On Mon, 11 Apr 2016 06:12:56 -0700 (PDT), Cindy Hamilton
> wrote:

>On Monday, April 11, 2016 at 7:31:25 AM UTC-4, wrote:
>> On Mon, 11 Apr 2016 03:55:43 -0700 (PDT), Cindy Hamilton
>> > wrote:
>>
>> >On Sunday, April 10, 2016 at 10:32:35 PM UTC-4, Doris Night wrote:
>> >
>> >> While we're on the topic, Americans (including you, Julie) frequently
>> >> go on about not having access to doctors outside of their insurance
>> >> company's group. I forget exactly what you call that. In Canada, there
>> >> are no restrictions like that.
>> >
>> >There are hundreds (or thousands) of different health insurance policies.
>> >
>> >With some, you are covered only if you see doctors approved by the
>> >insurance plan (unless it's an ER visit).
>> >
>> >With others, you are covered a lot for doctors participating in the plan, but
>> >less for doctors who are not participating in the plan.
>> >
>> >With still others, you can see any doctor anywhere and coverage is the same.
>> >
>> >Typically, the first arrangement is has the cheapest premiums and the
>> >third arrangement has the most expensive premiums. My employer offers
>> >insurance of the first type, and my husband's employer offers insurance
>> >of the second type. Our portion of the premiums is the same for either
>> >one, so we buy his insurance instead of mine. Why is the cost the same?
>> >Either it's because his company is a great deal larger than mine, or
>> >because his company picks up a greater percentage of the premium.
>> >
>> >Cindy Hamilton
>>
>> Wow that's complicated ! It's very confusing - do they actually give
>> you lists so you will know where to go or who to see?
>
>Websites, nowadays. Used to be a big book like a phone book of
>every doctor in the state that was "in network".
>
>The trick is to pick a primary care physician who's in the network
>(or vice versa, if you have a choice of insurance plans as we do),
>and then make sure any referrals he makes are also in network.
>
>In practice, because of competition, insurance companies want as
>my doctors as possible in their network so they'll look attractive
>when employers are shopping for insurance plans, and doctors want
>to participate in as many plans as possible so they'll look
>attractive to prospective patients. The downside is the stupid
>amount of paperwork that doctor offices have to fill out, since
>every insurance plan has different paperwork.
>
>Friend at work has a wife who's a doctor. She says the Medicare
>paperwork is the easiest. So much for the invisible hand of
>the marketplace.
>
>Cindy Hamilton

Thanks an interesting over view of how the system works. Sometimes it
is difficult getting a family doctor here - when my doc retired early
I wanted a specific doc but she wasn't taking patients so I wrote a
letter to her - at the end I told her it was a begging letter and pls
read it that way! She has a great sense of humour I have found, so I
was in, even though she wasn't taking patients.