Health and cost-awareness

[janestarz]

This rubbed me the wrong way. (A translation is here.)

Right-wing party VVD wants patients to become more aware of the costs of hospital treatments. It caused a serious WTF moment in my head (and as I was listening to this on the news when my alarm went off, my mood is pretty much spoiled before my day even begun). Call me an entitled Dutchwoman, but are you sure you want to go there?

"Patient should be more cost conscious"
The VVD wants patients to make them more cost conscious in each treatment in hospital insight into the costs. The ruling party hopes that people understand how and why health care costs on government spending to pay attention.
The Liberals also hope that patients so that they can go and check that the correct fee will be charged.
Translation by Google Translate, Original on Nu.nl.

We all know healthcare is expensive. We all know a night in the hospital is very expensive. But somewhere in our past, a politician decided "hey, it might be better for all of us if a large chunk of whatever is keeping the Dutch people healthy is paid for by the government." Taxes went up a bit, and we didn't have to pay for our hospitals ourselves anymore, insurance and the government would take care of those costs.

What do the VVD expect, really. Just as you walk into the hospital, you realise "Is that what this chemo-therapy costs? Gee, I never knew. No, you know what, let that cancer eat me alive!"
Or when you've been hit by a car: "Don't call the ambulance! Do you know what that costs? I'll crawl! It's only a kilometer or two!"

There are just no words. So excuse me for not writing anything else because my dad is picking me up so he can have that very expensive anti-nausea medicine that will make his chemo so much more bearable plugged into his arteries in a bit.

Comments

[laiv.livejournal.com]

This reminds me of a couple of US movies and series where the poor, sometimes homeless, people get worse or no treatment at all because they can't pay.
Where you see the interiors of family cars smudged with blood because they couldn't pay for an ambulance.

This should never happen here, IMO.

I've always hated the thought of hospitals as businesses. Health care shouldn't be about the cost of treatment. You have the treatment, use it.

What's next, putting a price on human life? what if the treatment is more expensive than the 'value' of the patient?

*grumbles*
WTF indeed..

[fiofiorina.livejournal.com]

It's not only on screen. In the US if you can't pay your treatment, you won't have any treatment. I have several friends who couldn't afford health insurance this year, and currently hope that nothing bad will happen to them.

It's also, if one considers - bearing a child costs a woman about 35-50K - just the hospital care during labour. Missing salary isn't calculated in.

[wannabe-bitch.livejournal.com]

Ik ben zelf deze week in het zieken huis geweest voor een consult. Ik had al bij de tandarts een foto laten maken omdat dit moest, kosten a80 euro, mag ik zelf op hoesten omdat de verzekering niet betaald.
Kom ik in het ZH mag ik weer dezelfde foto laten maken omdat die van de tandarts niet duidelijk genoeg zou zijn.
Ik zeg dat ik die foto niet kan betalen, maakte niet uit want als die foto niet gemaakt werd zou ik niet geholpen kunnen worden. Ik hoop heel erg dat mijn verzekering uitkeert, want anders heb ik een groot probleem.
Tuurlijk minister ik weet wat de kosten zijn, ik kan er alleen niet onder uit om het te betalen.

[fiofiorina.livejournal.com]

It is somehow ironic - those who propose "people should pay more" or "patients should be aware of the costs they cause" - are always the kind of people who don't have to turn every penny twice before spending.

Just out of curiosity - is Health insurance also as freaking expensive in the Netherlands as it is here in Switzerland? (Plus it is mandatory here... though not via taxes, but via insurance companies, and it's different from canton to canton. In Basel, general insured (no single room, no "have-your-pick-menue") coeliac me paid CHF 554.-/month, in Solothurn it's down to 305.-. Same company, but different location)

The matter of putting a price on human life:
Our federal court in Bellinzona just recently decided, that an insurance company does not have to pay a chemo-theraby medication costing approx 100k, for the reason that a) it's a very rare case this medication comes into use, b) it's still in trial and c) it would buy the patient only a few weeks (max 2 months) of more "life" or "vegetation" d) the company producing it is too greedy.

[janestarz.livejournal.com]

It is mandatory to have Health insurance, and those who can't pay the monthly fee of some 100 euro are allowed to have a sum from the government so they can pay. The rates for 2012 haven't been released yet, but the cheapest one so far is € 1242,- for just the basic costs covered (yearly fee). If you get money from the government to pay this fee depends on your income and your spouse's income.

I have an elaborate insurance, the costs of which were covered by my boss before I quit, so now for the rest of the year I have to pay the € 171,- fee myself. I get a lot of things reimbursed: dental, physical therapy, etc. but it's a hefty sum.

[fiofiorina.livejournal.com]

Dental isn't included here...

[nathreee.livejournal.com]

Ik wens die minister een koliek toe. Eens kijken hoeveel het hem kan schelen hoeveel een endoscopie kost als hij niet meer overeind kan blijven van de pijn.

[the-gersemi.livejournal.com]

I'm don't know much about the situation in the Netherlands, but when this issue is raised here, it's not about situations like chemo therapy or accidents. It's about people (especially old people) spending a lot of time with doctors even when they're not sick, doctors prescribing medicine "just because" or because their patients expect them to, and so on. My stepfather's mother is 83 or so and goes to see her doctor every week, even though there is nothing physically wrong with her. She's just old - and bored, and a hypochondriac. She's had MRIs and EKGs and what have you, because "something's not right, they *have* to find something". :/ These are the people who cause serious issues for the health care system, because they waste other peoples' time and resources and money.

[athiel-draaick.livejournal.com]

If it is not too much trouble, sure. But this sounds like something that brings along a lot of bureaucracy and does not really change anything. I agree with Samsom.

But the remark about patients checking the expenses is ridiculous. First of all, the insurance company's are the ones that are supposed to check that. They're the ones paying for the costs, they're the ones saving the money by not paying for things twice. (There is an article on vk.nl about how some costs are claimed twice.) Second, people depend on their doctors. You can't blame people for not saying "hey doc, how are you? Oh, by the way, you charged my insurance company too much for the treatment last month. Speaking of which, how shall we proceed with my treatment, radiation or chemo?"

[omdathetkan.livejournal.com]

The VVD is right: people in Holland *do* need to become more cost (and quality) conscious when it comes to healthcare. And I'm not saying that because I'm a liberal, but because I work at a healthcare insurance company.

For several years now, healthcare costs have been rising much faster than our GDP. This has several reasons, including technological and medical innovation, the rise of the average age and growing healthcare consumption. (For instance, a few decades ago visiting a psychiatrist was a taboo. Nowadays, it's perfectly normal to call in a shrink if you feel a minor depression coming up. As a result, national mental heathcare costs have exploded in recent years.)

This simply cannot continue. Several things need to change, and healthcare insurers have the (rather ungrateful) task to coordinate some of them. For example, we could realize massive cost savings while at the same time improving quality if hospitals would specialize. Nowadays, Holland has about 100 hospitals and they all do about everything. If we could get hospitals to specialize in certain medical procedures (particulary the ones that require expensive medical equipment and staff) while other hospitals would stop performing these procedures, healthcare costs on a national level would go down significantly. However, this would also mean that people would need to travel much further for certain procedures.

We need the backing and the help of the population to make this possible. People need to be aware of the differences in quality and costs between the various hospitals, so they can make rational decisions about where they want to undergo a procedure. This would automatically cause hospitals that are good in a particular procedure to become more popular, while bad hospitals would fall out of grace.

However, right now this is impossible. Since most people hardly ever see the bills of their healthcare consumption and are not aware of the differences in quality, they don't even understand why their insurance premiums go up every year. They are generally angry about this, they blame their insurers, they blame the politicians, they blame the euro and heaven knows what else - while still demanding the very best healthcare possible, preferably at their doorstep, without paying a dime extra than they did the year before.

As a result of this attitude, many hospitals aren't really focused on quality of service or efficient operations. Patients come to them anyway and the insurance companies are obliged to pay for it, so why bother?

If this is to change, if the healthcare system is to become more efficient, people have to become aware of cost and quality, and have to become willing to act on it.

Finally, consider this. For nearly everything you buy, whether it's a television set or a house, you spend time and effort comparing prices and quality. But when it comes to your most important asset in life, your own health, you don't give a shit and simply visit the first hospital you come across. In a way, that's just weird.

[cabaray.livejournal.com]

When i am looking for a tv, I could be in a hurry to return to work or an appointment. But when I am bleeding out...well, you can take me anywhere where they could help me.

specialization is a good thing and cost efficiëncy can be made that way. But there are signs right now that its going the wrong way (savings on cleaning, leading to death and desease because of improper hygiëne). But an emergency stays an emergency, and that needs to stay fuzz free out of basic human principal.

costs are rising already. That its expensive we knew already. I do not see the point why this cost conciousness would help. Its whole lot different then what you mention to better the system.

[woran.livejournal.com]

I've worked in the hospital. There are a lot of hypochondriacs, or people that just crave the attention of a doctor. It might not help for all of them, but I'm pretty sure we would have had a lot less people that didn't need any care at all if they knew what money they were squandering.

Being more aware of what your health care costs doesn't mean that you automatically have to pay for it. But it might help you think, and I'm all for that.

[cabaray.livejournal.com]

But what if that is not a moneyproblem, but an attention problem, a sign of loneliness. So is it properly investigated.

[woran.livejournal.com]

Often its not. People who are suspected hypochondriacs get referred to a psychiatrist. Someone they can talk to, get help groups, ect. But they decline. There must be something physically wrong with them. Not mentally.

[nokey.livejournal.com]

And then there's the people that don't believe that any disease can be between your ears, unless it's something that shows up on some kind of imaging device.