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Single-Payer Healthcare  
User currently offlineDocLightning From United States of America, joined Nov 2005, 20358 posts, RR: 59
Posted (5 years 11 months 2 weeks 2 days 9 hours ago) and read 2337 times:

OK. So some ruminations from a physician-patient.

I am a strong proponent of a single national healthcare plan for one very important reason:

"I'm sorry, sir, but you are not covered under our plan."

I can't tell you HOW many times I've been told this by various health insurance companies. In fact, it is a common tactic to try to harass patients who use their benefits by falsely terminating their benefits, then apologizing for the mistake, etc. This keeps the most expensive patients away.

In a single, national healthcare plan, there is a single healthcare company. Perhaps you can buy additional, "luxury" insurance on top of the national plan (like they do in Spain) but THERE IS NO SUCH THING AS "NOT COVERED."

The problem is customer service. Having just dealt with a horrible battle with the CA Medical Board and dealt with them simply refusing to do their jobs and having no oversight and no accountability, I cringe to think of what a National Health Service could turn into given the Government's way of operating. I'll call it the NHS but remember that it's a theoretical AMERICAN organization, not the UK's NHS.

So here's a few ideas.

1) Privatize the whole system under a single operator, much like Canada does with their ATC. That will get rid of a lot of government red tape.

2) Appoint an elected official in charge of the system. His sole job is to ensure rapid and efficient care. If care suffers, he gets voted out.

3) Place rules about performance into the system and enforce them by rewarding patients who suffer from delays and poor care with monetary benefits taken from the paychecks of those who work for the National Health Service. So if I have to wait over the mandatory 60 day period to have a claim processed, then I get $500 from the NHS. And that $500 comes out of every single employee's paycheck (totalling maybe $0.001). The idea being that if they are routinely late, sluggish, and inefficient, they have to pay a lot of these awards and thus don't get paid.

But I dream of a day when no citizen or resident alien of the U.S. will just get told (as I just did on the phone) "I'm sorry, sir, but you aren't on our plan."

55 replies: All unread, showing first 25:
 
User currently offlineFlighty From United States of America, joined Apr 2007, 8773 posts, RR: 3
Reply 1, posted (5 years 11 months 2 weeks 2 days 9 hours ago) and read 2329 times:



Quoting DocLightning (Thread starter):
If care suffers, he gets voted out.

And what about the 100 to 500 lieutenants under "him"? Would they be subject to review and termination? Generally in the government, people like that have job security. High level GS bureaucrats...

Your idea is a great one. Single payer health care is needed. It would save us money and we would be richer. No other country spends as much money on health care. We do because we're inefficient.

The issue is, like you say, it has to be a system designed to function efficiently and fairly. The current system we have now, should be thrown away. It is a disaster, and a complete failure IMO. We have the best doctors and hospitals, but we have the wrong system underneath. It costs more than double what the UK or Japan cost. We could take the Japanese system and have a giant amount of money for tax cuts or social programs, and never worry about health care coverage again.


User currently offlineLowrider From United States of America, joined Jun 2004, 3220 posts, RR: 10
Reply 2, posted (5 years 11 months 2 weeks 2 days 4 hours ago) and read 2267 times:

So you want to create a health care system with infinite demand, but limited resources? How do you prevent shortages and control costs? How do you control supplier costs without stiffling innovation? How do you ensure accountability of the single payer? Finally, why do you expect to get this out of the same government that brought you the IRS, Social Security, the current Medicare mess, and the Department of Education?


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User currently offlinePPVRA From Brazil, joined Nov 2004, 8977 posts, RR: 39
Reply 3, posted (5 years 11 months 2 weeks 2 days 2 hours ago) and read 2245 times:

I have a feeling you are talking about more expensive, non-routine care, so this Senate testimony might not go hand in hand with what you experienced this time, but I think it's a worthwhile read (it's a bit lengthy). The testimony is about a Doctor who opened a clinic in rural Tennessee mainly for the uninsured, and he does not accept any kind of insurance--private, government, or any hybrid creature in between. Straight up cash, which has allowed him to make major overhead cost cuts, among other things. He says his prices are cost-competitive with insurance co-pays.

At the very least it's a different perspective on the third-party/single-payer system and some points to consider.

[Edited 2009-01-13 22:11:01]


"If goods do not cross borders, soldiers will" - Frederic Bastiat
User currently offlineManuCH From Switzerland, joined Jun 2005, 3012 posts, RR: 46
Reply 4, posted (5 years 11 months 2 weeks 2 days 1 hour ago) and read 2230 times:
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I like the Swiss healthcare system, but I have no idea what it would mean to apply it in the US. We basically have many healthcare insurances offering the basic, mandatory insurance. This basic coverage, which has a law defining what the insurer has to pay, costs about $150/month. This way, everyone in this country (besides illegal immigrants) has basic coverage.

With basic coverage, you are treated when you are sick, and "sorry, you are not covered" doesn't exist.

Then there's extended coverage, where you can pay an additional $50 to $200/month, depending on what you want, for example for private hospital stay or alternative medicine. Everyone can pick what he wants.

The only current drawback is that about 2-3% of the people are not paying their basic coverage because they don't have enough money. In this case, their healthcare bills are paid by the state, in order to respect the principle that everyone has the right of being treated when they're sick.

Why wouldn't this work in the US? Is it because most people wouldn't want to pay a "social" monthly fee to cover other people's expenses? Is it because a hospital stay in the US is more expensive than in Switzerland?



Never trust a statistic you didn't fake yourself
User currently offlineDocLightning From United States of America, joined Nov 2005, 20358 posts, RR: 59
Reply 5, posted (5 years 11 months 2 weeks 1 day 23 hours ago) and read 2216 times:



Quoting Lowrider (Reply 2):
So you want to create a health care system with infinite demand, but limited resources? How do you prevent shortages and control costs?

The demand is not infinite. It is finite. There are about 300 million Americans. There are ways to do this fairly and economically. We spend more money per capita on healthcare than any other country in the world and much of that is due to the inherent inefficiency of a system where people are uninsured.

Remember, EVERY SINGLE OTHER FIRST-WORLD COUNTRY HAS UNIVERSAL HEALTHCARE. There is nothing magical or special about the U.S. that makes this impossible here.

Quoting Lowrider (Reply 2):
How do you ensure accountability of the single payer?

I just said so. You establish standards of performance and start paying people less if they don't perform.

Quoting PPVRA (Reply 3):
He says his prices are cost-competitive with insurance co-pays.

That's great until you get a sinusitis and need a course of "AUGMENTIN." That's $200, even generic.


User currently offlineFlighty From United States of America, joined Apr 2007, 8773 posts, RR: 3
Reply 6, posted (5 years 11 months 2 weeks 1 day 22 hours ago) and read 2209 times:

LR that is all a good point. But I do not think today's healthcare system is a "market" system. Not in any respect. There isn't accountability today. If your health insurer makes a mistake, you could sue them... but basically they are your overlord. Can you choose a new insurance provider, usually the answer is no. Your job dictates your insurance provider, in most cases.

How do you control costs? You auction out services in a fair and non-corrupt way. It is done fairly well today in Medicare and the Veterans Administration system (but it could be done better). But also, you take the very sickest people, and let them die. That is what they do in the UK and Japan. Ultimately there are limits to medical science. Ugly limits and they cost a lot of money. At some point, it is not worth it for society to pay for knee surgery for a 91 year old woman etc. The human body breaks down, this is by definition a compromise and a capitulation, no matter what country you live in.

Everybody dies from illness or injury. Fundamentally, that has to be OK. Human reproduction is how we survive... not health care. Health care is nice but we cannot allow it to overpower the reasons we want to live or the ways in which we might pay for it. Ultimately it's a luxury, a nice thing, not a stone around our necks.

The bottom line is that general health care is really very cheap. Most countries have cheap systems that work fairly well. If you want premium, high tech care, it is available and there is a cashier's window who will accept your cash payment. This is the only way I see health care working out financially. Free basics for everybody, and then a cash market for luxury care.


User currently offlineLowrider From United States of America, joined Jun 2004, 3220 posts, RR: 10
Reply 7, posted (5 years 11 months 2 weeks 1 day 17 hours ago) and read 2192 times:

Quoting DocLightning (Reply 5):
The demand is not infinite. It is finite. There are about 300 million Americans

How much medical care can each person consume, especially if the perceicved cost to the comsumer is zero?

Quoting DocLightning (Reply 5):
You establish standards of performance and start paying people less if they don't perform.

You have just stipulated a massive oversight and enforcement infrastructure, compounding your expenses and reducing your efficiency.

Quoting Flighty (Reply 6):
But I do not think today's healthcare system is a "market" system.

No, its not even close to one. Try to compare hourly rates to see a doctor, or lab fees. How is it the same product is priced differently depending on the consumer? Next time your doctor wants to order a lab, refuse to allow it until he tells you how much it costs. Because there is no transparency in pricing, there is little competition among service providers. Why must I submit a claim through insurance? I should be able to pay for simple items out of pocket if I so desire.

[Edited 2009-01-14 06:29:56]

[Edited 2009-01-14 06:30:15]


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User currently offlinePPVRA From Brazil, joined Nov 2004, 8977 posts, RR: 39
Reply 8, posted (5 years 11 months 2 weeks 1 day 16 hours ago) and read 2176 times:

Quoting DocLightning (Reply 5):

That's great until you get a sinusitis and need a course of "AUGMENTIN." That's $200, even generic.

At least you can prioritize where your help goes. Or limit what you get insurance for.

Another reason for U.S. health care being more expensive than other countries is because the U.S. does not have price controls on medicine. Price controls have a negative effect on research and development of new drugs, and for that, Europe should not get credit.

Quote:
Price controls seen as key to Europe's drug innovation lag

Pharmaceutical innovation is not only occurring faster in the United States than in Europe, but the gap is getting wider.

For those hoping that Europe might be redressing the imbalance in R&D innovation compared with the United States, two recent reports make gloomy reading. According to a competitiveness report published in November 2006 by the European Commission's high-level Pharmaceutical Forum, the US has established itself firmly as the key innovator in pharmaceuticals since 2000. "That dominant position continues to expand... a disproportionate share of pharmaceutical R&D is performed in the US," it laments.

http://www.nature.com/nrd/journal/v6/n4/full/nrd2293.html

The effects of a third party payer system goes beyond just the patient.

[Edited 2009-01-14 07:56:01]


"If goods do not cross borders, soldiers will" - Frederic Bastiat
User currently offlineKeesje From , joined Dec 1969, posts, RR:
Reply 9, posted (5 years 11 months 2 weeks 1 day 15 hours ago) and read 2149 times:



Quoting ManuCH (Reply 4):
offering the basic, mandatory insurance

I think that is what most European countries have. The "basic"package cover all serious health problems, the extra's are single rooms, dental care, alternative health care etc. People that somehow still are not insured (homeless etc) are taken care of by local instutions.

Mostly the systems are based on solidarity, healthy people willing to pay for those needing care. I have a feeling its hard to match making as much money as possible and taking best care of patients.


User currently offlineManuCH From Switzerland, joined Jun 2005, 3012 posts, RR: 46
Reply 10, posted (5 years 11 months 2 weeks 1 day 14 hours ago) and read 2119 times:
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HEAD MODERATOR



Quoting Lowrider (Reply 7):
Why must I submit a claim through insurance? I should be able to pay for simple items out of pocket if I so desire.

Of course. Can't you do that? I (luckily) never use my insurance, I pay everything out of my pocket (because insurance only pays if I spend more than $2000/year for healthcare, which never applied so far - fingers crossed).



Never trust a statistic you didn't fake yourself
User currently offlineLowrider From United States of America, joined Jun 2004, 3220 posts, RR: 10
Reply 11, posted (5 years 11 months 2 weeks 1 day 14 hours ago) and read 2117 times:



Quoting ManuCH (Reply 10):
Can't you do that?

No, I cannot get past the waiting room without providing insurance information. When asked about direct billing, I was told that all bills were first submitted through the insurance company, and anything not covered would be forwarded to me.



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User currently offlineManuCH From Switzerland, joined Jun 2005, 3012 posts, RR: 46
Reply 12, posted (5 years 11 months 2 weeks 1 day 12 hours ago) and read 2082 times:
AIRLINERS.NET CREW
HEAD MODERATOR



Quoting Lowrider (Reply 11):
No, I cannot get past the waiting room without providing insurance information. When asked about direct billing, I was told that all bills were first submitted through the insurance company

This is extremely strange. And what happens to all those who don't have insurance? OK, most of them probably wouldn't be able to pay, but what if a person who can afford it doesn't *want* insurance (as it's not mandatory in the US, if I understand this correctly)? Will they deny treatment?



Never trust a statistic you didn't fake yourself
User currently offlinePPVRA From Brazil, joined Nov 2004, 8977 posts, RR: 39
Reply 13, posted (5 years 11 months 2 weeks 1 day 11 hours ago) and read 2070 times:



Quoting ManuCH (Reply 12):

Page 2 of the link I provided on reply #3 might shed some light on what and why that happens.



"If goods do not cross borders, soldiers will" - Frederic Bastiat
User currently offlinePyrex From Portugal, joined Aug 2005, 4068 posts, RR: 30
Reply 14, posted (5 years 11 months 2 weeks 1 day 10 hours ago) and read 2041 times:

The problem in the U.S. is that you already have what almost amounts to, in essence, a single-payer system but without all the costs that need to come associated with it. There is a huge "long-tail" in the distribution of medical costs, by the very nature of it. I don't remember the exact numbers but it is something like the sickest 2 or 3% of the population are responsible for 70% of medical costs. Since a lot of these sickest people are effectively shut out of the private insurance market because they are too sick, they end up on Medicare/Medicaid, who ends up being responsible for something like 50% of all healthcare expenditure in the U.S. So basically, Medicare/Medicaid do not receive premiums from healthy people to help cover unhealthy people (thus creating massive losses for them) while private insurers are able to charge high premiums from healthy people confident that they can always dump the sickest ones onto the government (thus reaping major profits).

Imagine an insurance company that only insures reckless, drunk drivers, or beach houses in the Florida coast, and you get Medicare/Medicaid, with the exception that they receive no premiums.



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User currently offlineAa757first From United States of America, joined Aug 2003, 3350 posts, RR: 7
Reply 15, posted (5 years 11 months 2 weeks 1 day 7 hours ago) and read 2004 times:



Quoting DocLightning (Thread starter):
1) Privatize the whole system under a single operator, much like Canada does with their ATC. That will get rid of a lot of government red tape.

A government run organization gets rid of government red tape?

Quoting DocLightning (Thread starter):
2) Appoint an elected official in charge of the system. His sole job is to ensure rapid and efficient care. If care suffers, he gets voted out.

People elect their Congressmen and Senators and look at their approval ratings. George Bush's approval ratings have been low for, what, three years?

Quoting ManuCH (Reply 4):

Why wouldn't this work in the US? Is it because most people wouldn't want to pay a "social" monthly fee to cover other people's expenses? Is it because a hospital stay in the US is more expensive than in Switzerland?

There's a whole host of reasons that, in a way, separates the US from other countries. For one, what do we do with the many illegal immigrants?

Quoting ManuCH (Reply 10):

Of course. Can't you do that? I (luckily) never use my insurance, I pay everything out of my pocket (because insurance only pays if I spend more than $2000/year for healthcare, which never applied so far - fingers crossed).

There are different ways of using health insurance in the US. One is somewhat like the system you're describing. It's called a high deductible health plan. A person has to pay for almost all of his or her health care out of pocket until they hit the deductible, which may be something like $3,000. Then, insurance kicks in and the person only pays for a certain percentage of care.

Other plans may not work like that. Many plans have "co-pays," which are fees that a patient pays to the doctor/facility and then the insurance company is billed for the difference (at an arranged rate). So for example, when a covered patient visit's a doctor, the insurance company pays for that after the patient gives the doctor $20. So the insurance companies are left paying for tiny little things that the average person can afford (say three doctors visits, a blood test and an antibiotic over the course of one year), which really adds up.

The high deductible system works like car insurance. If you need to change your headlight, your insurance company doesn't pay for it. If someone hits you when you're stopped at an intersection, the insurance company does pay for a new bumper. The latter system, which AFAIK is more popular and common, is the equivalent to car insurance paying for headlights and oil changes.


User currently offlineLH423 From Canada, joined Jul 1999, 6501 posts, RR: 54
Reply 16, posted (5 years 11 months 2 weeks 1 day ago) and read 1968 times:



Quoting Aa757first (Reply 15):
People elect their Congressmen and Senators and look at their approval ratings. George Bush's approval ratings have been low for, what, three years?

Yes, but as the old adage goes, "All politics is local." Congress often has a low approval rating yet most people think THEIR politician does a good job. That's why we see so many career congressmen. They get sent back by constituents thinking that their congressman isn't part of the problem on the Hill.

As for Pres. Bush. Well, even with a healthy dose of revisionist history, I don't think Bush will be seen in the same light as Washington, Lincoln, Roosevelt, Kennedy, or Reagan. His low-approval ratings are do to a multitude of reasons.

That said, while I agree with the idea of a sort of elected ombudsman to oversee a national health care system, I worry that needing to be elected would politicise the office too much. Would the person in that office be working to make sure Americans have the best health care system possible or would he/she be worried about being reelected?

LH423



« On ne voit bien qu'avec le cœur. L'essentiel est invisible pour les yeux » Antoine de Saint-Exupéry
User currently offlineDocLightning From United States of America, joined Nov 2005, 20358 posts, RR: 59
Reply 17, posted (5 years 11 months 2 weeks 23 hours ago) and read 1963 times:



Quoting Lowrider (Reply 7):
Next time your doctor wants to order a lab, refuse to allow it until he tells you how much it costs.

He doesn't know how much it costs because 1) nobody tells us that and 2) how much it costs depends on your insurance provider.

Quoting Lowrider (Reply 7):

How much medical care can each person consume, especially if the perceicved cost to the comsumer is zero?

This is why I'm a strong proponent of co-pays and policies that minimize freebies. If you have to shell out a bit of money to use an ambulance and you have to shell out a bit of money to go to the emergency room and you have to shell out a bit of money for other things, you are less likely to just use the system for the hell of it.

Quoting Lowrider (Reply 11):

No, I cannot get past the waiting room without providing insurance information.

That's a stupid doctor, then. He can get a lot more by billing you directly than by billing your insurance. Pick a different doctor.

Quoting PPVRA (Reply 8):

Another reason for U.S. health care being more expensive than other countries is because the U.S. does not have price controls on medicine.

Yes and no. Some things bewilder me. BACTRIM is a two-component antibiotic that has been around for a few decades. I just paid out-of-pocked for a 7-day course, US$15. A 7-day course of AUGMENTIN, another two-component antibiotic that has been around for a few decades, costs about $200. Why? I have no idea.


User currently offlineLowrider From United States of America, joined Jun 2004, 3220 posts, RR: 10
Reply 18, posted (5 years 11 months 2 weeks 17 hours ago) and read 1942 times:



Quoting DocLightning (Reply 17):
1) nobody tells us that and

How hard do you look? How often does the question cross your mind?

Quoting DocLightning (Reply 17):
2) how much it costs depends on your insurance provider.

And therein lies a large portion of the problem. As I have said in the past, we should demand transparent, market based pricing.

Quoting DocLightning (Reply 17):
If you have to shell out a bit of money to use an ambulance and you have to shell out a bit of money to go to the emergency room and you have to shell out a bit of money for other things, you are less likely to just use the system for the hell of it.

What is "a bit" and who decided how much that is? If you set the bar too high, isn't that the same as having people who are not covered? If it is too low than it is not a deterrent.

Quoting DocLightning (Reply 17):
That's a stupid doctor, then

Perhaps, but that is not my opinion of him. Seems to be a good guy, but the group he is a part of has certain policies.



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User currently offlineDocLightning From United States of America, joined Nov 2005, 20358 posts, RR: 59
Reply 19, posted (5 years 11 months 2 weeks 17 hours ago) and read 1931 times:



Quoting Lowrider (Reply 18):

How hard do you look? How often does the question cross your mind?

Many times and the answer is always "We bill differently for it based on the insurance." It sounds like a simple question, I agree. But it appears to be one of those unanswerable ones. And that frustrates me as much as it frustrates you.

Quoting Lowrider (Reply 18):

What is "a bit" and who decided how much that is? If you set the bar too high, isn't that the same as having people who are not covered? If it is too low than it is not a deterrent.

Well, in my experience, the copay on an ambulance needs to be more than cab fare. People on Medicaid in the Bronx would come in by ambulance because the kid has a cold. Like, all the time. And because it was free to them, they'd just glibly abuse the system.

A $15 copay would not cripple anyone, but would cost more than a cab. That's just one example of how to get people to use the system appropriately.


User currently offlineWindy95 From United States of America, joined Dec 2008, 2755 posts, RR: 8
Reply 20, posted (5 years 11 months 2 weeks 16 hours ago) and read 1928 times:



Quoting DocLightning (Thread starter):
That will get rid of a lot of government red tape.



Quoting DocLightning (Thread starter):
Appoint an elected official in charge of the system



Quoting Flighty (Reply 1):
And what about the 100 to 500 lieutenants under "him"? Would they be subject to review and termination? Generally in the government, people like that have job security. High level GS bureaucrats...



Quoting Lowrider (Reply 2):
Finally, why do you expect to get this out of the same government that brought you the IRS, Social Security, the current Medicare mess, and the Department of Education?

It is not some form of healthcare that covers everyone or one that does not let people fall through the cracks that I disagree with. But the above mentioined quotes are why I would not ever support our Government controlling my healthcare. Our whole government sucks and is out of control with red tape and corrupted officials. Every system we have is a mess and Healhtcare would be no different. I do not trust our elected officials or the lifetime beuracrats for one second. I like your ideas a bit Doc and I like your passion but thinking of our government running this makes me want to go see my Doc for some blood pressure pills.



OMG-Obama Must Go
User currently offlineArrow From Canada, joined Jun 2002, 2676 posts, RR: 2
Reply 21, posted (5 years 11 months 2 weeks 12 hours ago) and read 1900 times:



Quoting Windy95 (Reply 20):
Our whole government sucks and is out of control with red tape and corrupted officials. Every system we have is a mess and Healhtcare would be no different.

You've outlined a more intractable, systemic problem; a problem we share with you to a certain extent. Wouldn't it be nice if real electoral reform were possible, but unfortunately the guys and gals who have to implement the reform are the ones who do best exploiting the status quo.

Having said that, it's hard to envision a national health care system based on a 100% private sector model, and I'm unaware of any country that has gone that route. We've managed to produce (on average) better outcomes at lower cost (compared to the US) with a system that is run entirely by governments, with some private sector involvement at the clinical level. And we've done a reasonably good job keeping drug costs in check because the government controls it.

Bottom line -- you have to trust the government to do it right. Our system was established at a time when governments were generally given more respect than they are now. And I wonder, given the current distrust of government, if we would be able to create the system that now exists -- or would we wallow in the inefficiencies we see to the south and end up forever wrangling over the ideological divide.

I'm certainly grateful that it was done here, back when it was possible to do it (there was a war over it even then). I've benefitted personally from it and wouldn't swap places with Americans.



Never let the facts get in the way of a good story.
User currently offlineMD11Engineer From Germany, joined Oct 2003, 14139 posts, RR: 62
Reply 22, posted (5 years 11 months 1 week 6 days 20 hours ago) and read 1854 times:

Here is an article (intended for ex-pats working in Germany) on how the Germany health insurance system works.

Quote:
Basic introduction

Health insurance is obligatory for everyone residing in Germany who is employed full-time by a company. The company pays half of the insurance contributions, the other half comes out of the employee's salary. The employee's half usually totals around 10% of their gross salary. When starting work with a company usually the employee won't have to worry too much about how the system works. The company will automatically sign them up with an insurance company and the contributions automatically deducted from the salary. Sometimes the employee may be asked if they have a preferred insurance company. It is recommended to simply go with one of the big names, like "AOK" or "TKK". They are all pretty similar.

Health insurance has been obligatory for everybody in Germany, including the self-employed, since 2007. Medical treatment can be hugely expensive.

There are two types of health insurance in Germany. These are the "public" and "private" systems. This system often causes considerable confusion. Full details are given below.

More: http://www.toytowngermany.com/wiki/Health_insurance


BTW, from my own experience, the system is pretty good, as are most European systems.
From my own experience (Ok, I'm rarely sick, but I had a few accidents in my life and also had an accute loss of hearing together with a tinnitus last summer), I never had to wait unduely long. Ok, once I had to wait for an hour or so in a hospital emergency room, where I went after an accident at work, where I thought I might have a broken ankle (turned out to be a bad sprain), because somebody else came in by ambulance with a life threatening condition and all emergency room staff had to take care of this patient first.

German hospitals usually provide state of the art treatment, as do the various GPs and specialists doctors all over the country. Treatment is all covered by the mentioned insurance schemes.

Jan


User currently offlineCanuckpaxguy From , joined Dec 1969, posts, RR:
Reply 23, posted (5 years 11 months 1 week 6 days 7 hours ago) and read 1824 times:

Well, not to get too personal, but there's one hospital here in Canada that has saved my life on two occasions. Aside from prescriptions I needed after being released from the hospital, my total healthcare cost was C$50 in 1993 from a major trauma visit (to pay for the ambulance ride); and C$200 in 2008 for a rather serious cardiac procedure (Because I chose to get upgraded to a private room, the cost would have been $1000, but my private insurance through work paid 80%). I'm told that if I had been in the USA, without insurance, my two procedures combined would have run me nearly $200,000.

Damn right I'm happy to be Canadian!

There are some common misconceptions though about medicine in Canada:

  • * Sometimes patient wait-times are called "unreasonable" by some. The Canadian system treats patients in order of medical priority so you may be sitting in an emergency room with broken finger for hours.
  • * Depending on where you are in the country, you may have a great deal of difficulty finding a doctor who is taking patients. There's a lot more $$$ for doctors in Canada to practise south of the border.
  • * Dental visits are not covered by the state unless you are on welfare, and even then there are limitations. Same goes for prescription drugs. These are often covered by employer health plans where available.
  • * Elective surgery, in most cases, is not covered unless it is directly related to an essential treatment. (Although I did hear rumours about a gender-reassignment surgery getting paid for).


Overall, it's a good system, and one I've come to really appreciate. Sure, it has its querks, but we Canucks have no grounds for complaint.

G


User currently offlineAa757first From United States of America, joined Aug 2003, 3350 posts, RR: 7
Reply 24, posted (5 years 11 months 1 week 6 days 3 hours ago) and read 1800 times:



Quoting Canuckpaxguy (Reply 23):
* Sometimes patient wait-times are called "unreasonable" by some. The Canadian system treats patients in order of medical priority so you may be sitting in an emergency room with broken finger for hours.

This is true in the US and I assume almost everywhere as its medical, not a way to manage things. Obviously, the most acute cases need to be treated before simple things like broken bones and minor illnesses.

In the US, places called Minute Clinic and similar "retail health centers" have developed as a much more convenient and cost effective way to treat minor problems that clog up ERs. Nurse practitioners and physician assistants staff these walk-in clinics and see only patients with very specific, minor illnesses. They'll try to bill insurance for you, but the prices are very low anyway. The US system does, like all systems, have flaws. One advantage it does have is innovation created by the free market.


25 Canuckpaxguy : That's one very clear advantage over our system! In Ontario, we're just now piloting Physician Assistants. The concept is brand new. I let you know h
26 Dougloid : Quite frankly Doc, your profession stands in the way when every person who graduates from a second rate medical school in Manila won't turn the key f
27 Cairo : First of all, I agree with some kind of national universal healthcare. BUT, These things work best in small countries, and, anecdotally speaking, see
28 Dougloid : Look closely at the Massachusetts model. That may be where we end up.
29 DXing : So they can be told "I'm sorry sir, you're not in our records, it appears that we have listed as having died a year ago. I'm afraid you'll have to co
30 Flighty : Americans could take 2 extra weeks off per year (as the Brits do) with all the productivity they saved (money) by switching to a Canadian type system
31 Arrow : The fallacy in this argument is that somehow, the private sector gets it better and doesn't perpetrate these kinds of bureaucratic nightmares. That's
32 DocLightning : OK. My education cost a quarter of a million dollars. How am I supposed to pay for that? Make my education free and then we'll talk. Oh, and your sun
33 Canuckpaxguy : Whoa! Slow down kids!! Free health care? Free university tuition? Sounds like a communist society!!! (Just kidding!). Medical schools are VERY expens
34 LTBEWR : There are a number of arguements against a government contolled or 'single payer' health care system. Many persons and providing institutions may not
35 DXing : I have a choice of providers, if I don't like the one I have now for the reasons you listed above I can fire them and get another. If the government
36 N801NW : Monopolies are not illegal, per se in the US. What is criminal is doing illegal things to maintain said monopoly.
37 Arrow : That's not true. I make all manner of choices in my health care, from which doctor I go to, which hospital I access, which pharmacy I buy my drugs fr
38 DocLightning : The USPS. The Military. The FBI. The electric company (in most places). The phone company (in most places). The water. The roads. The garbage. Health
39 Dougloid : First of all, Doc, you investing in your education is like anyone else investing in themselves or their business. If I invest in a dry cleaners, you
40 DXing : Yes they are. Government run means that no matter where you go the rules are going to be the same. You can shop around but the price is going to be t
41 PPVRA : Do you have any reason to believe this might be an expensive drug to manufacture? Expensive ingredients? Without going deeper into it I don't have an
42 Post contains links N801NW : To quote the Federal Trade Commission: Emphasis added.
43 DXing : Which is exactly what the government would doing by creating a single payer system. The only way a single payer system could be cost controlled is to
44 DocLightning : Where did I say that? Quote it. Go for it. I'm waiting.
45 N801NW : If a single payer system was implemented then it would most likely be monopoly. For example, in order to preserve universal access to mail, USPS has
46 DXing : I guess that about covers that. Which you some how extrapolated from what I said about monopolies.
47 Aa757first : Patching up wounded people is a lot different than treating them. Well obviously the market decides how to compensates doctors. And I don't have any
48 Dougloid : Wrong. When you're the only game in town you get to charge whatever you like. And when it's something that people go without at their peril. the noti
49 ManuCH : Some do. Read the PDF link in reply #3. Why not every MD is doing this? I have no idea. My opinion is that being an MD isn't just like "any other job
50 DocLightning : No disrespect meant to your son. But you disrespect the work I've put in, the vision and dream I have of using my education to move mountains for peo
51 Flighty : That's pretty much correct. Lots of smart people would be happy to be an anesthesiologist or a dermatologist. Especially making the pay they make in
52 DocLightning : Most doctors get paid shit. You only hear about the high-profile surgeons who make tons of money. I'll be lucky to make $80,000 a year as a pediatric
53 Lowrider : Considering many people who have labored for a lifetime have not made that much in a year, you aren't exactly doing that badly. Common fallacy. Only
54 DXing : Lowrider is correct. There are probably about the same amount of pilots making that kind of money as there are surgeons making over a million a year.
55 Aa757first : Most doctors I know (quite a few) and medical students I know (quite a few) aren't doing it for the money. Its because they don't know what else they
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