Unhealthy system

 Fri, 12 Jan 2018 22:49:49 +0100 
#^German doctors give private patients special treatment, says study | Germany| News and in-depth reporting from Berlin and beyond | DW | 12.01.2018
German doctors shut their doors to state insurance patients at the end of each quarter to save money, a new study has shown. Germany's profit-driven health care system is increasingly attracting criticism.

There exist telephone routing systems that give precedence to calls from known private patients if there is a waiting line, then unknown numbers and then known numbers from state insurance patients. Still hard to believe that there are developers who create such systems or that there is a demand for such a system from doctors.
Well, but also there was an interesting situation at the child doctor recently. We had been there for a vaccination for our youngest kid and also had to made an appointment for the next suggested child health review which is paid by the insurance. They said that there is a waiting lists for 2-3 months for such a check up. At the same visit I asked for an appointment for an expertise of one of the other kids that we needed and which we had to pay ourselves and I was surprised that this was done right away! I still want to believe that she did it because we have been there anyway and just wanted to be helpful and nice. But when paying cash it still left a bitter feeling somehow.
Marshall Sutherland
 Sat, 13 Jan 2018 00:52:49 +0100 
The researchers traced the phenomenon to Germany's "budget" system, which means that state health insurance companies only reimburse the full cost of certain treatments up to a particular number of patients or a particular monetary value. This limit effectively functions as a kind of "budget" for such treatments — which make up 50 to 90 percent of different kinds of treatment, depending on the expertise, the HCHE said.

Once that budget has been exhausted for the quarter, doctors slow down — and sometimes even shut their practices altogether. This effect was particularly noted among general practitioners, though also among dermatologists, ophthamologists and gynecologists. Meanwhile, privately-insured patients continued to receive treatment during that time.

On the other hand, treatments that do not have budgetary limitations mandated by the state insurers, such as vaccinations and prophylactic treatments, saw no fall.

I imagine that if plumbers only got paid the full amount for a certain quota of customers per quarter, they would probably stop taking calls once that quota was met, too.
 Tue, 16 Jan 2018 09:28:39 +0100 last edited: Tue, 16 Jan 2018 09:56:00 +0100  
The health care system has been out there for years in Austria, too. I think it is only now, that we start to see the consequences, especially in bigger towns. I once had to take my older son to the hospital, because he had an inflamed finger. We had gone to the doctor, she said we had to go to the hospital, because she is not allowed to treat the finger.
At the hospital they told us that the ambulance was open only from 8am-10am (apparently between 10am and 8am there are no emergencies) and that we had to go to a different hospital. In the other hospital, they could have X-rayd him, but could not have performed the surgery, because the operating room had been moved to yet another hospital.
Luckily a surgery is only needed in a fraction of the cases, and was not necessary with our son.
Edited to add: Although there are no private insurance companies in Austria, you can have a private insurance in addition to your state insurance. Also, health insurance and pension funds are the same thing here. about 60% of my social contributions go to the pension funds, which is part of why the health system is under financed.