What happened with HMOs?
HMOs are so much better than PPOs, but they&#x27;re rare these days. They are significantly cheaper than PPOs. Most HMOs don&#x27;t have deductibles, and all of them have lower premiums than PPOs. The &quot;out of network&quot; coverage of PPOs is an irrelevant scam. Your insurer covering 10% of a $200,000 out of network surgery is still going to bankrupt 99% of people in America.<p>HMOs require you to get a referral from your primary care doctor to see a specialist, which has the added benefit of making sure people actually <i>have</i> a PCP. Primary care is one of the few types of care where the more you apply it, the better a patient&#x27;s health outcome.<p>No one gets an HMO because they&#x27;re scared of having less choice of which doctors they can see. They pay more to have a choice that&#x27;s ultimately irrelevant to their health. Most people choose doctors based on friend&#x2F;family referrals and Yelp reviews, meaning they don&#x27;t know how to choose a doctor. Reviews&#x2F;referrals have no relation to health outcomes.<p>The end of the article refers to the &quot;medical loss ratio&quot; enforced by the ACA, which did indeed incentivize insurance carriers to tolerate higher healthcare bills. This affects PPOs much worse than HMOs. It should all be burnt down.<p>Further reading, one of the best books on the subject: &quot;An American Sickness&quot;