Nearly three years ago, living then in the over-regulated enclave of Santa Monica California, I had enough, and decided to give life in Europe a try. Having relative fluency in German (as the child of World War II transplants from Germany) and a small network of friends in Vienna, Austria through my past work as a museum curator, I chose Vienna as the place for my European "trial-run."
Shortly after settling into life in Vienna, I purchased a "private" healthcare plan from one of the major Austrian insurance companies (Vienna Insurance Group [Wiener Staedtische]). And, now, nearly three years later, after experiencing the quality of coverage that I am receiving from my private Austrian healthcare plan and the Austrian healthcare system itself, I can see more clearly than ever what is wrong with the American system and why Obamacare, instead of fixing the damage will actually support those who have gotten us into this mess (just like the banker bailout!).
Let me begin by saying that a discussion of the issue of healthcare "insurance" vis-├-vis healthcare itself must of necessity start with cost. And, in this regard, I can say that with the exception of "major medical," costs, which is to say, hospital care healthcare costs here in Austria are downright affordable and in some cases nearly free-of-charge.
Let me provide a recent example. I was at home on a Saturday night and by about 9:30 in the evening, what began as a seemingly minor skin problem, began escalating. I phoned a Viennese friend who lives around the corner and she thought that to be on the safe side, I should go to the hospital at once. It turns out there is a central number here that you can call to find out which hospital can best treat your problem (different hospitals here have different kinds of "clinics" and some are stronger in certain areas). The person at the central number recommended that I go to the Rudolfstiftung in the 3rd District, as this hospital was considered best for skin.
So my friend picked me up and took me over to the Rudolfstiftung. She insisted on coming in to the hospital with me, as this was my first experience with a Viennese hospital. I was pleasantly surprised to discover a very different "system" in Viennese hospitals from the American "emergency room" system. We entered a special part of the hospital where you go for immediate advice and/or treatment. But instead of one central "emergency room," there are all kinds of clinics with different specialties. Moreover, these "clinics" are separate from the "central" emergency room, which is only for immediate life threatening situations (heart attacks, car accidents, etc.).
Check-in to this 24/7 clinic was extremely efficient; despite about four people ahead of us, it only took a few minutes to get to the front of the line. The very helpful woman at the desk took my information, asked if I had insurance and what kind I had. When I told her I had private insurance, I was informed that I would receive a bill in the mail in the next few months (Austria tends to be extremely laid back even when it comes to billing and so happily you often don't get your bills until months after receiving the service). My friend asked what the charge would be for the visit to the clinic and was told about 46 Euros, which is equal to about $65.00. It took about forty minutes before I was called in to see a doctor who was competent, efficient and gracious and accurately diagnosed my problem in about five minutes. But, imagine that only $65.00 for first-class treatment, after-hours and hassle-free! Can you imagine paying $65 in the U.S. for a late-night visit in the "emergency room"? Can you imagine getting to the top of the line in a major hospital in a large city in forty minutes?
The doctor wrote a prescription for about five different medications that I would be on for several weeks, so off we trotted to the nearest pharmacy. The way it works in Austria during after-hours is that all pharmacies post on their door the nearest "after-hours" pharmacy. When we arrived at that pharmacy, the pharmacist announced that the medications would be quite costly as kind of warning, and I was therefore extremely shocked when the bill came to 160 Euros, which translates into about $225 at today's exchange rate. $225 for several weeks of five kinds of medications? Can you imagine what the cost would be for this in the United States?
Doctors' visits here in Vienna are equally low-cost compared to the U.S. The "normal" charge to see a doctor is 50 - 60 Euros, which translates into between $70 and $84 and that is calculated on the basis of a currently very weak dollar! But, get this follow-up visits, where the doctor has to add a procedure, or just check in with you, or do a minor procedure like give you a vaccine, are usually about 10 Euros, which is to say, $14. And, with my doctor, who offers both regular and homeopathic medicine (both covered by my healthcare plan), she freely offers no-charge advice on the phone.
Moreover, lab tests here are extremely affordable, and you can, for instance, get blood tests that cover numerous items done for about 100 Euros, which is about $140. A mammogram is about 100 Euros, again about $140. And with things like blood tests and mammograms you go to special sites with no appointment, but never have to wait more than about ten minutes.
The point that I want to make here is that, completely leaving aside the high quality and efficiency of the Austrian healthcare system, the prices are so low here that most people can afford to pay for medical costs out-of-pocket and it is only for major illnesses requiring things like surgery and hospitalization that health insurance is a necessity.
As is usual in the United States, the media and all the other hype have the public attention diverted away from the real problem. With all the emphasis on how many uninsured people there are in the U.S. and how people are being wiped out because of no health insurance, there is little or no mention of the fact that the cost of American healthcare and pharmaceuticals are obscenely inflated! Ridiculous costs for the most minor procedures and obscene costs for pharmaceuticals; is it any wonder why "they" want now to designate vitamin supplements as "pharmaceuticals," that will require a doctor's prescription for purchase? And, can anyone guess what may be at the root of the inflated costs of American healthcare? Might the "healthcare" industry itself be at the root of the problem?
For someone standing outside the American system, it is clear to see that rather than fixing the problem, Obamacare is going to facilitate the problem by draining money out of the American economy in order to support and give the heads-up to an extremely corrupt healthcare "industry" focused on the corporate "bottom-line" of "minimizing expenses and maximizing profits." (See excellent article by Peter Schiff, "Prescription for Disaster," LewRockwell, July 18, 2009, http://www.lewrockwell.com/schiff/schiff35.1.html)
Let me conclude with a word on private healthcare insurance in Austria. Having chosen the very best (1st tier) plan which includes private room in a private hospital of my choice (100% coverage with 1,200 Euro deductible [$1,691]), 80% reimbursement for all doctor's visits, medications, lab tests and which allows "conventional" as well as unconventional medical treatments (homeopathic, "Chinese," and a host of other alternative treatments), I pay 479 Euros per month, which translates into $675 at today's exchange rate. This health package also includes a complete dental plan (albeit with yearly limits), a complete eye plan (with limits) as well as complete coverage if I need any kind of care, prescription drugs or whatever in a foreign country (including the U.S.), and, it includes a once-a-year visit of three days to a wellness center hotel (including cost of hotel, all meals and all treatments!) in the Alps or, alternatively, a three-month enrollment in a local diet or fitness program!
There is another key item here which enters into the "equation" of health costs in Austria and that is the issue of mal-practice, but more to the point, -- mal-practice insurance. "Mal-practice" is another one of those "invented" issues with a distinct American pedigree; and one of countless examples where the insurance industry is in bed with some other entity, in this case, the legal profession. Now you might ask, "why would the insurance industry want to make big payouts to attorneys, thus supporting the American craze for medical lawsuits?" The answer is simple it is the ever-looming threat of mal-practice lawsuits on the American medical landscape that allows the insurance companies to rake in excessive sums of money from doctors, pharmacists, and you name it for insurance company "protection." Sort of like the old Mafia system of extorting money from businesses as "protection" money "you better pay us these exorbitant 'protection' fees or you'll be vulnerable next time you're hit by that mal-practice suit -- and we'll make sure you are!" But, the key point here is that a prime contributing element to the inflated costs attached to all aspects of American healthcare are the "hidden" costs (to consumers) of insurance company "protection" fees for potential mal-practice suits conjured up by the marriage made in heaven between the legal and healthcare industries.
One of the many items keeping all kinds of healthcare related costs down in Austria is the near absence of the marriage between the healthcare "industry" and the legal profession. Moreover, the insurance industry here is highly, highly regulated and does not get away with all the unsavory practices so typical of the American insurance industry. As a result, doctors in Austria do not hesitate to give you gratis "advice" over the phone; walk into any pharmacy with something that is ailing you and tell them about it and more likely than not they'll give you gratis advice and even an over-the-counter medication based on their advice. In one instance, I went to a pharmacist to buy something to extract a tick from my dog, and the pharmacist insisted on getting down on the floor with the dog to look at the tick and spent half an hour removing it with no charge of course!
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