Friday, February 12, 2010

In Canada, I simply call my doctor and make an appointment

My husband & I live in Canada but are in Arizona for 3 months this winter. We took out Blue Cross travel insurance. I have had 2 medical emergencies...the first one Blue Cross paid but I had to pay the second one.

When I paid the $125 to see a doctor I thought "for some families this would be like making a decision to go to the doctor when you needed medical attention or putting food on the table for your family."

In Canada, I would simply call and make and appointment to see my Dr. If it was an emergency, I'd be in the same day - otherwise it would be a case of waiting till the next day. Then I would receive care, a prescription or whatever. We never see a bill or know the cost involved. 18 years ago I was diagnosed with breast cancer. I had surgery within 2 weeks of my diagnosis and then had radiation, took Tamoxifin for 5 years. I picked up a 3 month supply at our local cancer clinic and went on my way.

No bills, no stress or wondering if I would be covered. And EVERYONE has care...it's worth the extra we pay in taxes for such piece of mind!!

Anonymous

Arizona
Cross posted from http://healthcare.democratsabroad.ca/

Write a letter to your Congressperson

This post is from Bob Haiducek, who is responsible for the website www.medicareforall.org and who runs the Million Letters for Health Care campaign. Bob's website allows you to do what he calls "sign up to stand up for single-payer, Medicare for All", so I recommend that you sign up to be counted as a supporter in whatever your U.S. Congressional District is in the U.S. Bob sends 1 helpful e-mail each month with a fresh set of suggestions that you can use directly or for an idea to personalize your letter.

Any American in any country can participate. If you don't want to pay for the overseas postage to actually send the monthly letter, you could do a copy and past each month of your letter to your U.S. Representative into an e-mail and do a cc: or bcc: to bob@medicareforall.org. Bob will get your letter to your U.S. Representative ... in an envelope in the U.S. Mail if the donations to his website allow him to be able to handle that expense.

Following are excerpts of one of Bob's monthly helpful reminders. You can use ideas from the list below, write your own letter, or go to www.medicareforall.org to download a sample letter.

==== SUGGESTION: select one of these to write or use as an idea for what you write ====

September 2009

People in other free-market countries wonder why we have not implemented low-cost high-quality health care for all like they did. It's time for us to act!

We know from President Obama's position in 2003 that he will sign if people communicate in every Congressional District. We are now communicating!

People need to automatically have full health care for their entire lives to improve the quality of life and help people have good preventive care.

People need to automatically have full health care for their entire lives to improve the quality of life without having any major medical bills.

We want this one action that will save families up to $8,000 per year in addition to possibly saving up to $2,500 per year with additional actions.
==============================


For Your Reference in Conversations --------

If you are among fellow activists, please consider bringing up the subject of the contents of this "Help Get Care" document:
http://www.medicareforall.org/files/helpgetcare.pdf
or its corresponding web page.

If you are among people who are supportive of single-payer and would like to know more, please consider these documents:
http://www.medicareforall.org/files/benefits.pdf
or its corresponding web page
and
http://www.medicareforall.org/files/twochoices.pdf
or its corresponding web page.

Friday, September 25, 2009

If I had to Choose Between Current US System and Current Japanese System...I Would Unequivocally Choose the Japanese System

"I’ve been living in Japan for over four years now and my experiences with the Japanese health care system have been universally positive. During my first year in Japan I was covered by the Kokumin-Kenkō-Hoken 国民健康保険 (national health insurance — i.e. “the public option”).

Since I had no registered income in Japan for the year prior to signing up with the national health insurance system I ended up paying the absolute minimum amount (the amount you pay into the national system is calculated as a percentage of your previous year’s income). I ended up paying 18,000 yen for a year’s worth of insurance, or the equivalent of around 180 U.S. dollars. This allowed me to see any doctor I chose with no limitation on consultations or on treatment. Of course, there were co-pays involved depending on the services that I needed, but these were so incredibly low as to be practically non-existent. For example, a consultation with a doctor would run me between 300 and 700 yen (three to seven U.S. dollars) and a two-week prescription for antibiotics might end up costing about 1,500 yen (about fifteen dollars).

In my second year of living in Japan new rules came into place and I was required to sign up with the insurance program offered by the university that I work for (supplementary insurance is available if you feel that the university insurance is insufficient). Now I pay somewhere between 100 and 300 dollars a month for my health insurance (I’m not sure exactly what the precise amount is since it’s taken out of my paycheck automatically and it doesn’t make enough of a dent in my earnings for me to spend very much time thinking about it).

As with a great many employers in Japan, the university that I work for requires its employees to take an annual medical exam (at no expense to the individual). This exam includes a host of standard tests (urine, blood, etc.), as well as a mandatory chest x-ray for teachers (tuberculosis is a problem in Japan, as is lung cancer). What this means, of course, is that doctors are able to offer preventative medical advice about lifestyle choices based on the readings they get from your annual exams, in addition to the obvious benefit of catching medical problems early enough that they can be dealt with at the stage when treatment is most effective — i.e., before symptoms escalate to the point of an emergency room visit.

Here's a more detailed account dealing with a sinus infection that I had: I came to the hospital with no appointment and was directed to the ear-nose-throat specialists. I did have to wait almost two hours (luckily I brought a book), but I was finally seen by the doctor who checked my sinuses, sent me for an x-ray to confirm that I had a sinus infection, and then prescribed antibiotics for me. The total cost out of my own pocket? About 3,500 yen, or 35 bucks in U.S. currency. I had a followup appointment the next week. I had to wait for about 15 minutes, the doctor asked me how I was doing and checked my sinuses again, saw that the medication was doing the trick, and sent me away. Cost? 300 yen (about three U.S. dollars).

Since I’ve been living in Japan I’ve had nothing but good experiences with the Japanese medical system and even though I have had two waits of longer than an hour, I was still able to see the doctor on the same day without an appointment and get the treatment that I needed. On the days when I had made a prior appointment I was able to see the doctor within 15 minutes of the appointed time (comparable to the States, except for one time in Berkeley when I was left waiting in the examination room for about 45 minutes before the doctor showed up). My visits to the doctor are unconscionably cheap, the doctors are always nice enough (though it’s true they don’t spend a lot of time with pleasantries), and they’ve listened to and addressed my questions. Whenever I’ve had medicine prescribed it’s been cheap and done the trick. When friends from abroad have come to visit they’ve had similar experiences (including being amazed at the incredibly cheap doctor bills). I have had the proverbial three-minute doctor visit (which was indeed a blunt instrument), but it worked —prescription given, problem solved.

Let me be absolutely clear — If I had to choose between spending the rest of my days with the Japanese health care system as it stands now or spending the rest of my days with the U.S. health care system as it stands now, I would unequivocally and without hesitation choose the Japanese system."

Trane DeVore
Kansai, Japan

Saturday, August 15, 2009

The Japanese Receptionist Apologized for the High Costs

I have Diverticulitis which sometimes becomes inflamed and I have to go to the doctor to receive antibiotics. The pain subsides within 24 hrs and disappears after about three days. My last problem with it occurred about 4 yrs ago.

Well, while I was visiting Japan a couple of years ago with my Japanese wife, it became inflamed and within 24 hrs I developed a slight fever and knew I would have to go see a doctor or go to the hospital. I was a little concerned as I had no national health insurance, but it had to be done regardless of the cost.

My wife called a doctor in the neighborhood and an appointment was made for an hour later. It was a Saturday morning and I figured it would probably be crowded. I had not received medical care in Japan since the 80’s when I was living there full time and, not knowing the present cost without insurance we took 60,000 yen (about US$600) with us as, in the US, with no health insurance the cost would probably be at least $200 if not more.

We walked the 10 minutes to the small clinic and upon entering, after removing our shoes and using the slippers (pink for females, blue for males) I was amazed that there were only two patients there, an elderly gentleman and a woman with a baby. Surprising for a Saturday morning as in the US on a Saturday the offices are booked solid and one must wait at least an hour over ones scheduled ”appointment”. The nurse behind the counter took my basic information and asked that I take a seat and said the doctor would see me shortly. Unlike the US there were no pages and pages of info to fill out for a first time visit.

Within 10 minutes the doctor called us in and I noticed his diploma on the wall from Tokyo University. I explained my situation to him in Japanese with help from my wife and what kind of penicillin I usually take for the symptoms. He understood what I was talking about, checked his computer for reference and asked that I lie down. Locating the pain on the left side of my abdomen he asked that I take a urine test. I left the cup on the counter in the restroom and as soon as I returned to the room he said that my urine was ok. Now that was fast!

He said that he would give me a 5 day prescription for antibiotics and pain killers and that if the pain did not subside within 24 hrs that I was to return. We went to the counter and we were given the medicine right there! No pharmacy to go to! Our bill was calculated and it was presented to us.

To my astonishment the total bill for the visit, urine test and two prescriptions was 4,610 yen!! Approximately US$38 at the then exchange rate! And that was with no National Health Insurance! My wife and I looked at each other with wide open eyes. I asked her if this was the normal cost and she asked the nurse. Yes it was and they apologized for the cost with my having no health insurance! Unbelievably reasonable in my opinion and there was no need for them to apologize if they knew the cost of such a visit in the US. It was way lower than either of us expected. Had I been living in Japan it would've cost me about US$7 - $10 for the visit under their health care system.

I calculated the cost of what this would have cost me in the US WITH insurance. The co-pays for the doctor, urine test, and two prescriptions at a pharmacy would have come out to about $60 and, with no insurance the cost would have been at least $200! This just goes to show how unreasonable medical costs are in the US.

Anyway, within a couple of days I was fine and my visit to Japan was not interrupted at all as I was still able to function thanks to the pain killers and had a wonderful time during the rest of my visit. I am very grateful that in Japan you are not ripped off for emergency medical care even if you have no health insurance!

Therefore, if you are visiting Japan and become ill, don’t fear that it will cost you an arm and a leg if you have to receive emergency care as the costs are very reasonable to one without insurance.

It's funny how many of the major pundits never mention Japan's Single Payer System and how successful it is. Rather they point fingers at the UK's and Canada's bad systems. In Japan anyone can go to any doctor or hospital at any time for any test or surgery or care. In Japan's system no one is turned down due to pre-existing conditions and everyone is required to participate and the monthly premiums average around US$250. THE per capita cost in Japan to the government is around US$2,500 whereas in the US the per capita cost, with the present system, is over $6,000!

Would such reasonable and affordable care happen in the US with a national health care system and the prices be so affordable? I think not as the US system is designed for profit whereas in Japan all prices from major surgeries to prescriptions to the number of stitches is set by the Japanese government every two years and hospitals must be not for profit. It would, in my opinion be a disaster in the US. The US must go slow on this and all congress people should be required to read the bill before it is passed. If not it will cost the US and their people trillions and will fail. Besides, the system is too corrupt in the US for it to be a success as the majority of our government is bought and paid for by the pharmaceutical industries and the insurance industries IMO. It's doomed to fail unless the people are vigilant and ensure that a reasonable system is enacted and where the average person can read and understand the bill now before congress!

Joe
Tennessee
Japan

Americans Who Can't Go Home Because of Health Care

Can't Go Home from Turtlebox Productions on Vimeo.

Cost for care in Scotland was zero

I'll make this short. Our daughter suffered for years in the United States with an undiagnosed case of Myasthenia Gravis. Her doctors, including a neurologist in New York, failed to diagnosis her disease and dismissed the symptoms as psychosomatic. Mind you, the symptoms, as we learned later, were classic for a young woman with this admittedly rare disease.

After moving to Scotland to start a Masters program, she could finally no longer swallow reliably or talk for more than a few minutes before her muscles no longer worked. After receiving no useful care at an emergency room, she went to see our local GP who referred her to the local teaching hospital. There, based on nothing more than a conversation and superficial examination, the UK equivalent of a new resident correctly diagnosed the disease. Since then, she has been hospitalized for a month, given two very expensive courses of IVIG treatment, and had her thymus removed in major, open chest surgery. Thankfully she is now much better and about to head off for a Ph.D. program in England.

Recently, we flew back to New York to consult with perhaps the world expert on Myasthenia. After reviewing her symptoms and treatment he declared that the doctors in Scotland were doing all the right things. He then asked how much this cost. He had a bit of a hard time understanding that the cost was exactly zero. By the way, I spent about two months paying various bills associated with that one visit to his office. Quite a contrast I'd say.

Is the system in the UK perfect. Of course not. Did they provide superlative care for our daughter. Absolutely.

John
Scotland
New York

Wednesday, July 1, 2009

Some Comments on French Health Care System

I just thought I'd put in my two pennies worth about the French system of universal healthcare.

In fact, I am a person who avoids doctors like the plague and only seek medical care in an emergency. Even so, I'd much rather be in France than in the U.S. when that emergency happens.

Medical emergencies
In 25 years, our family has only had two major emergencies and in both cases, the medical care was exceptional and cost us nothing. The first was when our 5-year-old daughter caught her foot in the spokes of my bicycle while in the carry-on seat. She almost lost her heel. The neighbor rushed us both to the emergency room of the nearest medical facility, a private clinic. We were met by a surgeon and she went straight into the operating room. We both stayed in a private room for a week. I had a cot in her room, could stay with her 24 hours a day, and had meals in the room with her. All we had to pay was for my personal telephone calls. Everything else was covered between social security and our teachers' mutual insurance. To this day, whenever any medical person sees her scar, they are amazed at the terrific job the surgeon did - she was within one centimeter of losing her entire heel.

The other occasion was when the coffee machine exploded on me and burned both hands and arms up to the elbow. Again I rushed to the same medical facility, was met by the same surgeon, and received instant top care. Again it cost us nothing. In fact, we then contacted our mutual and asked for household help, because I could not use my arms or hands. That same day, a specialized caregiver arrived on our doorstep, and was there to do anything that needed doing -- housework, meal preparation, driving.... She came every day for three weeks, until the burns were fully healed. Today I have no scars whatsoever, although at the time, all the flesh of my inner right arm had disappeared....

Giving birth
The French system has positive and negative points. One is that because everything is free, people tend to go to the doctor on the slightest pretext. They are also heavily over medicated. Each time I was pregnant, I was required to have an examination every month, plus an ultrasound at four months and another at 8 months. These experiences were traumatic for me -- they felt like a violation of my privacy and not necessarily good for the child. However when it came to delivery, I, like every other woman here, was kept in the hospital or clinic, for a full week after giving birth, and again, at no cost other than my phone calls. I have been told that in the U.S. costs for staying in the hospital just overnight after giving birth are astronomical.

Mental Health
When discussing medical coverage, we need to include mental health. When close relatives have needed mental health care, they have been able to walk straight into a clinic, and receive counselling, therapy, and psychiatric care at no cost. No identity papers had to be shown, no forms filled out. The care continued as long as needed.

Alcoholism is treated as an illness. One member of the family went to his doctor, confessed the problem, and was sent to an alcohol specialist who treated every aspect of the problem -- physical consequences, addiction, psychotherapy. If necessary, the person would have been sent to a reatreat -- however in this particular case, other solutions were found. The entire attitude towards alcoholism was very enilightened and effective -- and the person was charged nothing.

Similarly, when another member had a mental breakdown, she was able to go to a psychiatrist in a socio-medical center and follow therapy without ever laying out a dime or filling out a form or even showing an id card.

Pros and cons
The French social security system is much more comprehensive than anything in the U.S. The way it is financed contributes to the economic gridlock of the country, because social charges are so high that employers can't afford to hire additional personnel. Furthermore, the employer has to pay these charges whether or not s/he has had any income at all. This problem is being addressed in a variety of ways, as the government tries to find more flexible means of financing social care. In terms of medical and mental health care, as I mentioned, people tend to abuse the system -- going to the doctor for a sniffle, overmedicating, and not taking responsibility for their daily life.

Nonetheless, as I stated in the beginning, I'd rather be in France in an emergency than in the U.S. Furthermore, healthcare and a wide variety of childcare facilities were major reasons for staying in this country when the children were small.

Christine
France

Don't Believe What You are Told by Republicans

An American in France responds to a CNN story about Health care.
It starts with this:
"As an American living in France I speak about government health care based on experience. Don't believe it when you're told you won't be able to choose your doctors or treatment."

Watch the video here
http://www.ireport.com/docs/DOC-268771

Blog posted by Linda
Video by Sally in Paris

Friday, May 29, 2009

Prostate Laser Surgery for the Equivalent of $1500

I'm a permanent resident of Japan and therefore am an automatic Japanese National Health Insured Payee; I had the latest laser surgery (as per date of surgery) for prostrate complications, for around $1,500 on February 5, 2008. Period!!!!! It's called HOLEP.

I've researched the internet and wasn't able to come up with the costs in the US, but I do recall it cost almost $1000 alone to get checked in NY. And people who are familiar with this procedure are well aware that $1500 would barely cover the room costs in the US.

PJ Johnson
Tokyo
New York