The word came in earlier this morning on the @Deutschland_ Twitter-feed that I follow for EuroSavant purposes (it’s only in German):

The tweet refers to an interesting article in Der Spiegel, Economic crisis accelerates dying-out of hospitals, and normally is something I would gladly re-tweet.* But then I realized that, when it comes to news about any European country’s health system, I owe my readers a bit more than that in view of the couple of posts I wrote on that subject in the recent past, especially one on the same German system that astute readers will have perceived as particularly heavy in its irony. (more…)

Whoops, there’s another problem one sometimes is face with while trying to procure medical attention over in this continental “health care paradise” – at least in France, as Le Monde reminds us. You can probably guess it: your doctor can go out on strike, as it seems French GPs are doing this very day on a nationwide basis.

Closely related to that is that, again in France but likely elsewhere in Europe as well, your doctor is likely to belong to some sort of union. In fact, there are several French doctors’ unions, and they all have called for a strike today. Their grievance? They basically want the price doctors are allowed to charge for a consultation to rise to €23 (=$30.50); it seems the current price is €22. If that is all they’re getting angry about . . . citizens trapped in many other more privately-based health-care systems where a doctor’s visit tends to cost much more than €23 can only look on in envy.

Back to Health Care Reform. I know: the battle’s over, the President is now out doing his victory-lap, and even some Republicans think that, now that it passed, it’s here to stay.

But remember, this is above all a weblog with a European bent, so – if it makes you feel better – I can let you know (from an article in Berlin’s Der Tagesspiegel) that a certain turbulence is also currently afflicting that model of social(ist) health care provision, the German Krankenkassen. Those are the non-profit, government-supervised insurance companies that cover the vast majority of Germany’s population and are restricted to basing their premiums solely on the insured’s income. (You’re required to have medical insurance coverage there, of course, with very few exceptions, although if you prefer you can buy it from purely-private, for-profit insurers instead.) As the article reports, the public Krankenkassen are now experiencing extraordinary customer-turnover, often in the hundreds-of-thousands. Why? Because the government authorized them in February to charge those they insure up to €8 (= $10.85) more per month in order to shore up their balance-sheets, and some of them took advantage of that.

That’s right: eight euros per month more! Apparently that’s a deal-breaker for many Germans, who in remarkable numbers have proceeded to resign from the Krankenkassen which implemented the measure (known as the Zusatzbeitrag, or “supplementary contribution”) to go join those which did not. It didn’t help that someone made an elementary mistake about how to implement it, in that they made any interested Krankenkasse have to bill customers directly for the extra amount, rather than just letting it be charged as medical insurance premiums normally are as a wage-deduction collected by employers.

Just a word here, then, to let all interested know that it is not always sweetness & light over where citizens need not worry about medical coverage. (Not that there’s any indication that the firms losing customers are in any danger of going bust – like I say, they are state-supported.)

Health Care Reform is now on the lawbooks in the US, barring the unlikely event of a successful Constitutional challenge. As Europe reacts to this unexpected development – everyone thought that it couldn’t be done, particularly back in January – the prevailing attitude seems to be “Welcome to the club of states who don’t turn their back on the sick and the poor.” This new legislation does insert the US government more into the national health care business, in good European style, partly in order to finally enable (mandatory) insurance coverage for the 40 millions or so who are presently not covered.

But it’s always useful to remember that European opinion is never monolithic, even when it comes to the universal health coverage which has been the general rule there, in one form or another, since at least the 1960s. Not everyone in Europe opposed George W. Bush’s 2003 invasion of Iraq, for example; sure, the British even joined in with their own troops, but so did the Poles. And for one contrary view on America’s new Health Care Reform – one that is doubtful, not welcoming, but presumably intellectually palatable nonetheless – we have Czech commentator Radek Palata writing in the business newspaper E15 (USA: Savings don’t come for free). (more…)

Hope you’ll forgive me for going off-(blog)topic here. The last time I visited the US, one task on my list was to go to a doctor’s office to get a physical check-up. But the way the receptionist answering the phone at the first place I called went immediately and without invitation into a long introductory spiel about which insurance schemes they accepted and which they didn’t (I was a foreigner: I was simply ready to pay cash) put me off so, that I gave up on the whole idea.

Now we read on-line in the New York Times (Cost Dispute Halts Airlift of Injured Haiti Quake Victims) how US authorities have stopped evacuations of critically-injured Haitian earthquake victims to American hospitals because of a dispute about who will pay for their care. One doctor in charge of a nonprofit foundation assisting in Haitian relief efforts is quoted as calling this delay potentially catastrophic for these sufferers.

Ladies and Gentleman, I give you: Health Care Provision – American style! Cut out this crap: Send them on to Canada, or else over to France, where I am (sincerely) sure they will gladly be attended to properly.

But wait – who’s gonna pay for the extra fuel and aircraft wear-and-tear involved in diverting the medevac flights that way? Well, I’m sure there are some French planes there at Port-au-Prince as well, or could be if the American authorities in charge of the airport will allow them to land.

UPDATE: A subsequent NYT article of Sunday, 31 January 2010 now states that the primary reason American medevac flights from Haiti were suspended is because US facilities for treating these patients – mainly in Florida – were simply being overwhelmed. Nevertheless, it does mention Florida governor Charlie Crist mentioning specific financial considerations in a letter he wrote about the situation to Secretary of Health and Human Services Kathleen Sebelius.

Obama gave his big Health Care speech to a joint session of the US Congress early this morning (Central European Time). Let’s take a look at some material about that from the national press of France, the country which, it is widely admitted, has much to teach the Americans about how to run a national health care system.

We first need to consult the French paper-of-record, and that is still Le Monde, which provides initial coverage in a piece jointly credited to it, the AFP news agency, and Reuters (Obama’s big oral exam on health) and put on-line only a couple of hours after the event itself. Graphically, the article stands out due to the two YouTube videos embedded within it, which feature no dubbing or subtitles or any other concessions to French-only readers but which of course include that electric passage when the president was loudly heckled (Vous mentez!, he shouted – or would have, in French, if he had had any bit of class) by South Carolina Congressman Joe Wilson. The main insights of note here come at the very beginning – Barack Obama joue le tout pour le tout, or “Barack Obama is going all-in,” in poker-speak – and at the end: the piece remarks that Obama knows he needs to achieve something this year, as it will be even harder to do so next year, an election year. (more…)

Now that the question of reforming the US health care system is high on the agenda of the Congress and the President, it is quite appropriate that people are researching the medical establishments in other countries to gain insights and try to determine “best practice.” But there is one such establishment – built entirely from the ground up, in fact, over the past few years – that seems to have fallen between the analytical cracks, despite its quite unique characteristics. For one thing, it’s run entirely by third parties from outside the country; for another, it’s even financed entirely by outside parties as well.

OK, so on second thought maybe the example of Afghanistan has little to teach the US in the realm of health care after all. Indeed, the Americans (along with the Europeans, and the World Bank) are in fact the country’s medical paymasters. Nonetheless, an inspection may still be in order (to the extent hostile conditions within the country allow) of this nascent health structure that some do regard as “a minor miracle” because of the progress it has made. Reporter Rob Vreeken of the Netherlands’ De Volkskrant has taken on the challenge, in an account he entitles Come now, this isn’t Switzerland. (more…)