opinion may be warranted. That isnt necessarily expensive. I thnk there are other places beside Sloan and MD Anderson that are pretty good. We have Stanford and UCSF around here. For rare cancers, there are other good places below the radar.</p>
<p>Busdriver11, what is wrong with the Seattle Cancer Care Alliance?"</p>
<p>I think for someone who is really knowledgeable about this stuff, they may have a very strong opinion about what is best. Maybe a little different than most people would. I don’t think there’s anything wrong with the Seattle Cancer Care Alliance (but what do I know), it’s just the article said that it wasn’t covered. I always thought I’d go there if I needed…but that’s just based upon great commercials, not valid data. Then again, calmom thinks it’s all rhetoric, so maybe who is not in network is untrue.</p>