Many countries, many health care systems

I think it is an unfortunate situation that there are many people in
the United States who do not have adequate health care coverage, and I
think many other countries I have lived in do much better in this
regard...

In Austria, for more than 3 decades, I was covered by state health
insurance, which was quite complete coverage, and the system seems to
work well. You could have supplementary health insurance in
addition, but it did not really seem necessary. When I had
appendicitis in Austria in 1981, the hospital dealt with it well, and
I didn't have to pay anything at all - it was covered by state health
insurance, and almost nothing in the way of paperwork either..

In Japan the state health insurance provides basic health care
whenever I have a visa to stay in Japan for a year or more. But,
there may be some "loopholes" - it may be better to have some
supplementary - and I have not always found a solution that I am
really satisfied with. Short-term OK, but long-term still not really solved for me.

In the Netherlands, where I lived for 3 years, I didn't understand the
situation very well really, but I think it was better than in the US,
even now. Since they thought I was "well-paid", my employer said I
should buy into "private health insurance", required, which was
considered "adequate", I suppose.

Jimmy Macnaughton

Dates: I have not resided in the US since 1971.

Netherlands: 1971-1974

Austria: since 1974 except for time living in Japan

Japan:
1981
1990-1992
2001-2004 1/2 time in Japan
up to end of 2004, no problem with state health insurance in Austria

2005- present 9 months a year in Japan...

Long-term Hospital Stay in Spain

I had gotten a call from the daughter "M" of a fellow teacher, who I was helping while she was going to school, "K" is her apartment mate in this true story.

I got a phone call,"I don't know what to do, "K" is unconscious." "M" went to a neighbor and they called for an ambulance.

The next call from "M" was, "I am in the ambulance and we are on our way to Val D'Hebron Hospital." (In Barcelona) I left Sitges and was at the hospital within an hour and worked my way to the emergency room. There was "M" in utter shock and "K" was unconscious and being prepped to be moved to intensive care........

The doctors and nurses wheeled her up to intensive care and "M" and I waited about two hours before a doctor called us in to an office. She asked if we were relatives. We said no.....Fortunately "M" had grabbed "K's" purse. The doctor told us that "K" had suffered a sodium depletion and had aspirated her vomit and that her lungs had become totally infected......"You have to call "K's" mother immediately and get her here, we do not know if she will make it."

"M" and I phoned the mother from the hospital and explained the emergency, but did not mention the possibility that "K" might not make it. (To emphasize the emergency I told "Ks" mother, "I don't care how much you have to spend on the ticket, you have to get here.") I met "K's" mother at the airport the next morning and took her right to the hospital. "K" was on tubes and unconscious.

"K" was unconscious for at least three weeks and remained in intensive care for five weeks. She was then transferred to the General Hospital for a week when she suffered a pulmonary embulism and was put back into intensive care for a week and back to the general hospital for two more weeks.

When she was released, she was ambulanced back to the hospital several times for therapy.....

I was at the hospital every day of the first five weeks to help the mother and to translate with friends of "K"......

"K" Suffered from a sodium depletion, ARDS (Acute Respiratory Disorder Syndrome), Pulmonary Embulism........The only reason she survived was because she was a cross country runner and ran almost every day, she never smoked, and she never did drugs. She was well educated and is working on her PHD today.

She is a U.S. Citizen and was attending a university and working part time..........Tecnically she should not have been covered by the social security system here, but the University got that adjusted.

She was taking extensive amounts of drugs for a long time (Antibiotics, Anticoagulants etc.) She was monitored for about six months and eventually was released from hospital care with her "Alta". Once, after a trip to the U.S., she discovered a blood clot in her leg and learned that she had to inject herself with an anticoagulant prior to any flight...........

What was her bill at the end of all that ? "0" I believe the most she had to pay for any prescriptions after release from the hospital was 2 euros.........

In seven years of living in Spain, I have paid "0" towards my healthcare......I can join the social security system for 48 euros a month , approximately $68. However, even if I am not in the system and in an emergency, they will take care of me and worry about billing later......

Doctors are paid 42,000 to 46,000 Euros, about $54,000 to $59,000 a year (And probably work 20 hours a week for Spain) ........I have a friend who is a doctor. Since he is a capitalist, he has his own private clinic in two separate cities and makes about $125,000 a year total.

If I were President: I would make all licensed doctors participate in an annual national licensing program that they must serve 20 hours of service at a Nationalized Hospital......They would all receive $100,000 for that service.

What hospitals should be nationalized? County and state hospitals and private hospitals that are going out of business or not making it........Remember, Religious Hospitals get wicked tax breaks that private hospitals can not compete with.

Unless the United States takes the burden of healthcare off the American Businesses, Governmental bodies, school districts, wages can not be competitive with the rest of the world?

President Obama claims that, "We must impove the system we have." I disagree you must remove the system we have and build a new one......Yes, "We can rebuild America without greediness and corruption!"

Herbert Chersonsky
Spain

I have No medical horror stories

I've been living in Japan for 33 years
3 of my four children were born here (the eldest child was born in Denmark -- that cost me $26.00)
Last year I had a 3-hour surgery and stayed in the hospital for 3 weeks.
I/my family have never had difficulty paying any medical bills.
I have NO medical horror stories to tell.
Karen
Japan
California

Socialized Medicine is Exciting!

In honor of Michael Moore's movie SICKO that's getting tremendous attention everywhere, I thought I'd share a personal experience of my own. I just got home from the most amazing experience, it's called..... (drumroll)... SOCIALIZED MEDICINE!!! It was so exciting.

About 2 weeks ago I slammed my knee running for the train (late as usual). The concrete step crashed into the middle of my kneecap, and I could barely bend it for 2 days. Although it improved, I was worried cuz it was still hurting sometimes. I didn't want it to heal weird, and start throbbing every time there was a rainstorm, or something like that. So I asked the lady at my foreign-students dormitory where I could get it checked out. She gave me a list of doctors in our neighborhood (about 15, all covering different specialties). We agreed I should go to the orthopedic surgeon; "no appointment is necessary, just show up" she said. I went at about 5 p.m. today on my bike.

Oh my goodness!!!!!! It was about the most divine customer-service experience of my LIFE! Dr. Maeda's office was a little drab, but functional and clean. Not luxurious-looking like hospitals in the U.S., with lots of fake plants and plaques with donors names. Just wood-panel walls and old magazines. I gave a written description of my problem to ease the language barrier, and after filling out one short form (basically contact info only) and handing over my government health insurance card, I took a seat.
SIDENOTE: Did you catch that part? GOVERNMENT HEALTH INSURANCE CARD!!! It is a cute blue affair that comes with a free plastic cover. I got it the week I arrived in Japan. Fresh off the boat, new immigrant, terrible Japanese. Still, I qualified for inclusion and was so happy to finally be fully insured I hugged and kissed the dude in the City Office, jumping up and down and yelling as he sweated in his polyester shirt. It was the best experience of my first month in Japan. But I hadn't had a chance to use the card until today...

So Dr. Maeda called for me from behind a door. Only wack thing about the office: the walls don't touch the ceiling! So I guess they don't care about patient privacy. Everyone can hear everything, so if you have something embarrassing I guess you write it down and slip the paper across the table, like a bank robber.
Anyways, I sat down and put my purse in the basket conveniently provided for this purpose. Dr. Maeda is a cheerful, tanned Japanese Santa Claus type. I wish I took a picture of him. He was laughing and practicing his English on me: "You run for train! Haha! Is dangerous! Don't you listen to warning in station? Haha!" After a few minutes of poking and prodding my knee, he said "We do x-ray now."
He took 2 x-rays and I waited another 5 minutes. Then he called me back into his office. "No break! Just contusion! Haha!! No jogging please!" He thoughtfully looked the word "contusion" up in his ancient dictionary while I was waiting. There was no interpreter but we got along ok with my so-so Japanese and his enthusiastic English.
He called the nurse to put a medicated stretchy patch thing over my whole knee, and cover it with a short white netting thing. Wrote a prescription for more of the disposable patches and sent me on my way with a laugh, saying in Japanese "If you were younger it would have healed faster! Haha, just kidding! Stop running for the train, ok? Haha!" I was glad to provide him with a source of hilarity for the afternoon, and stepped out of the office smiling. I sat back down on the bench to wait for the bill. I had been reassured "it won't be too much!" but I had no idea what to expect.

Soon the secretary called me up. "Forenbaum-san?" She returned my health insurance card, and gave me a new laminated one to use if I return to Dr. Maeda's. Then the bill: $13.24 (JY 1,610). That's it!! I'm on the "30% plan," which means the government pays the other 70% of the office visit. That includes 2 x-rays, meeting with the doctor, and getting one patch applied. No appointment, no waiting, excellent service, an immediate diagnosis, everyone's friendly. The whole affair took 30 minutes, out the door.

As for the prescription for the patches, those of us in from the medical hinterlands called the United States know that getting a prescription filled can be the most painful part of being sick. I remember as a kid waiting for hours in the Kaiser pharmacy, in a packed waiting room with screaming kids, dope fiends in rehab, people with rashes, and lots of coughing. As I started to leave Dr. Maeda's, I was grateful I could put off filling the non-emergency prescription for the knee patches. But the secretary told me: "There's a pharmacy just around the corner. Across from the 7-11. Take this there." I hopped on my bike. "Feel better!" she waved as I pulled away.

At said pharmacy, I walked in and handed the paper to dude. He took it in the back. 4 minutes later, emerged with my stuff. Grand total? $2.80 (JY 340). 2 weeks of treatment, silver plastic bag, my receipt. I'm dumbfounded, but the pharmacist is looking at me like I stole something. "Uhh, do you need anything else?" "Uh, I guess not..." Nutrition posters and bottles of Shiseido shampoo line the walls as I walk out.

Riding my bike home, I felt re-energized. Enthusiastic!! Healthy!! When did I last feel that way leaving the doctor's office... Maybe it was the warm reception I received (despite being a grammar-mangling foreigner) or maybe it was the unknown drugs in the stretchy patch thing. Or maybe it was the fact that my life wasn't interrupted by this minor injury, and society seems to agree that pro-active care for my knee is a pretty good idea. That's calming. I pedalled down the hill to do some grocery shopping. I'm not worried about my knee, or any other part of my health, and can focus on my work and life.

Nina Fallenbaum
Kanagawa, Japan
California

Agness' health care video

Kathleen's Health care video

Autoimmune Disorder and German health care system

My parents who are from California and Tennessee came to live in Germany in 1971 to pursue their academic careers. Thus, my older sister and I were born and raised in Germany, but have only U.S. citizenship. At the time of my parents’ immigration my mother was already very ill with juvenile diabetes, slowly losing her eyesight. During my childhood she had almost a dozen eye surgeries which were all paid for by the universal health care system of Germany and helped maintain her eyesight a little longer. Sadly, also other aspects of my mother’s health declined over the years and she became dependent on nursing staff to come to her apartment several times a day to check her blood sugar levels for her. Although we had fights with our health insurance over the amount of care they would pay for, we were glad that we lived in Germany and were able to afford the care that was needed. When my mother was diagnosed with end-stage ovarian cancer in May 2003, she was so ill that she died in hospital within three weeks after diagnosis. As hard as it was for us to deal with losing our mother and making funeral arrangements etc. we can be grateful that she received excellent care at the university hospital and that we did not have to pay any bills related to her hospital stay.

Not only our mother was highly dependent on the German universal healthcare system, at the age of 20 I was diagnosed with an autoimmune disorder and spent several weeks in the university hospital in the city where I was attending university. A myriad of diagnostic tests was performed, and no one ever said that certain tests could not be done due to high cost, and I never had to pay more than the normal amount of health insurance and prescription fees. Unfortunately, due to this pre-existing condition even in Germany I could no longer buy life-insurance. Already at that time I realized that I would probably never be able to afford life in the U.S. given my health issues. No one expected what happened less than five years later. At the age of 25, I suffered a stroke to the brainstem and cerebellum which left me in intensive care and then in a wheelchair for weeks. My health insurance paid for 8 days on the stroke unit, 5 weeks in a university hospital neurology unit, transfer to and 9 weeks in a highly specialized neurology rehabilitation facility, another 7 weeks in an outpatient rehabilitation facility in my hometown, and finally 2 more years of physiotherapy, occupational therapy and speech therapy. They never put a limit as to how long they would pay for it as long as the doctors said that the therapy was required. I was highly motivated and practised a lot, otherwise my rehabilitation would have taken much longer I’m sure.

In the year after my stroke I required major abdominal surgery and have had health problems ever since. However, due to the great rehabilitation program I went through after my stroke and the high-quality diagnostics and therapy I am getting for my continued health problems, I have been able to go back to working full-time, although in a different line of work. I am able to continue (and afford) my hobbies of riding horses and travelling and consider myself to have a high quality of life. From what I hear from friends and relatives who live in the U.S., I am quite certain that I would not be able to maintain this life standard there regarding the cost of doctor’s visits, medications etc. that I need every year.

Natalie
Germany
Kern County, California

National Health Care Paid for Premature twins

In 1999, my twins were born in a hospital in Japan, 14 weeks premature. My first thought, after I found out that they had been stabilized in the NICU, where basic costs were 80,000 yen per day, was that my husband and I would have to sell our house and that we would probably be forever in debt. As a native of a country without universal healthcare, this was the only outcome I could imagine.

Happily, national and supplemental insurance covered my twins' four and five month hospital stays. Japanese national insurance also covered my daughter's subsequent hospital stays (she was hospitalized at least ten times after she got out of the USA due to hermias, and respiratory infections which required stays in the very expensive ICU, HCU and CCU.)

Although I love my country, I believe that my family can not afford to live there. Without the Japanese national healthcare system, my family would have been rendered impoverished.

Suzanne Kamata
Japan
South Carolina

National Health Care--No wait, easy sign up, cheap

In praise of universal coverage

The issue of health care is front and center these days due in large part to Michael Moore's new film. His documentary, "Sicko" shines a light on a dysfunctional health care system that does more to serve the interests of for-profit insurers than it does for the average American citizen. One of the most absurd features of the US for-profit health care system is denying someone access to treatment or a procedure based on a pre-existing condition.

I recall trying to explain the concept of pre-existing condition to a friend from another country. This person could not fully grasp the concept as applied to health care because in his reality it did not exist - a reality where every citizen has access to high quality and affordable medical and dental care and would never be denied treatment based on past treatment, or a present medical condition - isn't that when people would most need care - to treat a present medical condition? Of course it is.

I am privileged to be able to share a view on this issue as a resident of a country that has an excellent universal heath care system, and thankfully NO pre-exisiting condition exclusions. In Japan, where I work and live, I am fully covered under a comprehensive universal coverage scheme through my city office. The process of enrolling was straightforward and painless. I presented myself at the city office, answered a few questions regarding visa status (I hold a work visa), last year's income in Japan (I had none as I had been in the US) and then I waited for a few minutes. The clerk came back with a new health insurance certificate for my family and informed me that I would receive my insurance premium invoice in a few weeks.

Sure enough, in a few weeks I received my insurance premium invoice in the mail. The annual premium was approximately $300.00 US dollars. I had to look again and confirm this with a Japanese friend - there was no mistake. I had the option of paying in ten installments or in a lump sum. At that premium I opted to take care of it all at once and viola, our health insurance was paid up for a year. Of course, our premiums were nominal due to not having any income to report in Japan for the previous year; this year they are higher but still much lower (around $230.00 per month for two people) than what I would pay for a private policy for my family in the US - another excellent feature of this plan is that the premium also includes long-term care insurance for adults over the age of 40.

There is nothing like the feeling of security that comes from knowing that when necessary, you and your family have access to affordable medical and dental treatment. Having been without such coverage in the US and having experienced the accompanying anxiety, I feel fortunate to be able to participate in a system that is, unfortunately, and sadly, out of reach for 47 million Americans, many of whom are children.

Gregory
Japan
Seattle, Washington

See the original post here
http://broaderview.blogspot.com/2007/07/in-praise-of-universal-coverage.html

When our twins were born, we received a cash payment ...

In Japan, when our children, twin girls, were born, we received a direct cash payment equal to the full amount a typical hospital would charge for each birth, not some unrealistic fraction of the amount. Our daughters, now toddlers, will receive free health care until their mid teens -- vaccinations, coughs and colds, emergency care, major care if they need it.

We can use virtually any doctor or hospital, and their regular pediatrician is a Japanese version of a Normal Rockwell small town family doctor.

I feel like we get something worthwhile for my tax money in Japan -- not just the Rumsfeld-Cheney war.

Eric W. Sedlak
Tokyo