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Aug. 21st, 2012 10:55 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
liliaethIt's weird,but I'm always shocked to hear about the costs of healthcare in the US. Can doctors, and especially specialists really demand fees that high?
Just thinking, even without the Ziekenfonds here, I'd still barely pay 30€ for a visit to my GP. And a visit to a specialist costed me about the same, in preparation to my operation. With aid from the Ziekenfonds that amount can usually be cut in two if not more. The same goes for dentists.
Or when I hear about vet visits for pets that cost over a 1000. Now my Dru's only had one bit of surgery, aka her sterilisation. But even with that included, I don't think I've spent more than 200€ on all of her vet visits and care in all the years I've had the joy of her companionship.
I mean I've got a hospitalisation insurrance, but honestly, that's more for paying stuff like hospital rooms and post-hospital care, than to pay the doctors. And I don't think that I pay more than a 100€ a year on my Ziekenfonds either.
That aside, my stupid main comp refuses to start up since saturday. I have no idea what's wrong, everything was ok on friday when I pulled out the plug cause I was staying over at my mom's place, and now it utterly refuses to work. If I was actually able to bend over as I should, I'd pull out all unnecessery plugs and try again that way, but... just glad I recently bought this netbook or I wouldn't be able to go online at all.
Just thinking, even without the Ziekenfonds here, I'd still barely pay 30€ for a visit to my GP. And a visit to a specialist costed me about the same, in preparation to my operation. With aid from the Ziekenfonds that amount can usually be cut in two if not more. The same goes for dentists.
Or when I hear about vet visits for pets that cost over a 1000. Now my Dru's only had one bit of surgery, aka her sterilisation. But even with that included, I don't think I've spent more than 200€ on all of her vet visits and care in all the years I've had the joy of her companionship.
I mean I've got a hospitalisation insurrance, but honestly, that's more for paying stuff like hospital rooms and post-hospital care, than to pay the doctors. And I don't think that I pay more than a 100€ a year on my Ziekenfonds either.
That aside, my stupid main comp refuses to start up since saturday. I have no idea what's wrong, everything was ok on friday when I pulled out the plug cause I was staying over at my mom's place, and now it utterly refuses to work. If I was actually able to bend over as I should, I'd pull out all unnecessery plugs and try again that way, but... just glad I recently bought this netbook or I wouldn't be able to go online at all.
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no subject
Date: 2012-08-25 04:54 pm (UTC)The Americans have the most bureaucratic healthcare system in the world
The doctors have separate rules for different patients
In Britain the list of authorised procedures is put out by NICE. A consultant only occasionally needs to look to see what's changed in what they are allowed to do or they need to see what they want to do as part of their research work. Given that it's fairly big news when things change, this takes a negligable amount of time. I believe that you have a similar system such that the costs and procedures that are approved are mandated centrally. In America, you need to know what insurance model your patient is on. You need to be up to date with dealing with a dozen separate possible insurance schemes, some of which have ... odd exemptions. And for each patient you need to know what treatment you can provide. This is a double overhead - first it means you need to spend some extra time per patient and second the hospital needs to be able to brief the doctors.
Line by line accounting
In Britain, the cost of your stay is based on very few factors - and it's assumed that other than some very expensive drugs and a few parts patients average out. In America they sometimes charge for as little as a nurse delivering aspirin. What they do not explicitely charge for is the time taken to write and bill all that crap rather than just put it in the medical notes, and supplying the wards with standard stocks of drugs but it's an overhead.
Legal defensive measures
In addition to malpractice insurance, the legal costs are higher - a further overhead. And this also encourages the doctors to do more diagnostic procedures, protecting themselves from any possible charges of negligance. This costs a significant amount of money - which due to the insurance model is cost-shared to consultations (partly to make consultations cost-effective for the money-hungry junior doctors with their $150,000 debts). Otherwise they'd do fewer of them. So due to the legal system not only is the malpractice insurance rate much higher, but so are other costs. Including administration fees.
The insurance companies are almost pure bureaucratic overhead - probably the biggest single issue
One of the things an insurance company does is checks through all the claims to find out reasons to not pay out. They do this to both patients, and to hospitals - on a line item basis. This means that the hospital needs to charge for everything - and it needs an entire team of specialised people whose job is nothing more nor less than wrestling with the various insurance companies. Medical benefits from this team: Nil. And the costs American doctors charge needs to be inflated because the insurance companies are going to try to avoid paying out whatever they can. (The discounts if you offer American hospitals cash rather than go through the insurance companies can be up to 89% as they don't have an arm-wrestling match to see any money - for the record, those cash prices still look slightly high to me; one of the parts of my job includes working out for a major UK hospital how much we get paid per visit).