I don’t watch movies or films, so I definitely haven’t seen Michael Moore’s much-in-the-news flick about health care in the US, but I’ve read plenty about it online from all of the experts that seem to be everywhere on the internets. Anyway, I’ve been an adult for a long time, used the US healthcare “system”, loved and hated my insurance companies, have very good friends and family members who are doctors or in the health care industry, and just generally have enough experience in that world to have an opinion. And my opinion is that health care in the US is excellent, but insurance is fucked.
I now have some experience with Austrian health care. We recently had a baby here, and we’ve been living here as near-middle-aged adults for close to two years. We have private insurance through my work — not the Krankenkassen, so my experience may be a bit out of the ordinary. But my summary and expert opinion is that health care in Austria — or at least Vienna — is excellent and the insurance is awesome.
I plan to write some comparison and contrast type posts in the future, but I wanted to quickly tell the story that so many US Americans are wanting to hear that confirms an anecdote about EuroInsurance in Michael Moore’s movie.
Today, we had to go to the AKH (general hospital) for some tests on our baby. Now, the day sucked ass. We had one of those Vienna Days that makes you want to strangle people. First, a pediatrician said to go to the AKH to get this test.
We arrived a few days later at the AKH after having called and asked when we should come. We arrive at the designated time and wait in line. After we register, we are told “you have to pay.”
No problem, I think. We have private insurance and this is usually the case. We pay, then send the bill to our insurance and they reimburse us based on the coverage. So I whip out my wallet, but, here’s the deal: you can’t pay where you register. You have to go to another building and go to this special office called “Entlassung” (discharge), get the receipt and return with it to prove you have paid before you can join the queue to see the doctors.
This is fair, if a bit annoying because it was snowing, I had two kids with me, and, of course, in the US, they’d be very accommodating with the credit card machine. But here’s the part everyone wants to here. I go to “Entlassung”, and there are something like ten little Department of Motor Vehicle style desks with glass walls in front of them and little chairs for one to sit in while one conducts business with the administrative folks behind the glass. I hopped into a line that was labeled “private insurance” and watched as people in other lines delivered slips of paper to the people behind the desks and were given cash money Euros in return.
“Danke schön,” they’d say as they pocketed their cash and left the room. “Auf Wiedershauen.”
I finally got to the front of the line, delivered my slip to the lady, and started to have a seat.
“This is a bill,” she said, turning it over and sort of squinting at it in a mix of bewilderment and skepticism.
“Yes, I’d like to pay it.”
“You have to go the cashier.” She gestured toward the back wall. On the back wall was a typical Euro Kassa window with the typical money-sliding mechanisms and whatnot and a bankomat payment terminal. The thing is: it was closed.
She shrugged. “It’s closed. Maybe you can pay later.”
“I need to take the receipt over to the children’s hospital to see the doctor.”
“Oh, okay. Let’s see. How do I take your money?”
She finally figured it out, gladly gave me my receipt, and I was on my way.
So, yes, it’s true. It’s very hard to find a place in the hospital that will take your money
And that’s one of the things that’s just amazing about the Vienna health care system: it’s simply not all about the money.
We’ve had numerous doctors basically tell us that it’s more of a hassle for them to charge us because their service is normally included in the basic charges. For example, a specialist who visited my wife in one hospital after our baby was born, was actually part of the service for the hospital our OB/GYN normally works out of. He thought it was important she receive the visit, so the doctor traveled across Vienna, took a look at my wife, and never once worried about how she was going to get paid. When we later asked the OB/GYN, he said, “I don’t think you’ll see a bill for that, but you can call her if you want.”
Back to our story, where it turns into one of those Vienna tragi-comedies. We finally get in to see the doctor who was supposed to administer the test when, of course, he tells us that we have to wait several weeks before he can do the test because admitted patients take precedence over outpatient services. We could, he suggests, perhaps find a specialist in our neighborhood.
Remembering that our pediatrician once recommended such a specialist, we head home and call him in hopes of getting an appointment. It’s not quite noon, and his answering machine says he has visits from 3-8PM Mondays and Fridays. I leave a message and proceed to look for more specialists on the doctor listing website.
I call the first one, who denies he is such a specialist, but gives me the number of his hospital, who will gladly undertake the examination. I call the hospital, who, of course, denies such a claim and says that the only option is to go to the AKH (where we were just told to go elsewhere). A few other specialist I call all refuse or are on vacation or are otherwise occupied.
I finally find one who says she is in the office the whole day and to just show up. Oh, cool, we think. We can just knock it out. Are you sure I can bring you a three month baby? Oh yes. Anytime. We bundle up the family, trudge down the stairs and walk over to the office.
Upon arrival, she asks, “what is it I can do for you?”
I explain how I had just called and that she said she’d administer this examination to our daughter.
“No, I am not a pediatrician. I thought it was for the mother. Maybe there’s a pediatrician in the next street.”
So, in the end, we never got the test. So while the option is there, somewhere, and I’m sure a competent, thorough physician is willing to administer it. Vienna will do what it does best and bounce us around for a while before we finally land in the right spot.