It has been a very busy couple of weeks. Julie has been back to the US to visit her Mom while she is in hospital. Julie made it back on Monday, and Wednesday went in Hospital herself for a knee operation. We have gotten a glimpse of both the good and bad of the health care situation in the US as well as here. The strange thing is how alike the two systems really are, yet they are still very different.
Switzerland is one of the few countries in Europe that does not have (and I am going to use the US word here) Socialized Medicine. Honestly I do not like that definition, but I am not sure how else to describe it. On this side of the Atlantic, people use the word National for describing their health care system. Well Switzerland’s system is National. The difference being that taxes are not used to pay for the majority of health care like the UK system. Here everyone is required to buy insurance. The breakdown is that individuals pay about 80% of the medical cost. The government picks up the remaining 20%. One tidbit I find fascinating is that in the US they are proud that health care is not paid for by the government, yet the government pays for almost 70% of the total health care bill!
Here, the insurance companies are required to offer you a basic level of care. In earlier posts, I have expressed my frustration, that Julie was able to get the “better” insurance, but I am stuck with the basic care. She has coverage when we leave the country. I either have to buy a special insurance plan, or just take the risk. So the Swiss health care system is basically (again using the US terminology) running on the Affordable Care Act. This is exactly what President Obama passed in the US on a more limited basis. Of course the system has changed a lot in the US, but some of the tenants are still there.
Looking at the cost the US leads the way with over $12,000 per person spent on Health Care. Switzerland is second in the world at $10,000 per person. The UK with their system is pretty far down the scale at roughly $6000 per person. Of course there are good things and bad things about the different health care systems, and honestly, I am not going to get into much of that here. I mean there have been entire books written about this topic from learned people. All I have are observations and no scholarly evidence to back anything up! 🙂
One of the things in common that Switzerland has with the US is that Insurance companies really do not like to pay. One oddity about insurance here, is that Julie has two different health insurance programs. Companies pay for what is termed “accident” insurance. Now this is not just a workplace accident. If Julie broke her leg skiing, we would pay for the trip to the hospital, but then the accident insurance would kick in and pay for everything else. This is where some of our drama has come in.
Julie first started having knee problems about 10 months ago. At first it wasn’t that serious, it would just occasionally hurt. Like most injuries though, it kept getting progressively worse. I finally convinced her to go see a Dr. Her Dr diagnosed her injury as an accident; so she had to go back to work, and file the claim. It got tricky, because the first doctor prescribed some physical therapy. The accountant coded the claim wrong, and for the next 5 months we would fight back and forth between our private insurance, and accident insurance paid for by her company. We wound up paying all the bills and then the insurance company would pay us back. As the pain got progressively worse, her original doctor sent her to a specialist. The specialist said that surgery was the only option. So far so good, we were actually expecting that diagnosis.
Of course then the accident insurance stepped back, and said “WOOOOAH!!! Are we really sure this was an accident.” The company interviewed Julie multiple times, talked to the different doctors, but never made a call. It got more tricky, because the accident insurance wanted to do a final interview with Julie and it was scheduled the week before the surgery. Of course Julie had to postpone this because of the unplanned visit back to the US. She was finally able to get the interview done the day before the surgery. Here is where the drama comes in. 🙂
The insurance plan we pay for gives Julie a semi-private room in the hospital. The accident insurance her company pays for gives her a private room in the hospital. We learned there is a HUGE difference between the two style rooms. I would call it comparable to flying premium economy vs business class. Premium economy or the semi private room is comfortable, but pretty bare bones. Business class or the private room is pretty darn luxurious. Julie’s room had a balcony overlooking Lake Zurich. She was given a menu to choose what she wanted to eat, and the food was not the typical hospital type food we have come to hate in the US.
The hospital called the night before the surgery, and said there was a problem because the two insurance companies were still fighting over who would pay. They told Julie about the private vs semi private rooms. If the accident insurance would not pay, we would be on the hook for the entire hospital stay. The surgery would be covered by the 80/20 insurance split, but the room difference would be 100% on us. Julie asked the cost difference. We would have been on the hook for roughly $10000 for the one night stay. Again, we would not have to pay the whole room cost, just the upgrade. But the cost went from about $5 grand to $15 grand! Pretty big difference for a one night stay. Julie told the hospital that she would stay in the semi private room, but when we got there she was taken to a private room.
We didn’t unpack or do anything other than ask to speak to someone about the room. Eventually the nurse came back and apologized about the mix up. We were told something we would NEVER hear back in the US. “If the accident insurance does not pay. We (meaning the hospital) will eat the difference.”
So Julie was able to spend her time in Hospital as comfortable as could possibly be. The care she got was excellent. The staff was great. The language barrier was not that cumbersome. A lot of the staff seemed glad that they could practice their english with Julie.
I really hope this is our last experience with hospitals while we are here! Julie was able to go for a short walk yesterday, and this morning, she says the pain is a lot better; so hopefully she is on the road to full recovery. We really missed our hikes last summer, and we want to get back to it!
Oh, I almost forgot there was one other big difference between here and the US. Julie made the appointment for the surgery about four weeks ago. That part is perfectly normal, but four weeks ago she was also given her crutches, and the medicine she would need post surgery. No narcotics, but still something like that has never happened in the US. Last time we had a hospital visit there. We had to stop at a pharmacy with young George laying in the back of the truck after his knee surgery! Something like that would never happen here. In fact, when I get my blood pressure medicine it costs me less to get it from the doctor’s office rather than have them call it in to a pharmacy. Not sure exactly how that one works, but I guess the pharmacy has a higher markup than the doctor.
So Julie will be spending the next couple of weeks working from recovering from the surgery; so there will be no travels for the next month or so. Not sure what I will write about next. Anyone have ideas?
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