From a cost standpoint, the answer is it depends. If you are an employer looking to cover your employees care, you have a different set of criteria affecting your decision than does the head of household in the Individual/Family Plan market. Rule of thumb is in the Group market, HMOs are less expensive than PPOs. However, the opposite occurs in the IFP market. So, my answer is “we should talk” after your read this story. You may have a different opinion.

In my past career, I sold disposable medical products to Hospitals throughout the entire western US.  My products primarily served the Cardiac Cath Lab, Radiology, and Surgical areas of the Hospital. Of note, the Cardiac Cath Lab is the place where you go when you have chest pain, minor heart attack etc. This is where they use injectable die and fluoroscopy to see where the patient is experiencing narrowing of the vital heart vessels. Once identified corrective procedures such as “stenting” can be done. Usually, a patient comes in one day for an Angiogram to identify the narrowing, then back the next for the Interventional procedure, or stenting. I observed close to 1200 of these procedures over about 8 years.

On one particular day I observed a talented Doctor place 3 stents into the arteries of one patient in about 75 minutes. This I knew was a skilled physician. The next patient came in fir the initial Angiogram. This patient’s doctor fumbled around for almost 80 minutes to complete the basic Angiogram. Fighting falling asleep with the support techs and nurses, I asked one of the Lead techs “why was the first Doctor so fast and this guy so slow?”. He replied “it is one thing to have book smarts, and an entirely different thing to have the gift of God in your hands”. I then asked him “how many Doctor’s are licensed to Cath in this lab?” He replied “55-60”. “How many of them would you have work on you” I asked. “Five or Six” was his prompt but sad reply. Here is someone who see the skills of 55-60 doctors who says he would only let 10% work on him!!!

In summary, a PPO give you choice and the ability to shop for care. If that ever happens to me, God-forbid, for my family’s sake, I want access to the best.