So trivial, yet it really ticks you off.

[Trenchfriend]

In 2013, I waited for my "diagnosis-letter" from a bigger hospital in the next big city. And you know, german market-economie's hospitals are of course saving admin-staff, as much as they can and the paperwork stacks on their tables, which I know by my own eyes.

And this hospital-complex, where I was, got a legendary bad reputation since a long time, in all matters.

So, after a while I got enough and though, it has no sence, to make final pressure to the special-department, because no one knows, if the letter is still there or at the main-administration-offices.
Just experiment, blow up a little dust and write a message directly to their main postal-adress, but DON`T write a paper-letter and trust them, because you don't know, what's happening with the letter after coming in, their!

Just take their banal online-formular (!), to circumvent their analogue letter-box, write a real pissy letter, but in "formal" business-letter-language, and wait, what's happening!

And as far, as I remind, I got the letter a couple of days later!

Obviously, the pissy letter made the difference.
""How much longer I have to wait?""

The hospitals just ignore the patient, because the diagnosis-letter is for your "family doctor", in the first place, here.

 

[Zombie_61]

How the hospital bills here is piece-meal. If that's the case with you, I wish you all the best luck.

For my ER visit I went to ONE place. I got the following bills:
Hospital Hematology
Hospital CT
Hospital MRI
Hospital Physician
Hospital ER
Hospital Pharmacy

These are all separate billing agencies with separate phone numbers and locations...

If that hospital is anything like the hospital nearest to us, this is probably because no one who works at the hospital actually works for the hospital. You see, our local hospital (and many others, I suspect) sub-contracts every employee who works under their roof in order to insulate themselves from litigation. "Doctor So-And-So left a clamp in your chest cavity during your triple bypass, you had to have another surgery to have it removed, and you want to sue us? Sorry, Doctor So-And-So doesn't work for us; you'll have to call Doctors 'R' Us and talk to their legal department. Have a nice day!" So the Hematologist, the CT and MRI techs, the Physicians, and the Pharmacist, might all work together in the same department, but actually work for six different organizations which, in turn, bill you independently.

...I hate all the tricks and deception. There's a local urgent care here who refuses to submit to insurance. They have a "reputation" that you go there, you give them your insurance info, they "tell" you they are billing your insurance, and then they threaten to send you to collections so you personally pay up. It's a scheme I'm convinced to get money out of people, as they can bill you more than they can bill to a person with insurance due to participating insurance companies negotiating a lower rate. I just went to them and am collecting evidence to send to the Attorney General's office, because that is crooked and evil.

In 1988 I went to see a movie with a friend, passed out in the men's room afterward, and was hauled off in an ambulance to a local hospital for treatment. Two months later we got a bill from the ambulance company. When my wife called to explain such things were covered by our insurance and that the bill should be sent to them, she was told by an employee at the ambulance company that she was wrong (even though she had verified this with the insurance company), that we were responsible for payment, and that it would be sent to a collection agency if we didn't pay immediately. So my wife called our insurance company again, and they verified the ambulance company had already been paid. For the next month we received letters and phone calls from the ambulance company threatening legal action, and then the harrassment suddenly stopped. A week later the Los Angeles Times ran an article that stated all of the ambulance company's operations in the Los Angeles area had been shut down because they were under investigation for double-billing.

 

[Trenchfriend]

That usual damping-insoles in normal half-shoes. Everytime, any crumb of whatever came into the shoe and under the damping-sole.

What a luck, that I'm mainly underways in my higher trekking-boots since 2015, where this problem isn't happening, in general.

 

[Fading Fast]

In 2013, I waited for my "diagnosis-letter" from a bigger hospital in the next big city. And you know, german market-economie's hospitals are of course saving admin-staff, as much as they can and the paperwork stacks on their tables, which I know by my own eyes.

And this hospital-complex, where I was, got a legendary bad reputation since a long time, in all matters.

So, after a while I got enough and though, it has no sence, to make final pressure to the special-department, because no one knows, if the letter is still there or at the main-administration-offices.
Just experiment, blow up a little dust and write a message directly to their main postal-adress, but DON`T write a paper-letter and trust them, because you don't know, what's happening with the letter after coming in, their!

Just take their banal online-formular (!), to circumvent their analogue letter-box, write a real pissy letter, but in "formal" business-letter-language, and wait, what's happening!

And as far, as I remind, I got the letter a couple of days later!

Obviously, the pissy letter made the difference.
""How much longer I have to wait?""

The hospitals just ignore the patient, because the diagnosis-letter is for your "family doctor", in the first place, here.

I thought Germany had a large nationalized healthcare system - is that not the case? Do you have to go to the private healthcare hospitals?

 

[Fading Fast]

My monthly cost goes up (currently $1200 but soon to rise) as I downgrade my plan. My co-pay rises. I recieve more bills that my insurance does not cover. I can only get generic medication unless I can prove they cause further damage to my body. It matters not if they are not as effective. And, they sure are a lot of fun to deal with when I am able to get a hold of them.

My girlfriend and I have been on Obamacare since it started. In the first three years, the premium increased 30% (much less than in some states), but the deductible went up 150% - so I'm paying 30% more for meaningfully less coverage. Also, the doctors and hospitals who accept insurance form the health "exchange" has continued to shrink, my girlfriend and I have both had to find different doctors than the ones who accepted our insurance in the first year.

And, as others have noted, the billing when you have an "event" is impossible to rationalize. When I went to the emergency room for my kidney stone (didn't know that was what it was, thought my insides were exploding, literally, exploding), I still called my insurer first and got their "permission" on record to go to the ER. I also went back to both the hospital and insurance company a few days later and confirmed that everybody had all the right information and knew whom to contact, etc. It's now been a month and half, and the bills continue to dribble in, the "explanations of benefits" give lie to their name and my attempts at getting clear answers have resulted in my insurance "concierge" admitting that we'd only really know what the bills will be / what is covered after they go through the system - it took my best Perry Mason to get her to acknowledge that.

It is a freakin' mess. And the sad thing is I hold absolutely no hope for it getting better no matter who wins in November. One promises, what will be, more of the same and the other promises nothing coherent.

 

[LizzieMaine]

I've gotten so I don't pay anything to anyone until at least six months have gone by and I'm sure all the insurance stuff has been processed. They can bill me and be damned, I'm not going to pay a red cent until I'm absolutely sure it isn't covered. Especially since the insurance gets worse with every passing year because the people I work for want to make sure they only pay the absolute bare minimum for coverage. The NWU plan is looking better every day.

I don't really have a "choice" as to what doctors I use. None of the local GPs are accepting new patients, so the best I can get here is a PA fifty miles away. There's only one hospital within forty miles in any direction, and it's either use that, in all its substandard Mickey Mouse glory, or writhe in pain in the gutter.

 

[Trenchfriend]

I thought Germany had a large nationalized healthcare system - is that not the case? Do you have to go to the private healthcare hospitals?

The healthcare-regulation is statutory. But the doctors offices and hospitals have to work economic, like market-economy, especially since 1995 (launched budgeting). A semi-governmental system.

Short version:
The more complicated your problems are, the more "inefficient" is the medical coverage.

The stationary medical coverage is situated in an creeping elimination. The hospitals are forcing the expansion of the ambulatory treatment, emergency care, casualty surgery.

We got 1.980 hospitals here, in 2014. 596 public, 706 free-community-based, 694 private.

500.671 beds.

 

[Fading Fast]

The healthcare-regulation is statutory. But the doctors offices and hospitals have to work economic, like market-economy, especially since 1995 (launched budgeting). A semi-governmental system.

Short version:
The more complicated your problems are, the more "inefficient" is the medical coverage.

Why did it change in '95?

 

[Trenchfriend]

Why did it change in '95?

Because Germany was bankrupt, after reunification.

And both german federal rails and the federal post transformed to market-based capital companies...

 

[vitanola]

Many things about the German economy changed dramatically in the 1990's. The strains of reunification and the expense of both privatizing the collectivist East German economy, and the tremendous costs of preventing massive dislocations and political unrest during the process of economic reunification forced the German government to make many structural changes to its vaunted social safety net. Note that since the days of Bismark Germany had a system of compulsory national health INSURANCE. They never nationalized their system of medical providers in the West, though of course after the War the DDR had the usual State Medical system of the Stalin era.

 

[Touchofevil]

My girlfriend and I have been on Obamacare since it started. In the first three years, the premium increased 30% (much less than in some states), but the deductible went up 150% - so I'm paying 30% more for meaningfully less coverage. Also, the doctors and hospitals who accept insurance form the health "exchange" has continued to shrink, my girlfriend and I have both had to find different doctors than the ones who accepted our insurance in the first year.

And, as others have noted, the billing when you have an "event" is impossible to rationalize. When I went to the emergency room for my kidney stone (didn't know that was what it was, thought my insides were exploding, literally, exploding), I still called my insurer first and got their "permission" on record to go to the ER. I also went back to both the hospital and insurance company a few days later and confirmed that everybody had all the right information and knew whom to contact, etc. It's now been a month and half, and the bills continue to dribble in, the "explanations of benefits" give lie to their name and my attempts at getting clear answers have resulted in my insurance "concierge" admitting that we'd only really know what the bills will be / what is covered after they go through the system - it took my best Perry Mason to get her to acknowledge that.

It is a freakin' mess. And the sad thing is I hold absolutely no hope for it getting better no matter who wins in November. One promises, what will be, more of the same and the other promises nothing coherent.

Our rates went up and coverage started to decline pre Obamacare so I can only blame the crookedness of the insurance companies. They would mail out all sorts of insane reasons why we could expect our rates to increase, but now they just increase it without the excuses.

 

[Touchofevil]

I am so angry at them right now. We have to drive over 1.5 hours to the next closest urgent care.... this one is 20 minutes away. I only went there because it was a simple issue. Then I start talking to people and find out they pull this kind of stuff.

I had my insurance company call them on a three-way call so I'd have a witness... but they still haven't sent out an itemized bill or submitted to my insurance.... sigh.

Fight on! As you know, they want you to lose hope and give up. We have had to battle nonstop since the young'un came down with a severe case of ulcerative colitis. Fortunately, for the time being, my insurance covers her pretty nicely, but we have had our share of battles.

 

[vitanola]

Well, I was paying about $1200 a month for a pretty good individual policy in the early 'Oughts. this was the policy which was not renewed after my cardiac diagnosis. Many would not find $1200/month for a single male in his thirties "afforable" even today.

 

[Trenchfriend]

Health just can't be market-economy. That's asocial.
The older you get, the more expensive you get, the more you are screwed.

In Germany, it was always better, to be assured by law and not private, in general.

And since some years, private german insurance-companies have to offer a safeguarding "basic"-health insurance, by law, similar to the statutory healtcare!

So, to be private assured is nearly senseless, here.

 

[Fading Fast]

Our rates went up and coverage started to decline pre Obamacare so I can only blame the crookedness of the insurance companies. They would mail out all sorts of insane reasons why we could expect our rates to increase, but now they just increase it without the excuses.

My insurance has been on a downward trajectory since the early '90s - higher premiums, higher deductibles, smaller network, more rules, regulations, red tape - but it really accelerated downwardly since a couple of years before Obamacare. The first year in Obamacare was marginally better than the Aetna policy I had the year before, but year 2 and (in particular) year 3 in Obamacare have been much worse - I worry as to what year 4 ('17) will bring.

To emphasize, I wasn't blaming Obamacare - as noted things got worse for decades and really bad the two years prior to Obamacare, but, unfortunately, the last two years on Obamacare have been as bad as the two years prior to its start. Basically, four of the last five years (2 in / 2 out of Obamacare) have been insane - costs up a lot / coverage down a lot / red tape everywhere.

 

[Doctor Strange]

This is an industry wide issue, not just through Obamacare. The insurance I have through my job has become more expensive and covers less each year without fail. Since I haven't had a cost of living increase (or anything else resembling a raise) in eight years, it nets out to an annual reduction in my take-home pay every January. What's more, since my company and carrier are based in Florida, they often consider NY medical costs too high against national standards to cover them in full.

As others have said, the whole healthcare situation here is a mess, and it's unlikely to really improve anytime soon.

 

[Trenchfriend]

Or is social-market economy coming in the US, when your resources for the free-market economy are finally "exhausted"??

 

[LizzieMaine]

One thing I think just about any American you ask will tell you, with the exception of paid shills for the AMA and the insurance industry, is that they think the current healthcare system is a joke. Everyone has a horror story of being denied treatment, of being double-billed, of being jacked around helplessly at a time when they're most vulnerable. That's one thing that seems to cross all political and philosophical lines -- obviously there are differences of opinion on what ought to be done, but I don't know anyone, anywhere, with the above cited exceptions, who thinks the current system is just ducky the way it is.

The frustrating thing is that this conversation has been going on since the 1930s, and all anyone's been able to do in eighty years is make it worse by slapping on a new paint job here and some Bondo there to try and camouflage the obsolete, obscene rusted-out hulk that the system really is.

 

[Fading Fast]

Or is social-market economy coming in the US, when your resources for the free-market economy are finally "exhausted"??

If this kind of commentary is fair game, then am I allowed to ask why it was that the more "free-market economy" of West German had to bail out the failed socialist economy of East Germany - a worker's paradise that had to shoot its citizens to prevent them from leaving - and not the other way around?

Most of us have strong political opinions and, while we all stray a bit, make a sincere effort to abide by the rules. I'm happy to continue with that modus vivendi, but am tired of taking repeated shots like the above.

 

[Trenchfriend]

On the other side of the medal, the german system still produces people with "fully comprehensive mentality". But I think, this old mentality is fading out with the younger generations education. Servicing Doctor isn't a "friend of the family", today. It's just a doctor.