Jaeger wrote:
Fuckin' yikes.
Ah, the dirty underbelly of socialized medicine. Still probably better than strictly capitalized medicine, but... yeek.
Bullshit.
It's the DE-socialization of medicine that causes this sort of thing.
I've read up on this.
One of the ladies in hospital admin and my sister confirm this. My sister? Pediatrician at one of Germany's largest children's hospitals, would be the commanding physician or whatchacallit in English for infant ICU. She's been doing this for a few years, and she curses case-rates.
Used to be, privately owned hospitals were practically non-existent here. Hospitals were owned by cities, who wanted patients taken care of, by universities, or by charitable trusts, or were non-profit entities on their own.
Then the subsidies those needed were cut. And cities with empty coffers had to sell their own. Private investors, big corporations by and large, would fire as much personnel as they could and focus on making a profit.
Used to be, about 80% of cases treated would result in an itemized bill for the insurer. What the patient had was not relevant to the bill, only the treatments etc. they received. Only for about 20% of cases a flat case-rate was applied. And if some measure not covered by the flat rate had to be done, like keeping an elderly man with cardio-vascular problems and recent breathing difficulties for observation after he fractured two ribs (one of them double fracture). A hospital not expected to make a profit and subsidized by grateful tax-payers could swallow that.
But then the rules were changed, the itemized billing was phased out.
Mundane diagnoses, everyday stuff, they are sent home quick as they like, to free up the bed for the next case. They don't keep folk for observation no more if it's a common ailment. If the patient comes back with complications, hey! It's a new diagnosis, a new case for the hospital to bill.
I saw this when I was in the neurology ward in March. Guy I shared a room with, he had been to two doctors and a previous hospital. They had all ruled out MS, even though they had all been eager to find it. He had some stuff that could come from MS, but lacked several of the MAJOR diagnostic factors.
The last doctor he had seen, who had sent him into hospital that time, had pointed out that he had elevated values in his blood-tests that pointed to some form of infection. The lab work, and a letter form his doctor, the guy had given them to the neurologist at the hospital. And explained it, too. The neurologist nodded politely and then ordered a round of test for MS.
Because a bacterial infection and most viruses will warrant only a few hundred euros case-rate. Barely enough to keep a guy in hospital for a single day.
But MS? 200k.
And the hospital must run at a profit, not to treat patients. So MS was the diagnosis the chief of neurology wanted to hunt, didn't even order any further lab-work or biopsies to find or rule out an infection.
If there were absolutely anything to be afraid of, don't you think I would have worn pants?
I said I have a big stick.
