HEALTHCARE ACROSS THE POND AND BACK

Let's take a closer look

Healthcare in the USA:

You have a problem and visit your primary doctor. In many cases you must go there first, even if you know you need a specialist. That doctor can refer you to the next level of care. Going to the hospital? First, you must contact your insurance company for preapproval. They decide if the procedure is needed and might be covered. Yes, I said might. Each step of the way, you will need to ask the insurance company who can override the doctor's recommendation at any time. (By the way, the insurance provider is usually on the phone and may be far away from where you actually are.)

You have the procedure. Then the bills start arriving. There are lab bills for blood tests and xrays. There is a bill from the anetheologist. Some doctor you don't remember stopped by your room in the hosptial and sent a bill. Your surgeon sent a bill. And let's not forget the hosptial bill which I would like to add is NEVER itemized. (I once asked for that in writing and no one would even answer my letter.) Next you will receive statements from your insurance company. They have received submissions from your hospital and all your healthcare providers. These are listed, and the insurance company informs you how much of the amounts are covered. Usually it is less than what the provider requests; and sometimes the insurance only covers a percentage. That is only after you pay your copay portion. They also have lists of medicines with coverage limits or recommendations of generic brands they prefer you use. Each year that list changes so they send you a large book with the current list. There is a little good news: if you spend more than 7 percent of your income on your heath, you may be able to deduct some from your taxes at year end. One last thing, you have faithfully paid for your health insurance for years before you became ill, but that is not taken into consideration as your premiums rise when you age or actually need to use the insurance. Or worse, your employer decides they can no longer afford to keep you if they are paying part or all of your insurance in there group plan. This happened to my spouse.

I do want to say that there are excellent hosptials in the USA but they are often understaffed. So I was usually allowed to stay with my patient outside of visiting hours to make sure they ate and received the attention they needed if they were severely incapacitated.

I have known some great nurses and doctors in the USA, but I have also heard of some who quit because of the challenges of dealing with insurance companies. That industry needs reform. The drug companies also need reform. My husband worked at a hospital for a while. He said he would see the pharmacy sales reps arrive in Mercedes cars. Somebody is paying for those.

One last note: at one point I did not have insurance. My doctor discounted my bills because he was happy not having to submit all those forms to the insurance companies.

EU Healthcare:

I will start by saying they are much stricter with visiting hours, but staff is very dedicated. If you work and pay taxes, then you don't get medical bills. Instead you receive a statement from the hospital at the time of your departure with information about your treatment and instructions about your follow up. All your prescriptions are posted in the cloud so you can go to any pharmacy to pick up your meds which are often at a discounted price. Pharmacies have many of the same well known USA brands such as Jardiane for diabetes and Voltaren for joint health. While you may not speak the same language medical terms are often similar because doctors universally use Latin words to describe medical conditions. Also translation programs can help alleviate any possible misunderstanding.

Another covered item is the homecare nurse. This is great in monitoring your loved one in your own environment.

A downside could be long wait times if you visit a county hospital. But if you are an emergency, you do it priority. You also have the option of paying at a private clinic if you have funds and don't want to wait.

In the USA you cannot easily find the cost of a procedure. It depends on the hosptial and many other factors. There are 3 main types of hospitals: state, non-profit and for-profit. State hospital have the lowest prices but can offer excellent care especially if affiliated with a university where they teach doctors. Non-profits are often run by religious groups so can have sliding scale prices. As it sounds, for-profits are the most expensive and are often owned by doctors. Try to research the cost of a surgery and you can only get a range. I googled toe amputation it was $3000 to $8000. I got the same result for vascular leg surgery. I was told $5000 in the EU for the leg surgery. This challenge in getting financial data also applies to the dental industry in the USA. They can charge what ever they want, so shop around before you have major work done. In Europe dentists post their pricing structure on their websites. Nice!

My conclusion: if you need some great healtcare and it's not an emergency, then take a trip to Europe and use some vacation time to improve your health.