Not on a theoretical level, but how would you practically have to pay costs, access specialist doctors?

18 points

Australia here.

For most medical services, the govt will reimburse you a set rate. The GP or specialist can charge you whatever, sometimes the same as the govt reimbursement, sometimes quite a lot extra. You don’t pay anything at public hospitals (which are nice).

I recently had some great problems, I stayed overnight in hospital twice, for a total of 3 nights in private rooms, had an internal scaffold inserted in my artery. i also had numerous consults with specialists and drs.

The whole thing cost me about $500, a few days work on average wage.

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3 points

Hospital was free.

I’ve been to the GP a bunch of times, cardiologists also, then meds also.

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5 points

I have a card that gets scanned at the doctor’s office. It contains most of my data plus history iirc. That’s it.

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7 points

It doesn’t

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30 points

I’ll start with the German system. Here you are either automatically insured in one of the public insurances (there are many), which marginally differ in their cost (think single digit euro differences) and have to cover basically the same procedures. If one reaches a certain income level, being privately insured is possible.

If you are publicly insured, you wont see most costs, as these are directly handled between your insurer and the doctor/hospital. For some medications and procedures there are co-pays that are flat fees (5 Eur for Medications, …).

Access to specialists mostly need a referral from your family doctor.

In private insurance, often you yourself will be billed and you will need to hand this to your insurance company.

The good side is that in most common situations I have never needed to worry about cost in public insurance, wait times for referrals can be very long and understanding what you need to get certain care can be very difficult. Private insurance often has better payment schemes for providers and less artificial limits on number of patients or which doctor is able to provide services, so access to most care is faster and more widely available.

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4 points

Access to specialists mostly need a referral from your family doctor.

That hasn’t been the case in many years now, you can just make an appointment without a referral.

Well, for most specialist. There are still a few cases were it is required, e.g. radiologist.

Also with public insurance you might have to wait longer for your appointment with a specialist - but if you have a referral from your family doctor, they can add a urgency note (Dringlichkeitsvermerk) on it and you will get an appointment faster. With that you can also call the health service hotline (116117) and they have to find an appointment for you.

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5 points

That is not correct anymore - they are absolutely insured as long as they are entitled to Bürgergeld,even if they don’t actually get it or have the three month block in it. The problem is more that the insurance works retroactively in that situation and they often are billed privately by health care providers (which is somewhat illegal) and some of these claims “stick”, especially if you don’t have the resources to fight it.

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1 point

Seems like one of the best types of systems in the world to me. Public insurance should have to compete with private insurance.

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