[anjel]

Like air transport, in America Healthcare has its First Class, Business and Steerage tiers of medical care.

ACA (Obamacare)HMOs may have opened healthcare up to a lot of people who until then were going without. But its a faaaar cry from from Employer PPOs. And the ACA PPOs somewhere in between.

An don't forget the Trumpcare policies, with major policy exclusions.

[nradov]

You appear to be mixing up a number of unrelated issues. Employers often offer both HMO and PPO plans. The differences are typically in provider networks and deductibles/co-pays/co-insurance. Employer sponsored PPO plans don't necessarily make it easier to access higher quality providers — especially because most of the metrics for measuring provider quality are unreliable or even misleading. And in practice there is very little difference in networks between most health plans; the majority of major provider organizations accept all the major plans.

If you really want "First Class" health care then you'll have to pay out of pocket for concierge medicine. That isn't directly covered by most insurance plans, although they will reimburse for certain services delivered through concierge medicine practices.

[mindslight]

I've heard this before, but I still can't figure out where this first class medical care is hiding. For the regional medical system I'm familiar with, there are two major hospitals, each with a set of associated providers. They both take most "insurances", because they effectively have to. I'm mostly familiar with the "better" one, and my experiences there have not been good. Are they checking the class of a patient's "insurance" plan behind the scenes, and sending different doctors based on that? Do I need to travel to a major 1M+ city (somehow even during an emergency)? Or what else gives? Where are these engaged doctors, who actually give you more than a 10-20 minute slice of their time, actually hiding? Ones who don't simply pass the buck to a different place (often booking many months out), recursively? Because from what I've gathered, I suspect that most people are just not very good at judging the competence of professionals, and are absolutely unable to judge the constructive incompetence of systems.