(not political) Aspects of socilized healthcare

[Jayster]

People that live in countries other than America
(just because we don't have it),

Again without being political, I was really wondering about the use of 'holistic medicine' in regards to;

When do you see a doctor, is a virus a reason to go?
Certainly a broken bone or something like that would be covered, but are there any gray areas?

We've(America) discouraged the use of herbs, and other 'natural medicines' that are not approved by the FDA. How do things like 'home remedies' fit in, or do they at all?

[Spivonious]

Trying not to get political, but the reasons I think healthcare costs are so high are:

1. People go to the ER for everything, not just emergencies. If your kid has a fever, give him some tylenol and call your family doctor. Don't go to the ER.

2. Crazy malpractice rewards. This causes doctors to order every test on the planet just in case because they don't want to get sued for not doing something.

3. Crazy malpractice rewards. This causes doctors' malpractice insurance rates to go up. Doctor salaries go up to compensate and these costs get passed on to the patient.

4. Health insurance pays for everything, even routine checkups. More payouts = higher rates. Also, since the insurance company is paying, hosptials charge whatever they want to. I went to the ER a couple years back for abdominal pain (turned out to be gallstone passing into my stomach) and they charged me $700 for an ultrasound.

5. Not so much about costs, but attaching health insurance to employment is ludicrous. We should buy health insurance like we do car insurance.

So to fix the system,
1. Detach health insurance from employment, but force employers to pass on their savings to employee salaries.
2. Change health insurance to be for emergencies. You don't use your car insurance to get an oil change; you shouldn't need health insurance to get a checkup.
3. Limit malpractice suit rewards to something reasonable. No more $2 million for pain and suffering.
4. If someone goes to the ER for a non-emergency, send them home. This would be up to the doctor to decide.

Nothing political here. I couldn't care less what political party wanted to do what. This is just my opinion.

[Carbuff]

Yes, #2 is a huge problem. My GP was telling me this exact thing last week. When he was a resident in the ER he used to order every possible test even though his diagnosis was correct all the time. Some doctors would get mad at him but he said with the sky high cost of malpractice awards he had to cover is ass.

[Jayster]

Spiv and Carbuff,

I agree with you guys the costs are high(will not get into different reasons here), and malpractice awards are often ridiculous;

I.E. ~ Recently a man was awarded 9 million dollars for scarring to his penis, after using a home injected substance to treat ED. This is much more than most AD&D policies would pay for anything!

However, what I wanted to discuss/learn about was in pre-exisiting 'socialized healthcare systems' - what is the role of 'holistic medicine' and are there are areas of questionable coverage?

[Spivonious]

Sorry for the hijack.

I think (and it may just be my American upbringing) that most holistic treatments are a wash. Purely a placebo effect.

[Jayster]

I think (and it may just be my American upbringing) that most holistic treatments are a wash. Purely a placebo effect.

Again drifting from point of thread;

Spiv, holistic treatments come from nature. The basis of most modern medicines also come from those same natural products, until they get them in a lab and either change them somewhat or just multiply the strength of the 'active components'.

I believe in the bible and there are many references to using 'holistic medicines' located in it, my family has a previous track record with successfully using non-pharmaceuticals in health care. It's an approach that many don't understand, that being said - I've no problem with going to the doctor when needed or taking certain prescriptions(although I do try to limit them(somewhat).

I will not get a flu shot, they may or may not work(some people still get sick after receiving the shot). If you look up the possible side effects for the 'vaccine' there is about 3 pages of potential things that can go wrong, up to and including death. I'm not even going to go into depth, but there are 'rumored' links between autism,GWS and other diseases associated with some of the compounds included in vaccines.

If and when I get sick(flu or cold); I'll use elderberry, plenty of fluids, proper diet and rest. Generally this seems to keep me healthier than many of my co-workers(with a shorter duration of sickness).

Now, perhaps we may address the OP?

[VitaminG]

I don't know quite what you're asking, Jay, but I go to my GP when ever I or my children need to ie. if it's bad enough to keep us away from work/school. As an adult, my GP charges me a consultation fee of around $70 (which I pay) a portion of which I will be reimbursed by visiting the local Medicare office. This fee can increase if you require additional services while visiting the doctor. For example, I had to pay an extra $10-15(?) when I had a spirometry test last year, and when my daughter was referred to a separate clinic for an ultrasound, we had to pay the other clinic for the scans.

I guess this payment system dissuades folks from bothering the doctor every time their acne flares up, but if you don't mind paying, you can see the GP any time you want.

Kids are another matter though. If I'm taking my children to visit the GP, the doctor bulk bills for the consultation, which means it costs me nothing at the time of visit & they receive payment directly from the government. So no one has to deny their kids treatment just because they can't afford it. This also means it's not necessary to be choking up ER waiting rooms with kids with a sniffle, and most things that a GP can treat.

There is a physio clinic based at my GP's practice too, and the same applies. I can see a physiotherapist any time I want for a consultation fee of $70. The difference between physio and a visit to the family doctor is that I can't claim any of the fee for my physio on Medicare.

I believe other treatments, like chiropractic, acupuncture, other alternative treatments are all out of pocket expense to the patient and aren't covered by Medicare. But you do have the option of buying health insurance over here and if your health insurer allows you to claim those treatments under your policy, then you're golden.

This is a timely topic actually, since I had to take my 10 year old to ER last weekend. It was late (around 11) on Friday night so no GP would have been open. I had no choice but to take him to ER. The doctor attending to my son determined after an ultrasound that they couldn't treat his problem in ER, and that he was going to require surgery. We were going to have to stay in overnight for an operation the next day. The next morning, they prepped him for surgery and took him in around 11am. He spent a groggy afternoon asking questions like "have I had my surgery yet?" and the doctors deemed him unfit to travel that day. So in the end, we had consultations with a couple of doctors, an ultrasound, anaesthetic, a surgical procedure, 2 night's accommodation & food, all the coffee I could drink and a couple of days hanging out with pretty young nurses, and how much did the whole adventure cost me? Absolutely nothing.

Now I know some may argue that it does cost me, through my taxes. But the point is, I very rarely need this kind of medical assistance but when I do, I can get it without worrying about how I'm going to pay for the treatment. Or maybe not getting treatment at all because I can't afford it

[VitaminG]

I think (and it may just be my American upbringing) that most holistic treatments are a wash. Purely a placebo effect.

I'm skeptical about some holistic treatments. For example, my wife recently spent 300 frikkin dollars on some underblanket with magnets in it. So now I sleep in a lumpy bed and wake up with a bunch of different aches and pains. But I'm always open to suggestion.

Some treatments really seem to work though. My wife used to suffer the worst period pains (which of course caused suffering for everyone in a half mile radius of her once a month). She had tried numerous drugs to try to deal with it and while some were more effective than others, there was always this underlying pain which would be almost debilitating at times.

We were visiting my mother when she recommended we try out an acupuncturist and gave us the name of a guy she knew. The ball-and-chain was hesitant because despite the pain, she hates needles. The prospect of being turned into a pin cushion didn't hold much appeal.

So after a short period of having needles wedged between her toes and in her scalp and I can't remember where else, she levitated down the stairs from the clinic, pain free and blissful. And the pain has never returned with the same intensity.

[Jayster]

Cool thanks Gary,

Sorry about your lumpy bed, there are certainly some things that I would consider to be 'fringe' as well(lumped in with holistic medicines). It's also cool to hear that acupuncture worked for your wife, I've never tried that. Also hoping a speedy recovery for your son.

I believe other treatments, like chiropractic, acupuncture, other alternative treatments are all out of pocket expense to the patient and aren't covered by Medicare.

So in general these services are available, just separate.

Side note ~ I used to believe that chiropractic was BS, because of what I'd seen. They were just some 'bone crackers'. However I'd injured my lower back a few years ago, followed my GP's advice using all my vacation time on the couch(doped up on meds for pain and icing it). The morning I returned to work it acted back up, I had to leave. I went to a somewhat highly regarded chiro(group lumping), he was practicing Orthospinology. Without using any muscle relaxers I rapidly improved and have not had any similar issues with my lower back since(amazingly enough, I also have a better 'range of motion' with my legs). I've since learned that many professional sports teams use this type of holistic treatment as well.


As far as prescriptions go; are they included in your office visit, an extra fee, or how does that work? In the course of discussing your treatment, do your doctors ever refer to herbal and dietetic changes or just stick to the medicinal sides of things?

[VitaminG]

My wife has been visiting a chiro lately and has benefited HUGELY from it. She is a coffee shop manager & barista so can spend 40+ hours a week on her feet, often hunched over a coffee machine. The improvements in her posture, not to mention the reduction in tension through her shoulders & back and the subsequent reduction in headaches has been marked. I believe she paid $80 for the initial consultation and pays something like $40 for each visit after that. But it's worth it for the improvement in her quality of life.

Prescriptions aren't included in your visit to the GP. But you're obviously free to go to whichever pharmacy you choose to have your prescription filled. We have a pharmaceutical warehouse downtown that offers the best prices around on medication and I can often save as much as 50% by getting scripts filled there.

Those other services generally have to be paid for and when I've visited a physio for treatment on a sports injury I've had to pay each visit. Although I'm currently on a program after a referral from my GP to have work done to a long standing injury to my right knee. The idea being that if I can rebuild my knee with physiotherapy, I can avoid a more costly surgical solution. Better for me, and cheaper for the system. As it was a referral, I was on a waiting list until they could see me, but now that I'm on the program it isn't costing me a cent.

[javert]

I think it was the American ambassador here or the Danish ambassador in the US who was on Danish television explaining why the whole public health care thing is such a big issue. He said something very interesting, which is that you spend three times as much per citizen on health care as it is than we do with our system here. And the number one reason for that is over-diagnosis over fear of malpractice lawsuits.

Anyways, the way it is here is that you can 1) go see your own GP, 2) phone a doctor "service", 3) go to the ER. If you go to the ER over minor things, they'll tell you to go see your own GP, same thing with the phone service--if it can wait, you'll have to go see your own doctor. The phone service is good if all you need is a new prescription or something like that or in case of emergencies, but they may also decide to make a house call, if it's really bad. When I call my doctor to make an appointment, they've never asked me why I wanted to see him, but I guess that if I called every week, they would start asking questions

About prescriptions, we have to pay some amount for them, so it's not completely "free". I can't remember the rules, though.

[QuantumRider]

In Japan, everybody has basic health insurance at least. If you're employed or can be claimed as a dependent of someone with a job, you are covered under the employer's plan. If you are unemployed, there is a "Citizen's Health Insurance Plan" that you have to (I'm pretty sure that it's mandatory) pay into.

The thing is, the "Citizen's Insurance Plan" and the plan that employers enroll their employees in are both run by the government, and are exactly the same from the patient's viewpoint. Regardless of which plan you are enrolled in, you pay 30% of all medical bills (including presciptions and dental), and the government picks up the remaining 70%.

30% may sound like it will end up being a lot of money if you have to have some serious surgery, but medical costs are super cheap here (compared to the US), even though Japan has the second highest GNP in the world and we get great care. I was in an accident a couple of years ago, and was taken to the ER by an ambluance. At the ER I got a CAT scan and an MRI. As a result, I had surgery and a 5 day stay in the hospital, and my total out of pocket expense was 130000yen ($1300) .

On top of that, if you pay more than 100000yen ($1000) in medical bills during any given month, the government pays the difference back to you.

The monthly premiums aren't that high either. When my wife got laid off from her job, and I couldn't claim her as a dependent until the next fiscal year because she had made too much money that year, I think that she was paying like 3000yen ($30) a month for the "Citizen's Plan".

Kids are a different story too. All children get free healthcare for the first year of their lives in Japan. Thereafter, kids may get free healthcare until they turn six or until they turn 15, depending on how much the household income (adjusted for the number of kids in the family) is, and also on the municipality that you live in.

There are some quirks, though.

For example, pregnancy is considered to be a natural phenomenon, and not a "medical condition (disease or injury)". So, I had to pay full price for all of the prenatal examinations, the birthing, and my wife's 6 day hospital stay. Of course, all of the above only cost 340000yen ($3400).

As a final twist though, medical bills not covered under insurance are tax deductible, so I ended up getting back about 130000yen ($1300) after I filed my taxes.

So that's the way it is in the Land of the Rising Sun

Jay, chiropractice is not covered under insurance here either, but I'm pretty sure that acupuncture is, as it is a very well established form of medicine here.

EDIT: I hope that your son is doing OK, G!

Double edit: We also have private insurers here, and people can buy into additional plans that will offset their 30% burden.

[Jayster]

Hey thanks guys, this is some interesting stuff(if you find this stuff interesting).

[Endrik]

Over here most people usually go to see their "family doctor" in case of non-emergency.

A family doctor is a doctor who does a treatment for most basic diseases (flu, fever, coughing etc.) or sends you to specialists when the issue is more serious or you have a specific issue (eyes, legs, ears etc.). You can change family doctor if you want to.
He/She also organizes all kinds of tests. Blood, urine, X-ray etc. the most basic stuff.
All that is free of course.

But many also just walk in to an hospital and ask to see some specific doctor at the desk.

But to get free service you have to be registered in Estonian Health Insurance Fund. Every citizen has the right to be there. It's a big organization which is run by doctors and medical experts who make all the budgets, financing etc.

And every year you have to update your "status". If you are working, unemployed, student, retired, whatever. Based on that you get discounts on drugs. Retired folks and students get the most discounts. 50% or 75% discount or sometimes free. Depends of the situation and drugs.
On some cases when the medicine is really really expensive then you are all covered.
My father has to inject very specific drug twice a week for his muscle pain. One shot costs 400 bucks. He gets it free because of the high cost.

In case of emergency you go to ER. In that case everything is done very very quickly. I had a very rare toxic connective tissue inflammation. They did every test known to man in one day. And drove me to other hospitals which specialize on certain tests. And then I was hospitalized and taken care of.
All that is free of course.
On a serious case they take the issue very seriously.

When it comes to natural medicines.... it depends of the issue. Many doctors recommend it. When you are coughing and have small fever they recommend drinking a lot of peppermint tea or something like that instead of pumping yourself full of drugs.
Even private and "beauty" hospitals recommend some natural medicine.
It all depends of the issue.

When it comes to alternative treatments by non "typical" doctors. Then usually it's not covered because many can be just full of shit.
But there are some great "healers" and sometimes "real" doctors recommend them when there's no other option.
My family knows a man who only uses natural medicine and has cured many terminaly ill people. And his treatments doesn't cost much at all. It's a joke.

Natural medicine and all that is a tradition over here because it's been practiced here for a long long time. Originally the folks were pagans and had many shamans and whatnot before the crusaders came here. But many of those traditions have still remained.