Henning's Headquarters

[Harry]

In the Netherlands you simply get the help you need, if you are insured. What happened to Karl is fully covered, also the treatments to get a person back to a maximum level. After such an event the treatment starts 2-3 days after the incident. There is no difference between one insurance or another, this belongs to the basic level of treatments.

[Florestan]

In the Netherlands you simply get the help you need, if you are insured. What happened to Karl is fully covered, also the treatments to get a person back to a maximum level. After such an event the treatment starts 2-3 days after the incident. There is no difference between one insurance or another, this belongs to the basic level of treatments.

Pretty much same here in Romania but the biggest problem is the shortage of hospitals and rehabilitation centers, resulting in overcrowding and quite long waiting periods.

[Harry]

Pretty much same here in Romania but the biggest problem is the shortage of hospitals and rehabilitation centers, resulting in overcrowding and quite long waiting periods.

Yes I am aware that the health situation in Romania has such problems. Just the other day I saw an Arte docu about this issue. It is a source of great frustration amongst the people. Understandably so, after what I saw.

[Ghost of Baron Scarpia]

In the Netherlands you simply get the help you need, if you are insured. What happened to Karl is fully covered, also the treatments to get a person back to a maximum level. After such an event the treatment starts 2-3 days after the incident. There is no difference between one insurance or another, this belongs to the basic level of treatments.

So far I gather Karl is also fully covered by his employer-based insurance. I think there is a good chance that will continue to be fully covered, although perhaps not at the "acute rehabilitation" center where he is now. The absurdity of the U.S. system is that different parties: private insurers, public insurers, hospitals, doctors, the ill person or the family of the ill person, engage in an adversarial negotiation over who pays, for what, and how much. It is very stressful, but the patient gets a say. The complication with Karl's coverage may be that he is in a very pricey facility and the insurance company has negotiated special rates at some other facility which, according to their best practice guidelines, is just what Karl needs. In a country with government provided universal health care all is simple. I lived in Canada for almost two years and used the Alberta Health Service. You just show the your ID card and you never see any sort of bill. But they decide what care you need and if you don't agree, that's too bad. You can't see a specialist of any kind unless your GP refers you, and the referral can be rejected. My experience is everyone in Canada knows someone who claims their health was ruined because the national health service was too cheap to give him the treatment they think they needed, or because they were on a waiting list for a year before they got the treatment they needed.

No system is perfect, the US system is less perfect than most.

[North Star]

In a country with government provided universal health care all is simple. I lived in Canada for almost two years and used the Alberta Health Service. You just show the your ID card and you never see any sort of bill. But they decide what care you need and if you don't agree, that's too bad. You can't see a specialist of any kind unless your GP refers you, and the referral can be rejected. My experience is everyone in Canada knows someone who claims their health was ruined because the national health service was too cheap to give him the treatment they think they needed, or because they were on a waiting list for a year before they got the treatment they needed.

No system is perfect, the US system is less perfect than most.

In Finland we have universal health care too. I haven't heard of anyone's health being ruined because of too cheap national health service or waiting lists. Obviously their funds are not limitless, so some ultra expensive treatments are the last choice, and a patient's opinion is not necessarily enough to justify a treatment or a test. But they can always go to a private hospital and have all the tests run that they want, and get billed for it.

[Cato]

The fund-raising effort for Karl is at c $3,300 thanks to 40 people or so.

Again, if you want to send a donation (e.g. pre-paid credit card) to them, let me know via Personal Message, and I can supply you with the address.

A member in Europe asked about Western Union Money Transfers: I think that would work with just the name and address.  They offer a cash pick-up as well.

 

[(poco) Sforzando]

A member in Europe asked about Western Union Money Transfers: I think that would work with just the name and address.  They offer a cash pick-up as well.

Western Union fees are quite high.

[André]

In Finland we have universal health care too. I haven't heard of anyone's health being ruined because of too cheap national health service or waiting lists. Obviously their funds are not limitless, so some ultra expensive treatments are the last choice, and a patient's opinion is not necessarily enough to justify a treatment or a test. But they can always go to a private hospital and have all the tests run that they want, and get billed for it.

That's the way it is in Canada, too. One problem with universal health care is that it cannot cover each and all conditions. In a way it works like a super-generous and comprehensive insurance company. Problems arise when you have a rare condition with very expensive medication or treatment. Also, if you can't wait for an exam or treatment (understandable in some cases), you can always go to the private sector and pay for what you feel is required.

Another problem is that universal health care can foster a culture of entitlement and/or laissez-faire. Prevention is the best medicine in most cases, but why bother with exercise, healthy lifestyle and food when there are no immediate consequences ? As usual it's the story of the grasshopper and the ant (La cigale et la fourmi).

[Ken B]

Scarpia has hinted at a point I want to bring out. A major problem with the US system is OVER insurance. Too many people have too much insurance which covers too much. (These are the so called "Cadillac plans" which Obamacare tried to do away with but didn't.) The result is that there is too much demand for certain services by consumers who don't pay much for them. When I had such a plan the doctor would order all kinds of tests and so on, which I really did not need. That drives up the cost for those not on such plans.

Why are there Cadillac plans? Because decades ago *employers* were given a tax break for providing them. If my tax rate is 50% for example that means if the employer could buy the plan for $100 he would have to pay me $200 to allow me to buy the same plan. Add in the effect of a big employer's buying power you can see the strong effect.

The result is a distorted market. (Obamacare was an attempt to fix some of those problems, but was screwed up from the start. The high level idea was good, the execution was not.)

There are other factors at play, but that is the central one. And why having work provided insurance is so important, which is a very bad thing indeed.

It is important to distinguish care from coverage. American heath care is top notch, especially for serious problems. It's who pays for it that is messed up.

[Brian]

One more little note on Obamacare...the most direct effect it has on Karl is probably the fact that it helped digitize all medical records...before the law, many hospitals used digital records but most kept patient information on paper. It's now much easier to transfer patients to new facilities using the digital records.

Anyway...enough politics from me...

I remain optimistic and hopeful for Karl, and it has been a pleasant surprise seeing him back on Facebook with his unique sense of humor. But definitely concerned for him, for Maria, and for the whole family.

[Ghost of Baron Scarpia]

In Finland we have universal health care too. I haven't heard of anyone's health being ruined because of too cheap national health service or waiting lists. Obviously their funds are not limitless, so some ultra expensive treatments are the last choice, and a patient's opinion is not necessarily enough to justify a treatment or a test. But they can always go to a private hospital and have all the tests run that they want, and get billed for it.

I didn't say anyones health was actually ruined under the Canadian system, just that people find themselves thinking that they were given short shrift by some bureaucrat and they have little or no recourse.

At first I was puzzled by the Canadian system. It is a different paradigm. In the U.S. you are a customer, the system is pandering to you if you've got a health insurance policy they can squeeze the juice out of. It is totally different in Canada. You are a petitioner, hoping they will deem your complaint worthy of treatment. Ultimately I decided that I should think of the Canadian health care system as more similar to the U.S. Postal Service.

Here's another story of U.S. health care. I got minor surgery, done as an outpatient in a clinic in the surgeons office. I was in there an hour, 15 minutes for a nurse to take my blood pressure, 15 minutes waiting for a local anesthesia to take effect, 15 minutes of snipping, 15 minutes for the nurse to take my blood pressure again. They sent a bill to my insurance company, I think it was over $15,000. The insurance company said that according to their guidelines, they pay $1,500 for that procedure. The bill was mysteriously adjusted to $1,500. If I had no insurance, I would be on the hook for $15,000?  Maybe not. The provider was just trying to find out how much they could get out of the insurance. If I had no insurance maybe they would have charged the real price.

[North Star]

I didn't say anyones health was actually ruined under the Canadian system, just that people find themselves thinking that they were given short shrift by some bureaucrat and they have little or no recourse.

Ah yes, that certainly happens a lot.

I remain optimistic and hopeful for Karl, and it has been a pleasant surprise seeing him back on Facebook with his unique sense of humor. But definitely concerned for him, for Maria, and for the whole family.

+1

[vandermolen]

I remain optimistic and hopeful for Karl, and it has been a pleasant surprise seeing him back on Facebook with his unique sense of humor. But definitely concerned for him, for Maria, and for the whole family.

+2

[Ken B]

Ah yes, that certainly happens a lot.

The problem is that you don't recognize it as a problem.

When I was in the states I got an appointment for an MRI within 2 days, and there was no reason to think I was in a serious condition. In Ontario, especially in some parts of Ontario, even the seriously ill might have to wait months for an MRI. Not all of those who wait get worse, but some do, and all must wait for amelioration and treatment.

I didn't say anyones health was actually ruined under the Canadian system, just that people find themselves thinking that they were given short shrift by some bureaucrat and they have little or no recourse.

At first I was puzzled by the Canadian system. It is a different paradigm. In the U.S. you are a customer, the system is pandering to you if you've got a health insurance policy they can squeeze the juice out of. It is totally different in Canada. You are a petitioner, hoping they will deem your complaint worthy of treatment. Ultimately I decided that I should think of the Canadian health care system as more similar to the U.S. Postal Service.

Here's another story of U.S. health care. I got minor surgery, done as an outpatient in a clinic in the surgeons office. I was in there an hour, 15 minutes for a nurse to take my blood pressure, 15 minutes waiting for a local anesthesia to take effect, 15 minutes of snipping, 15 minutes for the nurse to take my blood pressure again. They sent a bill to my insurance company, I think it was over $15,000. The insurance company said that according to their guidelines, they pay $1,500 for that procedure. The bill was mysteriously adjusted to $1,500. If I had no insurance, I would be on the hook for $15,000?  Maybe not. The provider was just trying to find out how much they could get out of the insurance. If I had no insurance maybe they would have charged the real price.

That is very typical. It's a manifestation of the over insurance problem. Likely you wouldn't pay 15 k one way or the other. But you don't want to try to find out.

Studies have shown that the Canadian system excels at routine primary care, but falls down on more serious illnesses.
There is also the important fact of drugs. More and more advanced medicine is drugs now. Many operations are now replaced by drugs. The Canadian health system does not pay for most drugs (it's a bit complicated due to set schedules of prices for many things). Physical therapy, which Karl will need, is not covered either. So it's not as comprehensive as it sometimes sounds.

None of which has anything to do with Karl.

[Ghost of Baron Scarpia]

Studies have shown that the Canadian system excels at routine primary care, but falls down on more serious illnesses.
There is also the important fact of drugs. More and more advanced medicine is drugs now. Many operations are now replaced by drugs. The Canadian health system does not pay for most drugs (it's a bit complicated due to set schedules of prices for many things). Physical therapy, which Karl will need, is not covered either. So it's not as comprehensive as it sometimes sounds.

My impression is that the Canadian system is good for routine care and good for critical care (when you get taken to the E.R. for a heart attack you are worried about your recovery, not the bill) but not great for non-acute care, when you end up on the waiting list. And as mentioned, not really universal. Employers provide health insurance to cover prescription drugs and other non-covered services.

[vandermolen]

Earlier this year I had my first experience of an extended MRI scan which lasted 40 minutes. I was referred very quickly by my GP (doctor) and also had to have a hospital biopsy. As I was lying in the scanner I remember wondering how much it would all have cost me if I had had to pay for it. There are many unsatisfactory aspects of the NHS (National Health Service) but I remain very grateful for it. Fortunately for me nothing too terrible was revealed (famous last words) but it made me very grateful to Mr Attlee's Labour government for creating the NHS after World War Two.

[Ghost of Baron Scarpia]

Earlier this year I had my first experience of an extended MRI scan which lasted 40 minutes. I was referred very quickly by my GP (doctor) and also had to have a hospital biopsy. As I was lying in the scanner I remember wondering how much it would all have cost me if I had had to pay for it. There are many unsatisfactory aspects of the NHS (National Health Service) but I remain very grateful for it. Fortunately for me nothing too terrible was revealed (famous last words) but it made me very grateful to Mr Attlee's Labour government for creating the NHS after World War Two.

Nixon (of all people, and a Republican) wanted to introduce universal health care to the U.S., I've read, but it went nowhere. That was the time to get it done.

[vandermolen]

Nixon (of all people, and a Republican) wanted to introduce universal health care to the U.S., I've read, but it went nowhere. That was the time to get it done.

Interesting - thanks. Makes me see Nixon in a different light although didn't he end the Vietnam War?

So sad that people have to worry about paying the bills when they should just be focusing on getting better.

[Ghost of Baron Scarpia]

Enough politics, good to see that Karl is displaying something of his trademark sense of humor on Facebook. Let's hope it keeps coming.

[vandermolen]

Enough politics, good to see that Karl is displaying something of his trademark sense of humor on Facebook. Let's hope it keeps coming.

Totally agree.