Health care wars -- one more try -- INTERNATIONAL DUers, PLEASE READ

[warren pease]

As I said in yesterday's widely ignored post, I'm looking for DUers who live outside the US and who can describe your experiences in getting simple tests -- in this case, some blood work -- under your national health care systems.

I want to contrast your stories with this one I got yesterday from someone who had read an article I did highly critical of for-profit medicine and sent it along to me in hopes I might be able to use it in a future article. This is excerpted from his/her note:


==================================================================
I am in the throes of dealing with three medical
problems. In order to get three simple blood tests performed this
week, I had to do the following yesterday:

1. Phone call to primary insurer to ensure coverage
2. Phone call to secondary out-of-state contractor to find approved lab
3. Phone call to doc's office to get procedure code--not known
4. Phone call to first (erroneously chosen) lab to get procedure codes
5. Phone call to secondary insurer to give procedure codes. Lab is
not approved even though the hospital it is attached to is approved
6. Phone call to approved labs to find out whether I need new
form--no answer at either facility
7. Series of six runaround voice mail messages at lab 1--after
reaching correct person, I get cut off
8. Series of four runaround voice messages at lab 2--asked to be
called back and never am
9. Direct call to lab 2 to confirm procedure code--must have new form
from doc
10. Phone call to doc to get new forms--two voice mail messages
11. Phone call to lab 1--no new form required

All of this required two hours of my time. For one blood test. In all
I was transferred or left a voice message or had to listen to menu
options a total of 22 times. For one blood test.

And this is after the secondary insurer misinformed me that all the
facilities of an approved hospital are within the network. They are
not. Just because a lab is contained within a hospital, employs
hospital staff, and bills through the hospital does not mean that it
is part of that hospital.
====================================================================


Now, I just can't believe this kind of crap goes on in any sane, civilized country. To support that hypothesis, I'm trying to get as many brief (one paragraph is all that's necessary) describing how you'd go about getting and paying for blood work in your countries.

This could be a great article with enough input to constitute a reasonable sample of international systems and how they deal with a simple blood test. I'd like to include your story in this upcoming compare/contrast article I have in mind.

But I can't possibly do it without a great deal of help. So please try to take a couple of minutes and send me just a quick overview of what's involved, now much bureaucracy you have to put up with, and how much would it cost.

Also, if you haven't had any personal experiences with this issue, please distribute this note far and wide among your friends and contacts.

Finally, this kind of piece can be a small but significant blow against the mentality that created and supports the US medical madness. It would be my great pleasure and privilege to personally, though figuratively, flip one of the thousands of switches that blow the official story straight to hell.

You can post responses here, send them to me via DU's PM system, or mail them to my account at [e-mail]/

Edited to add: Also, please let me know if I can use your name, screen name, or just identify your country.

I'm also going to post this in the Health forum, and maybe elsewhere if I can find a forum that fits.


Thanks a lot for reading through this, and many thanks in advance for any contributions you can make to this project. Christ knows, we need all the help we can get here in the land of the medically fucked.


Best,

wp

[nashville_brook]

1. kick

[RaleighNCDUer]

2. kick

I'd like to see those responses.

[warren pease]

3. Ask and ye shall.... blah, blah, blah

Here's yesterday's thread that I referred to in this OP.


http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x1304392


This reply is fairly representative: From Australia:



I've had a couple of blood tests in the last few years. Procedure is:
1. Visit GP who orders test for diagnosis. (no charge, covered by Medicare, generally no longer than half hour wait)
2. Take GP's written test order to local path lab for blood drawing. (no charge)
3. Re-visit GP for results. Usual time frame 2 - 5 days. (no charge)



Of course, since we have the greatest health care system in the world, we'd be foolish to want a system that works like that described like above. I mean, some of my more rewarding discussions take place with Blue Cross representatives as they assure me that, no matter what it says in the contract, procedure XX is no longer covered by my plan. And this after a minimum of 1/2 hour on hold listening to music only the tone deaf could appreciate.


Anyway, thanks for the kick.


wp

[Crunchy Frog]

4. I would try posting in some other forums.

Particularly the Health, http://www.democraticunderground.com/discuss/duboard.php?az=show_topics&forum=222

and the international, http://www.democraticunderground.com/discuss/duboard.php?az=show_topics&forum=194

http://www.democraticunderground.com/discuss/duboard.php?az=show_topics&forum=199

http://www.democraticunderground.com/discuss/duboard.php?az=show_topics&forum=190

http://www.democraticunderground.com/discuss/duboard.php?az=show_topics&forum=191

[warren pease]

5. Great suggestions -- thanks a lot n/t

[prairierose]

6. Here's a kick for you Warren...

I would like to see some responses too. The only thing that will change people's minds about the "evil of "socialized medicine" will be to read some real stories that are such a contrast to the US experience.

Thanks for what you are doing.

:kick:

[warren pease]

7. Another necessary kick -- my toes are getting sore n/t

[Grey]

8. I'm a Canadian and the same is true here.....

This reply is fairly representative: From Australia:
From Canada


I've had a couple of blood tests in the last few years. Procedure is:
1. Visit GP who orders test for diagnosis. (no charge, covered by Medicare, generally no longer than half hour wait)
2. Take GP's written test order to local path lab for blood drawing. (no charge)
3. Re-visit GP for results. Usual time frame 2 - 5 days. (no charge)


I have trouble believeing what you have to go through.... It's Bonkers.

P.S. I took a few liberties with that post. Name is Grey.

[Swede]

9. Canada here.

I go see my doctor,get examed. I was only ever refered to a specialist, once in my life. I had numbness in my hand. Waited a couple of weeks for the test. I had a pinched nerve. The end. Cost-zero.

My SIL was sent home with terminal cancer. I was there for the last week. Two nurses came every day,one was a palliative carenurse,the other came to adminster drugs that my brother couldn't. There was also a lady that came a couple of times a week,that would come and do any housework that we needed done. Again zero cost.

[bdamomma]

10. getting a blood test goes directly goes to my insurance company

and they pay.

[DutchLiberal]

11. Here's my story

Well, 'story'... it's not very long.

My name is Mark, I'm 21 years old and I'm from The Netherlands. (Hence my screen name.) A couple of years ago, I had to see my doctor because I was nearly fainting every time when I would get up after sitting for a while. You know, I would get dizzy, see spots or it became black before my eyes. I picked up the phone and made an appointment for the next day. So, the next day, I went to see my doctor and after talking for a while, he said I had to do a blood test in the hospital. He made an appointment for me and I think one or two days later, I went to the hospital. They took some blood samples and I went home. I got the results I think a week later. They found nothing. (Luckily, I never experience it these days.) It cost me nothing. It's been paid for because I have health insurance.

I don't know much about the costs and who pays what and how it's arranged. Most people don't know, because they don't have to worry about it. (It's like when Michael Moore asked the Canadians about it in 'Bowling for Columbine').

[warren pease]

12. When you say you have "insurance,"...

Do you mean you and/or your employer pay premiums to a health insurance company, for-profit or non-profit? Or are you insured through a central or local government agency that acts as the sole payer for medical expenses?

The former is a version of what we've got here, and the monthly costs are insane. For example, my wife and I pay about US$1,060 a month for mediocre coverage that still requires a deductible, co-pays, doesn't cover or partially covers most prescription drugs, and always pays physicians less than they've billed for -- which means we pay the uncovered balance.

I doubt you're living under that kind of system -- at least I sincerely hope not.

Also, is there such as thing in The Netherlands as disqualification from medical coverage for "pre-existing conditions?" Which is to say, in the US, your history of dizziness might disqualify you from coverage at "reasonable" rates, limiting your options to insurers who specialize in "high-risk" subscribers -- which is to say, those who might actually cost the bastards a little money -- and whose rates make what my wife and I pay seem cheap.

Thanks for your reply. If I use your "story," can I use your real name, screen name, or just identify you as from The Netherlands?


wp

[DutchLiberal]

13. I looked it up and

it turns out the story is not as simple as I made it appear. That's because I'm a student and in college and my parents take care of those things. :blush: I don't know if the following explanation makes any sense to you. Turns out we have a very complicated system. Not that we have to wait long to get treatment or that we have to go through 10 phone call to get a blood test, like in the example from your opening post, but it's difficult to wrap your head around, because there are so many exceptions and 'possibilities' (you'll find out what I mean with that).

Essentially, you are legally obligated to have health insurance. That means that every month, you pay a certain amount to your insurance company, which then takes care for the costs whenever you need a medical treatment. Usually (99 out of 100 times) they give full coverage. (Let's say I need a surgery that would cost €800, they will pay it all.) The monthly sum depends on whatever you wish them to cover. There is, however, a basic 'package' that all insurance companies are obligated to supply. Everybody has to be covered for that basic 'package'. But it's possible to insure yourself for certain supplementary treatments, but not for treatments you're most likely not going to need. You can base that on your medical history, for example.

When you have a job (whether it's a full-time or a part-time job), your employer is legally obligated to pay a certain percentage of your salary to their insurance company, so they are covered when an accident happens at work. I believe it's 6% of the salary (but that's what my parent's employers have to pay and I'm not sure that goes for everybody).

Depending on your income, the government will pay back to you €35 every month. If you have a high income, you won't receive that money. The €35 is essentially paid to make sure that people with low incomes can also insure themselves.

I don't have a job. My parents pay my insurance company €105 so that I'm covered for the basics and for supplementary dental care. (You see, it's very complicated to explain, because everybody can take another 'package' of insurance and all 'packages' have different rules and exceptions.) Because I don't have a job and therefore no income of my own, I receive €35 per month from the government. So essentially, I cost my parents €70 each month for health insurance.

My parents pay €350 every month to our insurance company for the four of us. That includes the basic 'packages' which are legally obligated and supplementary insurance for certain treatments (like dental care). Whatever happens to us, we are covered for it, even if it would cost €1000 to treat us.

Also, to answer your last question, there is not such a thing as disqualification from medical coverage for "pre-existing conditions". In our country, nobody is denied medical treatment, not even when somebody does not have insurance, like illegal immigrants, homeless people etc. In such instances, essentially the government pays the bill. They're paid out of tax money.

So to get back to my example about the blood test: after I got tested, the hospital send the bill to the insurance company, which then pays the bill.

I hope it's all clear to you. It's still a bit complicated to me. ;) I hope you can use my story. You can use both my real and my screen name.

[nashville_brook]

14. i have a question for international patients too -- regarding PAIN treatment

in the US, pain sufferers are treated like criminals. primary doctors rarely treat pain -- for this we have to go to a "pain clinic."

doctors in the US are scared to prescribe pain medicine because the government goes after doctors who prescribe "too much." pain clinic patients are given random piss tests to see if they are taking illicit drugs, but (in my experience) are not treated for any underlying problem. in my case, chronic back pain turned out to be an infection in my spine. it went untreated and i nearly died.

i'm wondering if the criminalization of pain in this country is also tied to the for-profit/anti-patient model we have. it seems to me that primary doctors' primary concern is to keep THEIR MANAGEMENT COMPANIES off their back -- and by extension keep the feds off their back. and vice versa.

my question is -- do patients in other countries also have trouble getting treated for pain?