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RE: If you have any question on european healthcare - 9/8/2009 9:27:18 AM

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quote:

I did? Only the answers would indicate that, not the questions.

Sorry it's so hard sometimes to recognise those non rhetorical questions.

quote:

I thought the OP was here to answer questions not duck them? Why is my viewpoint a factor in your answer? It was represented that the OP "been there and done that". Well...

With respect I think the issue of legal representation and the various mechanisms set up to ensure fair representation of a grievance is totally separate to that of how healthcare is funded. What would be your argument that it isn't? i.e. read some claims made against the NHS, they do exist and they are decided by people independent from government or the NHS.

quote:

I'm not surprised that you want to limit discussion to only certain aspects of the subject; unfortunately you can't make a legitimate comparison unless ALL factors contributory to access and cost are addressed. Here's "insight" concerning comparing a European system with a USA system; you can't just change the plug on any electrical device and use it here. The same problem exists when 'access' is the only aspect of health-care being discussed. You can't 'plug in' one part of the system and expect it to work.

The systems of government are complex are you saying we can't change anything at all i.e. we are a paralysed conservative worrying about the unrealistic implications of change? Make a logical case to answer that state run healthcare will reduce your legal representation in terms of bringing a claim?

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RE: If you have any question on european healthcare - 9/8/2009 9:48:46 AM

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quote:

are you saying we can't change anything at all i.e. we are a paralysed conservative worrying about the unrealistic implications of change?

"Unrealistic implications of change" is not the point. Change that does not consider all the facets of the problem doesn't solve anything, it only creates more problems. The civil, or tort, costs are not only reflected in litigation charges and settlements. Much of the current "standard operating procedures" in the US which contribute to the $16,000 2 day hospital stay are a direct result of tests, required by insurance company 'risk managers', for the purpose of avoiding litigation. An MRI instead of an X-ray. A CAT scan for the 1 in a Million change of discovering what normally would be missed, costs money. When 999,999 don't need it but the costs are incurred to insured that 1 person doesn't litigate; I'd say that is a factor that must be considered.

From my first hand knowledge of the European system; the philosophy testing a million for the 1 'worse case' is not in place.

quote:

Make a logical case to answer that state run health-care will reduce your legal representation in terms of bringing a claim?

That's not what I'm saying. I don't think the legal representation in the US will curtail at all. In fact I think it will go up. There will be many more, having access to care, who will have tickets in the 'law suit' lottery. Since there is little if any 'tort reform' in the current version of the Health-care Bill which would reduce litigation to levels equal to the 'European' standard; any budget being considered in the US can not use a 'European' standard of cost.

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RE: If you have any question on european healthcare - 9/8/2009 9:50:21 AM

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quote:

ORIGINAL: Arpig
I wish the guy who started the thread would come on and answer some of the questions posed, rather than the snarky replies by somebody else.

Arpig,
I think he exhausted his 'expertise'.

(in reply to Arpig)

RE: If you have any question on european healthcare - 9/8/2009 10:08:08 AM

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Or maybe he doesn't spend all day on CM? There is that pesky time zone problem.

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RE: If you have any question on european healthcare - 9/8/2009 10:18:52 AM

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quote:

ORIGINAL: Mercnbeth
Change that does not consider all the facets of the problem doesn't solve anything, it only creates more problems. The civil, or tort, costs are not only reflected in litigation charges and settlements. Much of the current "standard operating procedures" in the US which contribute to the $16,000 2 day hospital stay are a direct result of tests, required by insurance company 'risk managers', for the purpose of avoiding litigation. An MRI instead of an X-ray. A CAT scan for the 1 in a Million change of discovering what normally would be missed, costs money. When 999,999 don't need it but the costs are incurred to insured that 1 person doesn't litigate; I'd say that is a factor that must be considered.

Are you saying risk managers are deciding what tests should be conducted instead of Doctors basing that judgement on a medical opinion? I don't think this makes a good case for the current system.

quote:

From my first hand knowledge of the European system; the philosophy testing a million for the 1 'worse case' is not in place.

No generally patients present with symptoms and then a doctor decides what tests they need to make a diagnosis. Although screening programmes exist for people in certain risk groups. Something terribly bad could be wrong with me now and testing for everything under the sun could find this at an early treatable stage even with no symptoms but I'm not being asked if I live near a busy road or if I like dancing in a thunderstorm holding a long metal rod. You just can't live your life worrying about all the unseen deadly killers, I don't think that is healthy.

quote:

Make a logical case to answer that state run health-care will reduce your legal representation in terms of bringing a claim?
quote:

That's not what I'm saying. I don't think the legal representation in the US will curtail at all. In fact I think it will go up. There will be many more, having access to care, who will have tickets in the 'law suit' lottery. Since there is little if any 'tort reform' in the current version of the Health-care Bill which would reduce litigation to levels equal to the 'European' standard; any budget being considered in the US can not use a 'European' standard of cost.

That's a good argument, I don't know how you address this claims culture. The philosophy here I suppose is if you give people no reason to complain any complaint they make will be asinine and so hard to win. People will always complain but you need a patients charter which outlines what are realistic complaints and what aren't. I've seen people treated so badly by the NHS but they wouldn't think to complain not for personal profit but perhaps to improve the service and highlight shortcomings, it's a different culture really I suppose. Those differences getting less distinct though.

< Message edited by SL4V3M4YB3 -- 9/8/2009 10:19:50 AM >

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RE: If you have any question on european healthcare - 9/8/2009 11:09:01 AM

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quote:

Are you saying risk managers are deciding what tests should be conducted instead of Doctors basing that judgement on a medical opinion? I don't think this makes a good case for the current system.

Was the subject making a "good case" for the current system or bringing reality into the discussion about any "new system".

The answer to your question regarding risk managers is yes.

quote:

You just can't live your life worrying about all the unseen deadly killers, I don't think that is healthy.

I would agree. However, as a health care provider in the USA you better worry about each and every unseen deadly killer that you may have, or could have seen and didn't because if you don't you'll have a very unhealthy litigation expense.

quote:

I don't know how you address this claims culture.

I do - loser of the litigation pays; which is the case in the UK system. However, you could never get that concept in place in the US because of 90% of Congress is comprised lawyers and the legal industry lobby would never allow any such change to occur.

quote:

I've seen people treated so badly by the NHS but they wouldn't think to complain not for personal profit but perhaps to improve the service and highlight shortcomings, it's a different culture really I suppose.

When you would be required to pay the cost of litigation if you didn't prevail in your litigation, all you can do is complain. In the US, you go home and complain and see a lawyer's advertisement which tells you it costs you nothing to file a lawsuit; and "you pay nothing if you lose". Worth a phone call?

Don't "suppose" - it IS a totally different culture. In the case of litigation the distinctions can't be any more clear and there is no trend or indication of a start of one, which points to this key distinction being less so.

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RE: If you have any question on european healthcare - 9/8/2009 11:20:33 AM

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quote:

ORIGINAL: Arpig

I wish the guy who started the thread would come on and answer some of the questions posed, rather than the snarky replies by somebody else.

snarky?

I live in Europe...there is no European system. That is propably why he can't answer the questions.
He can only answer them for his country.

In Holland we have to pay for health insurrance , because it is in the law. That amount is payed by every one.
IF you want extra insurance you pay more.
If you go to a hospital the bill is send to the insurances. Most will be payed for you. ....or you just pay part of the operation.
My last operation and stay in a hospital costed approx 8000 euro..I payed..150 to the insurrance. Medicine before and afther were payed by the insurance. So are house docter visits..etc etc..
In short...most is covered by insurrances here....

< Message edited by TurboJugend -- 9/8/2009 11:28:17 AM >

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RE: If you have any question on european healthcare - 9/8/2009 12:52:00 PM

Arpig

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My remark wasn't directed at you Turbo,sorry, I should have made that clear.

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RE: If you have any question on european healthcare - 9/8/2009 12:57:13 PM

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If it helps...

Both Germany and France put money more into nationalised healthcare than the English.

In England.....

My Grandma was dying a while ago and spent 3 weeks in hospital being cared for. There's no way she could have afforded private treatment and died comparatively pain free.

I was in hospital a few years ago with back problems. Booked an appointment - was in hospital within a couple of weeks - x-rayed etc etc - all the usual tests for back problems and received physio on the NHS for which I waited a bit longer for appointments.

It's not free of course because you pay tax toward the NHS.

You can jump the queue if you so wish by going private. Whether or not you get better quality is debatable - my understanding is that you get the same doctors that are employed in the NHS.

The NHS isn't perfect and value for money is difficult to compare - value being subjective.

It's really a philosophical and cultural argument - are people entitled to treatment regardless of the ability to pay?

And in the interests of balance it's fair to say that smoking and alcohol related problems place a huge burden on the NHS - and of course you will pay for other people's addictions - but then again someone could pay for your addictions or poor health depending upon whether or not you fall on hard times.

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RE: If you have any question on european healthcare - 9/8/2009 1:03:33 PM

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quote:

ORIGINAL: UglyTruth

[
Okay, thanks for the offer.

Can I go to any caregiver of my choosing (such as a midwife for births?)?
Am I free to shop around for the best price for the care I'm looking for?

If I am a health care professional, can I open up my own shop?
What kind of regulations would I be subject to?

Those are just off the top of my head.

Thanks, again.

I will only answer for Switzerland this time, and take my example I have an average insurance (linked to me, not to an employer):

Can I go to any caregiver of my choosing (such as a midwife for births?)?

---> Midwife, I do not know, I am a man

but dentist, doctor and hospital yes, without restrictions

Am I free to shop around for the best price for the care I'm looking for?

----> You get costs estimates from dentists, but I shop around for quality, and doctors usually have the same pricing

If I am a health care professional, can I open up my own shop?

---> there is a territorial division for doctors, if an area is already full of them, I am not sure you can install yourself and be paid by insurances. But as an external sure. It would be extremly stupid economically however, better to go in the landside and get a practice subventionned by the canton.

What kind of regulations would I be subject to?
---> Quality control mostly, you are supposed to give the best treatment, period. There are a few HMO in Switzerland but thank Go this stupid american idea has not yet taken hold, Swiss value their health to much to give its control to a CEO.

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RE: If you have any question on european healthcare - 9/8/2009 1:13:55 PM

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quote:

ORIGINAL: Mercnbeth

quote:

If you have any question on European health-care

What is the specific procedure when you feel you are a victim of medical malpractice?

How many lawyers specialize and advertise for clients?

What are the fees involved?

How long does the process take?

Who has the burden of proof?

What is the cost involved?

Is it ruled by a jury or judge?

Provide some examples of recent published awards

What was the most recent 'class action' medical or drug company law suit?

How many commercials per hour appear on European TV that compare to; "ATTENTION YAZ or YAZMIN USERS - You may be entitled to money damages! Call Attorney or www.yazfirm.com now!"?

How are these costs handled by the 'European' system?

What happens if you, as the plaintiff, lose?

For Switzerland, but it is basically the same in France in Germany,
You sue the doctor or the hospital, with a bit of luck, in France the state attorney will pursue to.
No one advertise
I do not now who has the burden of proof
You pay your own lawyer either after a bareme (Germany, France?, Switzerland) or you can try to negotiate, I do not htink that success-based fees are allowed.
In all three a judge
No clue
Class action are relatively new in France and Germany, unheard of in Switzerland
no such commercial
no clue what you mean.
In Germany, you pay for the complete trial (your lawyer, the other lawyer and the justice), in France and CH, I do not know

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RE: If you have any question on european healthcare - 9/8/2009 1:17:06 PM

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quote:

ORIGINAL: TurboJugend

There is no European healthcare..it is different from country to country.
And for sure different from the American system....but Europe is not a unity when it comes to healthcare.

There is ONE European healthcare... in the media, especially fox news, and the current Republicans do not know that we have several countries over here

Be seing you

Henry

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RE: If you have any question on european healthcare - 9/8/2009 1:39:36 PM

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quote:

There is ONE European healthcare... in the media, especially fox news, and the current Republicans do not know that we have several countries over here

You do realize that there are other sources of news, or is your channel locked?

It is no wonder that FOX is the #1 rated source of cable news.

quote:

ORIGINAL: Falkenstein

quote:

ORIGINAL: Mercnbeth

quote:

If you have any question on European health-care

What is the specific procedure when you feel you are a victim of medical malpractice?

How many lawyers specialize and advertise for clients?

What are the fees involved?

How long does the process take?

Who has the burden of proof?

What is the cost involved?

Is it ruled by a jury or judge?

Provide some examples of recent published awards

What was the most recent 'class action' medical or drug company law suit?

How many commercials per hour appear on European TV that compare to; "ATTENTION YAZ or YAZMIN USERS - You may be entitled to money damages! Call Attorney or www.yazfirm.com now!"?

How are these costs handled by the 'European' system?

What happens if you, as the plaintiff, lose?

For Switzerland, but it is basically the same in France in Germany,
You sue the doctor or the hospital, with a bit of luck, in France the state attorney will pursue to.
No one advertise
I do not now who has the burden of proof
You pay your own lawyer either after a bareme (Germany, France?, Switzerland) or you can try to negotiate, I do not htink that success-based fees are allowed.
In all three a judge
No clue
Class action are relatively new in France and Germany, unheard of in Switzerland
no such commercial
no clue what you mean.
In Germany, you pay for the complete trial (your lawyer, the other lawyer and the justice), in France and CH, I do not know

Thank you for confirming a few of the major differences and reasons why little, if any, of the European Health-care system programs can be applied to the US system. Litigation and the fear of litigation adds exponentially to the current costs and, as a result, access.

Curious though how you would apply Republican geography ignorance as a cause for the incongruity of applying any European health-care system in the US. Based on your expertise it would seem that there is no comparison regardless of party affiliation. Wouldn't any Democrat citing any of the European models as 'ideal' examples of what the US should do, without considering these differences be economically ignorant at least at the same level of your FOX news source and the Republicans?

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RE: If you have any question on european healthcare - 9/8/2009 1:42:20 PM

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quote:

ORIGINAL: Arpig

My remark wasn't directed at you Turbo,sorry, I should have made that clear.

NO problem... ;)

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RE: If you have any question on european healthcare - 9/8/2009 2:00:46 PM

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quote:

ORIGINAL: UglyTruth

quote:

ORIGINAL: Falkenstein

...You can ask me

I surely do not know all the answers, but been there and done that etc. I can give you some insight.

I quite surprised by the way European Healthcare is described in the US media and especially by the way it is disparraged by the Republicans.

Healthcare systems in Europe face serious problems too, but they are never mentionned.

So, if you are interested in what the Swissification of Healthcare means,

just post here.

Take (health)care

Henry

Okay, thanks for the offer.

Can I go to any caregiver of my choosing (such as a midwife for births?)?
Am I free to shop around for the best price for the care I'm looking for?

If I am a health care professional, can I open up my own shop?
What kind of regulations would I be subject to?

Those are just off the top of my head.

Thanks, again.

I'm gonna try to help by replying to these, the main point however is that there isn't just one european system you can ask about, be best off asking about specific countries.

Caregiver of your choosing: Depends, the majority of nations do it on an insurance basis, france is the most commonly cited because it's so good, and yes you could choose whoever you liked in france, and probably the same in most other insurance based systems, but can't guarantee....things vary from nation to nation.

In a system where the actual hospitals and doctors are public sector, such as the NHS....not so much. You may be able to object to one specific midwife and ask for an alternative, but don't always get to pick. Again though, it varies in different systems.

Are you free to shop around? In insurance systems generally yes, but the govt will only refund a set price, if you choose to go somewhere expensive you have to pay the difference. In france many of the middle earners have extra private insurance, so they can go to expensive docs and claim what the govt won't pay from their extra insurance.
In public systems....well yes, but....you probably won't. The NHS for example, if you choose to do it on the NHS there is no shopping at all, and it is a very authoritarian left-wing kinda system....but you could go private if you wanted, so the answer is still yes....just doesn't actually work that way for most living in the UK.

Opening up your own shop...yes, absolutely. This is much easier in insurance systems where most docs are private practive, but you can do it anywhere.

Regulations really depends, mostly it's the same kinda stuff you'd get anywhere, the big differences in regulation are mostly aimed at the insurance side of things....this question is too vague to answer well, but as a doctor/whatever it will be pretty much the same stuff wherever.

(in reply to UglyTruth)

RE: If you have any question on european healthcare - 9/8/2009 2:12:12 PM

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@Merc, isn't that a little dodgy......saying that you shouldn't change to systems where litigation is kept down because litigation isn't kept down?

In the UK things are much more american......there are no-win-no-fee adverts all over the tv, it's very similar to usa in that respect with a couple of things.
Mostly, there is no UK version of class action.
Secondly, there is an impression over here that usa judges and the system in general allow ridiculous claims to go through and make money, that americans reaaally like their sueing. Most of that may be just a perception though, but I've known enough americans to know that 'I'm getting sick, better phone my lawyer' is fairly usual approach to dealing with the american insurance companies...

As for talking about what system you should adopt based on how they work in other nations.....it seems fairly sensible to me....otherwise you're just theorycrafting surely...

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RE: If you have any question on european healthcare - 9/8/2009 3:09:39 PM

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Nope,

you see, here in Europe, when something is not working in one country, we go to other countries which get better results and try to find out what they are doing right. In the worst case, our representative are out of the country and cannot make mischief, at best something even gets implemented.

For example the French (yes, the arrogant French) took over from the German the concept of an indepentent central bank long before the Euro, are trying (but so far with limited results) to emulate the jobless system of Denmark and are looking deep into the Finnish school system to better their own. They even took from the USA the idea of CNN, my preffered source of information with the Financial Times, the WSJ, the IHT and the Economist.

Of course you can have a look at what other countries are doing better and see how you can acclimate it at home.

And since almost all European countries fare better than the USA in terms of health and health costs, you should at least give it a try, a damn good try.

Be seing you,

Henry

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RE: If you have any question on european healthcare - 9/8/2009 3:20:36 PM

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quote:

****Merc, isn't that a little dodgy......saying that you shouldn't change to systems where litigation is kept down because litigation isn't kept down?

It would be if that is what I said.

The subject was comparison to "European heath-care"; my position is that no comparison works unless it is used in a vacuum. My point was any attempt at comparison is useless. To be clear on the interjecting the issue of politics and/or political parties; both sides to the issue in the US use the vacuum approach.

quote:

As for talking about what system you should adopt based on how they work in other nations.....it seems fairly sensible to me....

What is the relevance of any nation's program when the nation doesn't compare fundamentally at one of the causes of the problem? No 'class action' lawsuits. A dramatic difference in lawyers advertising contingency fee based litigation. Up front costs for filing any claim of malpractice. Put any or all of those in place in the US and you dramatically change the current problem.

I would submit that the label "theory-crafting" is better applied when the new system being considered doesn't take into account those differences. What good is a theory based on a wrong foundation? Access is only one way they work. Cost and ongoing viability of the underlying system for implementation and record keeping must also be addressed.

Before any working system should be considered you first need to identify what "it" is. Can you honestly tell me you know what 'system' is behind pondered at present in Washington? Once you define 'it' you have to implement it. How will it 'work'? How will fraud and duplicity in reporting be controlled under the proposed Bill? Finally you get to how will it be funded and costs controlled.

When a large portion of current US cost is incurred because currently 'risk managers' avoiding lawsuits require health care providers to conduct millions of tests to find the one exception I think it should be a fundamental adjustment to undertake in the system before adding the estimated 46 Million more potential litigants.

If you are going to change 'it' - change 'it' all. Unless you do, all you accomplish is putting more resources in the hands of the 'special interests' pushing for this Bill. You will not see the goal of improving the health care in the US, and you may not even improve access.

(in reply to DCWoody)

RE: If you have any question on european healthcare - 9/8/2009 5:04:32 PM

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Ellen, was it TR Reid?
http://www.npr.org/templates/story/story.php?storyId=112172939

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RE: If you have any question on european healthcare - 9/8/2009 8:17:39 PM

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quote:

ORIGINAL: Falkenstein

quote:

ORIGINAL: TurboJugend

There is no European healthcare..it is different from country to country.
And for sure different from the American system....but Europe is not a unity when it comes to healthcare.

There is ONE European healthcare... in the media, especially fox news, and the current Republicans do not know that we have several countries over here

Be seing you

Henry

Yea, the current republicans know there is more than one country over there. Now I could make a crack about all Europeans being rude, but it would be wrong to judge all those people based on your one post.

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