Text 12864, 97 rader
Skriven 2008-03-14 16:39:27 av Roy Witt (1:397/22)
  Kommentar till text 12598 av Robert Bashe (2:2448/44)
Ärende: Health care
===================
13 Mar 08 08:27, Robert Bashe wrote to Roy Witt:

 RB> Roy Witt wrote to Robert Bashe on Wednesday March 12 2008 at 13:19:

 RB>>> ...which apparently neglected to mention that there is no such
 RB>>> thing as government-set "standard rates" for medical services in
 RB>>> the US, and thus that the prices for such services can vary widely
 RB>>> from city to city and doctor to doctor.

 RW>> On the contrary, Bob. Times have changed and the government (social
 RW>> security medical and social security disability sets prices they
 RW>> will pay for services.

 RB> That doesn't apply to the entire population, though.

In a way it does. But only for those with health insurance. Those
companies have as much influence as mine in the medical field.

 RB> It does in Germany. There's a huge catalog of medical services, from
 RB> office visits and phone consultations up to removal of a lung in the
 RB> hospital, and the entire medical community is bound by them. And they
 RB> apply to the entire population, to all patients, not just retirees or
 RB> pensioners, and to all doctors and hospitals.

Each insurance company, including mine which has taken over the service
from the Feds, have certain prices laid out in their guides to coverage
booklets. A doctor who works within the insurance' guidelines will accept
those fees. Some may try to charge more, but they can't really collect if
the set price has been paid. It used to be that Medicare paid 80% of the
bill and you were liable for the rest, but now days almost everyone has
suplemental insurance to cover the gap.

 RB> If you have the government health insurance, which is expensive in
 RB> younger years (percentage of earnings), restrictive in what it
 RB> provides, and is forced on most of the population (compulsory), you
 RB> can continue on it after retirement by paying a certain part of your
 RB> pension. If you're privately insured, as I am, you continue your
 RB> private insurance. People without health insurance are very rare in
 RB> Germany.

Texas has just instituted a state insurance plan for the children of those
parents who don't have or can't afford health insurance. At least no child
will be without it.

 RW>> Mine is Humanna. Yesterday I paid $5 for an office visit and some
 RW>> lab work...I go again in two weeks and get the results and any
 RW>> modifications to my HMO-paid-for drugs, for another $5 co-pay.

 RB> Sounds a little like the government insurance here.

I just got a letter today that tells me that any stay in a network
hospital with acute care will cost me $65/stay. Note; not per day.

 RB>>> In the States, doctors actually _compete_ for patients - something
 RB>>> totally unknown in Germany and presumably elsewhere in the EU.

 RW>> Only those in private practice.

 RB> That's what I meant.

 RW>> Those in HMO service don't compete with anyone else in the HMO, as
 RW>> they're assigned patients by the HMO after the patient selects them
 RW>> from a list of doctors.

 RB> And this is something I know essentially nothing about, since this
 RB> system developed after I left the States. All I know aboout are
 RB> private doctors.

You would be surprised at the differents plans of coverage. You've heard
of HMOs, but you probably haven't heard of PPOs. They're just more
intensive coverage under a different plan with a slightly higher premium.

 RB>>> Here in Germany, there are standard rates for all services, and
 RB>>> except for charging multiples of those (up to 2.3 times the
 RB>>> standard rate), doctors and hospitals are bound to those by law.

 RW>> In private practice here, the doctors charge what the traffic can
 RW>> bear. Usually higher than the average person can afford.

 RB> Yes, that's what I meant.

 RW>> Back in 02 I visited the ER and it only cost $100, which included
 RW>> some morphine for the pain I was having. However, the MRI cost
 RW>> $1200...All toll, my out of pocket costs were for my gasoline to get
 RW>> there...

 RB> Amazing. I didn't think emergency room treatment extended so far.

They also gave me the magnetic images to take to my doctor. As I recall,
there were four 18x30 films with 24 or so images on them.

                R\%/itt



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