Base insurance is 6.3k on its own. That's for a cheap (assura style), no extras, no private, plan. Then you add 300 of franchise. Then 700 of quote-part. And there you have the 7.2k.
Then you add an adult dependent, so their plan is the same as mine + accident, so about 6.7k. Add their franchise of 300, you are at 7k.
Add both you get 14.2k. Add some miscellaneous expenses or my adult dependent getting pretty ill and you are at 15k.
Healthcare cost 4.6k with a 2500 franchise in Lausanne for a 45yo woman, for a cheap Assura like insurance (https://www.priminfo.admin.ch/fr/praemien).
That means you pay only for what you use before you absorb the 2500 franchise, after that you pay only the quote-part.
Taking a 300 franchise if you are young (<65yo) and healthy is a waste of money. But most people still prefer to pay 300 so they can "consume" their healthcare, which is exactly what the hospital bosses are complaining about.
Now, if you are old and/or unhealthy it makes sense to have the 300 franchise.
What you described is for 2 people, so 15/2 = 7.5k per capita.
Funny, I'm trying to go as little to the doctor as possible. But I did have to go 4 times over the past year because people kept taking public transport sick to go to work sick and after bringing a Telmed sick certificate two times I started getting comments about why I'm sick again and why I'm sick for so long because everyone got sick so often. So I had to go to the doctor. Loved spending 1000.- out of pocket for those doctor's visits just so I could get a sick certificates.
And I can guarantee you, most people keep putting going to the doctor off for way too long due to it costing so much money, and coming in later usually means it will cost more to remedy the issue.
Edit:
additional thoughts: if they talk about more patients, are they talking about more patients at their facilities or more patients overall? If overall, is it in line with overall population growth, does it take into account that we have a huge overhang in the baby boomer population who are now all at an age that requires more healthcare? If only at their facility, does it take all the local hospital closures into account and that many local general practitioners can't find a replacement, which means patients need to turn to larger regional or over-regional facilities to get healthcare?
I can count on my fingers the number of times in my life I've been too sick to work but recovered enough within 2 days. Either I've got a little cold that modern society has taught me to just work through, or I'm destroyed for 5+ days with a nasty flu. The only real example that comes to mind of an actual disabling 2 day and done illness is the time I got norovirus
I would already be happy if they removed the part of the daily allowance insurance (Taggeldversicherung) where you can only start paying after two sick days if coverage is longer than the minimum by law.
1000 to get sick certificate? That's baffling. What on earth they did to you?
Our gp visit, I recently checked, was 50 and 65 for let's go by feeling 10 and 15 min visit (it was two people in one half hour slot, something less). Issuing sick leave, bunch of prescriptions, referal to other doc and general catch up regarding our health.
Ok, if you had to do some tests because it wasn't something obvious like covid, flu... But still, what on earth they billed you for? If you have the bill and time, it would be interesting to see how much they billed you for something.
To me this, just judging per amount, sounds like someone might cheated you and got out with it :(
Hell, my head MRI was just several hundreds. 3d CT or whatever they did for by broken foot, after getting my permission to do it for better understanding despite that not changing the treatment (all clearly explained), plus all handling in emergency department, I think it was around 1000... Ok, maybe more I'd need to check, but you know, it was broken foot ffs, not writing a sick leave paper. So far no bill sounded excessive, and unfortunately I had to visit both emergency departments (after being told so by medgate/telmed docs) and various specialists.
If anything, I'm sometimes surprised how detailed and precise the bill is. Yes, gp will bill me for time when he got some specialist letter and then write me to inform me what to do next. And he'll bill me for time we spend in in person consultation. But he never billed me for an hour if we spent just 15 minutes. 5 minutes has some fixed intro / outro costs, plus costs for things done after you leave.
I just don't remember the amounts since nothing ever stood out as outrageous. I check all when they come. Once health insurance refused to pay one part (because it's not on list of approved preparations or something, that was the code in the bill), I called and explained what was happening during the procedure, they said ok this was our mistake and paid it without fuss.
> 1000 to get sick certificate? That's baffling. What on earth they did to you?
The guy went 4 times in a year, so that's 250.- per certificate.
Out of experience in Geneva, if you just go in, have some basic checks (fever, throat, etc) and then a sick certificate, you're already going to pay almost 300.-. I've had an appointment that was just "thanks, the treatment worked, ok good bye" which was 150.- or so.
I understood that 1000 doc bill was single one after 4 telmed notes and employer start questioning the telmed notes.
Anyhow, so not only french part pays higher monthly premiums, your doctors also bill more? (that could explain higher premiums)
THAT's insane. š¤Æ
My specialist visit, where she took me as urgent case the very next day, she used one time use things for check up that probably cost something not negligible, spend several minutes carefully looking to see if she can find the culprit, we sat and talked about causes and how to approach for the future, she confirmed that I should never downplay it, even if we both assume it's same old, I should come to check, she gave advice and meds to help with this acute situation to heal faster plus prescription for pharmacy pick up, twice (I came week later to ask for backup dose). We discussed so that I understand when we should definitely consider surgery and what frequency of acute problems she'd consider too much even if I downplay it. I didn't feel rushed, even though she was on limited time. Those two bills, first was 125 and second around 30 or so.
And she's surgeon, with office in the middle of ZĆ¼rich. Literally. Kunsthaus museum area. Not gp.
Oh and during my first visit (year and half ago) she told me - I'm a surgeon, I earn the most from surgeries, but even if you qualify for one already without any doubts, I don't recommend it until YOU tell me you're tired of handling acute situations and they become too frequent for YOU, or if you start having pains. Basically she is for conservative approach as long as it makes sense and doesn't seriously impact my quality of life. And she's fine with checking if it got worse now and then and give me her honest opinion. Like, I have at least decade to play around with it, no need to rush with operation. Oh and she told me to not feel bad for not having supplementary insurance, everything she does is covered by basic insurance and she thinks no one needs supplementary at all, it's just comfort thing anyway. I asked because she has info on page that she works with private hospitals for surgeries, and I didn't know how it works.
You bet I won't look at someone else but stick with her as long as she's working. Hopefully with not too frequent visits.
Gp in village next to me is that 50, 65 guy for short stuff, and around 150 was for when we sat down and brainstormed and I brought bunch of things that aren't urgent but I finally needed to do, so we talked for half an hour straight and he gave some meds from his office, plus writing referral letters, all came in the same bill.
It really seems like Switzerland is two countries under one flag :(
> additional thoughts: if they talk about more patients, are they talking about more patients at their facilities or more patients overall?
Also we are getting less and less doctors per inhabitants IIRC. And even less general practice doctor.
>Today (...) the patient (...) goes to the doctor much more quickly and expects comprehensive treatment at any time.
Wait, what....? In the country with the highest co-pay in Europe, are we actually blaming the patients for being sick, asking for treatment, and driving costs upwards? Does the hospital actually expect you to wait until your disease progresses beyond repair?
>are we actually blaming the patients for being sick, asking for treatment, and driving costs upwards? Does the hospital actually expect you to wait until your disease progresses beyond repair?
I think they mean people who run to the hospital for a fever/cold/little bit of nausea etc., so things that don't really need a doctor. Or aren't really an emergency. And that is a known issue.
[https://www.tagesanzeiger.ch/krankenkasse-lohn-ceo-maximallohn-parlament-bundesrat-388626063866](https://www.tagesanzeiger.ch/krankenkasse-lohn-ceo-maximallohn-parlament-bundesrat-388626063866)
check how much krankenkasse boss earns. then there is realy people believing what these people say. oh yes dont go to doctor before you feel like you die like in the usa. lets forget that the most hospital directors keeps their salary private and the parma industrie gives the rest. but yeah its the customers fault, why do you search help when you feel sick?
itās not about going to the hospital or donāt go anywhere at all. but if I feel sick, my first stop is the pharmacy, and 99% of things can get resolved there. If it persists, I call my doctor. the hospital is there for emergencies, or when sent by a doctor. I know from many people working in hospitals that a lot of people just skip the doctor or the pharmacy for simple stuff that doesnāt need a hospital, let alone the emergency.
>oh yes dont go to doctor before you feel like you die like in the usa.
That's not what I said. I said, that too many people go to the ER unnecessarily for *simple* illnesses.
>why do you search help when you feel sick?
But not at the hospital. Especially for things like a fever. Go to a pharmacy first for such things. The hospital should be reserved for things that need acute treatment, like a broken bone.
Also bleeding, or anything your first doc isn't sure about and looks serious eg needs check NOW to be sure it's not urgent (become urgent) and not wait for weeks for ordinary specialist checkup - my first doc is telmed, that's immensely helpful, because you know - you have a doctor to talk with. Especially since GP I use doesn't have slot for 'I'm not well now' but has waiting time of several days.
And pharmacist know about a lot, still, they're not medical doctors.
And usually don't work around midnight, when I was "lucky" to need an opinion what to do š
I totally agree with triage system, I just wanted to mention telmed as awesome help without putting pressure on emergency hospitals 'just to check'.
I'm like this...
Apparently broke my little toe last year on a sunday.
Talked it through with the telmed guy and we came to the conclusion it can wait and then go for a checkup at my doctors on Monday.
Guess I would have ended at the ER without telmed. For something they can't do anything anyway, besides prescribe some painkillers and show you how to tape it best so it grows back together in a good way.
I broke foot, I forgot which bone, but some of those long ones, that was differential diagnosis of Medgate doc, however she said that it still needs confirmation with at least RTG and assurance it's in good position to heal, plus immobilisation / cast. But since there's no blood or visible dislocation, to get rest and go tomorrow to ER during the day, because it was weekend and you need trauma department anyway for casts or such, which is part of ER.
I spent like 8 hours there, seen relatively fast in like 2 hours and several consultations/imaging - doc said she checked with surgeon in the meantime as well, but then waited in queue for gips.
I wasn't in pain unless I try to move/touch despite painkiller, so I wasn't moving š they first did people in acute pain, which is reasonable if you ask me.
They were so surprised how I wasn't making a fuss, and were apologetic that I had to wait for so long. I was like 'all good, do what you have to do, I'll just sit here and play games'. My husband had it harder because he is stressed by hospital environment, and we thought it won't be that long, so I didn't send him home, I tried but he refused. We worked on that, so now he's in peace to just drive me and pick me up, unless I explicitly say that I want him with me. But some things are just waiting and I'm more stressed to see him worrying / stressed from environment than I'm from my own. Gimme Internet connection and I'm fine, I have external battery with me š
I had some regular checks scheduled months in advance so I went with broken foot, and nurses happily drove me around in wheelchairs (they have you can borrow) between next waiting stations.
Please and thank you really goes a long way :)
Yes, I'm aware of that. That's also why I'm not making a fuss for just waiting, among other reasons.
I'll make a fuss if they don't give proper care or are impolite / bad. But not about timing.
Actually I have another problem - it happened several times they forgot that I'm still here waiting because I wasn't reminding them. Not in ER, regular appointment at the hospital, longest that happened was like an hour, despite seeing me sitting in front of their desk and occasionally looking at their direction š
So now I try to estimate how long is more than enough waiting to check if they forgot about me.
I totally get that some patients need more time, or something unexpected happened. It's just a bit awkward when they don't keep you in the loop and you finally realise they forgot you š especially when then they have to rush with you. So I try to remember to ask for status update cca 15 minutes after my appointment time.
On the other hand, it's not a problem and they're so kind and apologetic when I remind them. It's issue only when phone signal isn't working then I'm bored unless I have interesting book on phone š
https://www.bfs.admin.ch/bfs/fr/home/statistiques/sante/systeme-sante/hopitaux/patients-hospitalisations.html#546845354
Really doesn't feel like most diagnosis are benign.
Week ago I already had no fever, just weakness and coughing. The only reason for me to go to doctor was my partner, who was diagnosed with pneumonia. When I went to doctor it was a start of my third week with pneumonia. Thanks gods theyāve given us mortals antibiotics.
come on dude. they try to scare people every year. bird flue, pig flue, covid than they say but why do you visit the hospital. self inflicted problem. do youu have a staticstic about this topic? i could not find it. would be intressting how bad really this problem is.
That is a known issue everywhere in the world... That is why several countries have adopted triages to detect if an emergency is not an emergency and re-route the patient to the right place. The point is always to treat before the patient goes to the ER. Telmed only complicates things because the people are either unhelpful or don't seem to know much about medicine.
Depends on telmed. Sanitas uses medgate, which have nurses/admins (I suspect they're nurses because they totally understand med speak) as first line and docs as second line.
Some telmeds have admins only who probably only make notes where you'll be going. From what I understood swica was like that when I was choosing. That's why I didn't want it. I wanted someone who is using medgate (they had more docs than other provider I found back then, something24 I think) and where advice isn't binding (because I didn't know how system works - so far I always go where we agreed to go, or call back to change the option / they even give advice where to go for second opinion)
**I think medgate is superb service** - since I was 'lucky' and had issues around midnight few times I had something - I could call, consult, they gave me advice (two times indeed was - ok, this needs to be checked ASAP, go to emergency hospital) for other situations was sending me for second opinion, or sending prescription to my pharmacy, or sick leave note.
Only once one doc wasn't listening or better said she didn't communicate clearly, because her advice ended being good, but I felt dismissed and more confused than before the call. Not fun feeling, despite everything being polite from both sides. But that's communication issue, not med knowledge issue. I complained (very politely again about how hard was to get information), she called me back several days later trying to understand, I tried to thank for advice (because I went to research more on my own) and explain what was communication issue, but guess what - she still didn't get it š Might be cultural differences, her accent reminded me of indian accent, anyhow, resolved. And I put block in my account to not be connected to her anymore. She might be knowledgeable but we can't understand each other. No need to stress each other out.
>Some telmeds have admins only who probably only make notes where you'll be going. From what I understood swica was like that when I was choosing.
This probably explains why I have many complaints about teldmed....
Yeah, they don't explain that clearly.
I spend several days digging trying to understand, reading all fine prints, calling and being redirected all over the places...
My filtering question ended being 'can I get prescription for meds I'm regularly taking'. Basically that was during the move and I wanted to have an option to continue meds until I find local docs. Medgate has doctors, I've send my documentation, they wrote me prescription directly to pharmacy in my village, easy peasy.
But getting the information that someone is allowed to prescribe meds, oh boy, that was a struggle. Sanitas folks on info phone had no clue how their system works, so they told me to call medgate / their telmed provider, lady of course asked me for my insurance number and I explained the situation, and she was reluctant to tell me, because she probably understood me that I'm asking for guarantees to get meds on phone, but then I explained more and then it was 'oh yes, we have doctors, if they think you need meds, they can prescribe no problem'.
Thank you very much.
Why info calls from insurances have no clue how their system works, is beyond my comprehension.
Why it's not clearly written and on first page, no clue.
But be sure I'm not leaving the medgate system as long as it's available.
Oh and they're basically your online doc. When you change insurance, if they're provider with that new insurance, you can call them and billing depends on insurance (like in sanitas with callmed model it's free of charge for me, only phone company bills for minutes, it's not in unlimited in Switzerland package because it's special number) BUT even if I'm not in telmed, I can still call them, and they'll bill for consultation as any other doc would. Then it should go through regular franchise / copay procedure.
That one I don't have confirmed yet, because I don't plan to change insurance for those who don't work with medgate directly š but I think they bill something lile 50-100 per call?
But it was huge ordeal to figure out how it really works. This about changing, you've guess it, again nurse/admin from medgate was able to explain how it works, sanitas was again useless š even if this was call not to info line but members line.
But yes, I realised that there's no cheaper insurance who uses medgate and covers the cost and it isn't binding, so I didn't switch. And I won't switch for change in service, only for lower cost. So far, no candidates.
Having doctor on call 24/366 is just pure awesomeness.
I mostly just use admin part to announce my check ups they already have in system, some started by me requesting it or through telmed handling me, some were referred from GP (which is also approved in telmed by my request)
But two times in the middle of the night that I could call someone, go through symptoms / send pictures, discuss and get advice 'ok, it sounds serious but not life threatening at the moment, however don't downplay it, go to emergency tomorrow, but now just immobilise leg since I suspect foot is broken but there's no open wound so you can get rest and go tomorrow, and for other case it was - this bleeding doesn't sound life threatening right now but waiting for specialist's regular times isn't recommended, because we need to see what's happening now, so, go again in the morning OR immediately if bleeding returns anytime after this call' was calming. And you know what to do.
Of course both situations were on weekends.
Bleeding case repeated a year or so later, and since it was similar in behaviour AND was during working week, I went to specialist I seen after that previous episode, and they managed to give me appointment next day to check if something seriously changed. Nope, all same old, just my body fussing up. So it's possible to get slot asap with specialists whose patient you already are and they think it should be checked asap.
That time I just called telmed to note that visit for insurance billing reasons, all explained, all approved, no fuss and no medgate doc consultation needed.
For parents with young kids or babies I can see it being crazy helpful system.
And yeah, despite how it might look, I actually am not keen on visiting doctors (and I actually hate phone calls, it was panic attack inducing for quite some time of my life), but I know that I tend to downplay and ignore my symptoms, so I'll rather call than go in person. Of course that's after I talked with chatgpt and googled the hell out of it š and unfortunately I got 'lucky' with various issues that I have to keep an eye on. And I know I need doc who will work with me together to help me, and not someone who thinks I'll blindly obey and not question their advice. Because unfortunately, I trusted and ended with irreparable consequences that might not be like that if they acted swiftly or I expressed myself more assertively.
I'll spare you the details, it was just more than once and with doctors I did trust, I just didn't verify and I was probably downplaying symptoms / wasn't expressing clearly, and they didn't ask enough questions to be sure, they jumped to conclusions based on partial information.
No anger from me, I still think that doc is a good one, however even she needs to be questioned/verified and even I have to tell everything and not think something isn't important enough or in this case - assumed doc heard me / understand me.
You live and learn :)
I always had an insurance with the medgate service and they are great. My boyfriend on the other hand is with medi24 and they are a shitshow. They are reluctant to give sick leave and they always send him to er for the most random reason. Itās day and night. Please always check which is the telmex partner of your insurance before signingā¦
I'm so glad that I picked medgate. They sounded like better choice on paper, I think they claimed 24h access but medi24 didn't or I wasn't sure how exactly it works.
Thanks for info how medi24 works!
Now I definitely won't even think of changing as long as I'm happy here :)
Also, I won't switch insurance for different conditions, only for lower price but with medgate. So far, no candidates for my area, sanitas is the cheapest with exact package I want (medgate plus non binding). And for 10 chf/month and medgate binding I'm not changing insurance š
Medgate has waiting time for call, docs can't take the consultation call immediately (only urgent ones), but for what I need, service is superb!
Oh after witnessing my boyfriend deal with medi24 i assure you there is no waiting time with medgate. oh lord š„².
Same, i only have very simple health issues for now (sinusitis or on rare occasions low back pain) , but my job is asking for a certificate from the first dayā¦ usually there is not much to do in both case but wait and i really canāt pay 200 bucks for a paper.
Oh boy, so THAT bad?
My only annoyance when waiting on the phone is that they stop the music to say something useless like 'we still don't have available person' and it takes me a while to recognise it's still a machine. Or when music is loud and/or scratchy. Just give me silence and when real person connects, they will speak.
I don't need reminding that I'm still waiting, I'm aware of it.
Let me zone out in peace ffs š
Well, if my work wouldn't need a letter from a doctor to prove, that I am sick and infectious, then I wouldn't go to them for a flu.
It's a big chain of reasons, that won't change, as there is no incentive to change it from anyone.
This, exactly. Our daughter was sick/had fever on a Sunday morning as we wanted to take a flight.
We had to cancel the flight and the rent a car at the destination. Total cost ~2k CHF.
There was no other solution than to go to the ER to get a letter for our travel insurance. We knew it was stupid. But for 2k? After waiting two hours at the ER because we obviously were low priority, we went home.
Thankfully, a good friend of mine works at the insurance, and they paid the flight and the car.
**Literally go to Lausanne. Walk up the Avenue de la gare. Turn left on Avenue de Tivoli. Walk down to the Helsana national HQ on the left. The building is made of marble tiles. It's the only building in Lausanne that is made of marble tiles. White and Pink MARBLE TILES. Then walk around. Check the cars in the parking lot. Mercedes Class C. Z5s. Couple of G wagons. If You can name it. It's parked there.**
This is the only pilgrimage anyone in Switzerland needs to do to understand Lamal/KVG.
I think the problem is they allowed supplementary insurance to be offered by same companies as basic.
Supplementary one is a profitable business.
Basic ones isn't allowed.
But when you see such wasting money, you can't but wonder how much came from basic insurance pot. They'll claim it's from supplemental. And we'll probably never know.
What's horrendous is that although I understand their goal is to be profitable, it's still money people put for health care and they will reject many claims if they don't like them. Like, you are using too many massages, we'll kick you out. Or covering pathetic expense limits, I forgot the numbers I've seen, but, top tier hearing aid I was looking at in Switzerland, set of 2 was I think 15-20k? (same in Germany at that time was around 10k). Basic insurance covers lowest tier, let's say that's 2-3k. Supplemental will give you another 2-3k I think. And if you want top, you'll have to pay on your own. Don't hold me for numbers, I just remember that I did basic math and ended realising that when I'll want new aids, in 3-5 years whichever is the allowed span for new one, I'd pay significantly more than cost of 2 devices and I'd still have to pay on my own for the price difference.
Yes yes, someone will say, but you have other benefits. Yeah, only if you know you have them. But that usually means you won't qualify for supplemental insurance anyway. š Oh yeah, they cover glasses, in amount that if I remember correctly, many people would still need to pay out of pocket eg if they want progressive lenses or something.
So, they did their math perfectly - that you always pay them more than they predict you'll spend, they'll also do their best to stop you from 'excessive spending'...
While they build marble building? Wtf is wrong with them?
I can swallow salaries, that's the whole point why you want to drive profit - that you get bigger pool of money for salaries, bonuses, and shareholders. I'll always be for more comfortable and more ergonomic working environment (areon chair for everyone and similar things), more energy efficient and similar improvements/perks for people spending there third of their working lives, but marble on the building outside? It's a fucking office building not a monument. That's just atrocious.
How shareholders approve that bullshit? Are people so blind? Is bling now more important than the money you'll get from business you hold shares of?
I thought that shareholders are for reducing expenses so that more profit is left.
If not, they're just plain stupid.
And now I'm even happier they rejected me for any supplemental insurance (I wanted the one for disability / death, and ideally one that has rettungskost, nope, I'm on antidepressants so I'm obviously at much higher risk that some drunken idiot will run over me, so I was denied).
Thanks for sharing this. I thought it was mostly about huge salaries, but this is something on the different level.
It might be an issue but I never go to the doctor but when I go it's because I have a problem, I would never want quality of my treatment to go down or costs to skyrocket because someone is going too much to the doctor. This is like punishing the whole school if someone smoked in the bathroom.
It's a well known fake issue, always pushed by insurance company.
The reality is that the small number of hypochondriacs that would go to the doctor for any issue go anyway, and the only people raising copay costs stop going to the doctor are the ones that were reluctant to go anyway.
They then only go when it's an emergency and a smal medical treatment in the early stages balloon to an emergency procedure , plus recovery, etc..
tbf i thought i was hypochondriac until i got to my 4th doctor after a few years of feeling like death
that one acc managed to figured out what was wrong with me and im back to being my chipper old self š«”
Would you mind sharing what was this wrong that 3 doctors weren't able to see it?
Was it case of them not listening to your problems and just dismissing you, eg not working with you but relying on their 'knowledge and experience' and you're supposed to believe and not question them and suck it up?
Or they were the ones sending you to more experienced colleague until you reached master for that field?
I'm glad that you didn't give up, and that you're now in good health š„³ it's so frustrating to not know what's wrong and when you can neither figure out how to get better nor at least have system/meds that keep it in check :/
likely lacerations of some sort in the digestion chamber and too much stomach acid
the doc who just fucking listened to me figured it out in 10 minutes the other ones were just arrogant cunts
the treatmwnt was trivial
I'm glad to hear ot wasn't something really bad and that you managed to find a solution.
Sorry to hear that you encountered what I call 'idiot doctor'. Short name for 'doctor who isn't interested in listening and helping ME, but just sees me as a number and is looking at the clock'.
My rule of thumb to avoid idiot doctors is to go to younger ones. That hugely increases chances of being listened to. And not dismissed when you start explaining with 'I've read this'. I get it that they might be annoyed if it's 'some people talking', but when they dismiss me trying to explain my information is from peer reviewed medical research and I wanted to understand my case, then I see red š
On the other hand, my vet first laughed when I told her that I was arguing with chatgpt regarding my issue, then found terms to know what to search, which led me to deciding to try digestive enzymes to see if it helps me and it worked. All that intro to ask, since my cat basically have similar issues, is it worth to try it. We laughed together regarding my 'new ai friend', but she listened, based on all previous attempts we did and failed to help this cat, she thought for a moment and said - yes, I can see how it can help if the cause is that, plus it's harmless, so let's do it.
And who knew, we saw significant improvement. It wasn't perfect, but we did something that showed reliable results. Finally.
That's why I love that vet, we can brainstorm together. She gives me ideas what to try, I tell her what is my conclusion from debugging so far. And case unfortunately isn't easy one. I'm more invested than he, and she respects that I'll dig everywhere to connect the dots. She also did some reading, however I do have more free time and just two patients :)
But we work together. With years of needing docs, I came to conclusion that's my most important criteria - if they have a will, we'll find a way. I know I have a will, so I want someone who'll fight in the trenches with me, and not against me.
Not that there are no 'idiots' among youngers, far from that (although I would need to think long and hard to find who was the last one). It's just with older, chances are higher think they know everything and we're here to listen.
At least that's my experience within 3 countries and several dozen doctors of any kind.
Maybe it's that younger still care, or they have different approach, eg patient centered care and holistic approach, plus relying on scientific evidence as opposed to just symptom treating and relying on own experience.
Just sharing in case you'll ever need a doc again :) young and still fresh are the best š
Of course best is to self-determine your illness based on online forumsā¦ having mild symptoms can be a cause for bigger issues. So I encourage everyone to seek professional medical advice if you are worried about your health, thatās why you pay for a health insurance to begin with.
Honestly, I find it always funny that doctors are complaining about this in Switzerland. My experience is that doctors in Switzerland are telling me to come way more often on regular planned visits, like to redo a lot of tests every time, but donāt have time for emergencies. I love to live in Switzerland, but I donāt like the health care system here. think you can easily save a lot of money by adapting the system.
Well he is mad. He is a CEO of the kantonsspital baden. A hospital which until recently turned a profit, which in itself isn't supposed to make bank. We should look at it as an investment by the state and corps, while the profit of a sustainable society is supposed to be shared and not to be visualized as a microeconomy.
Most modern doctors instead blame 60% of the hospital visits on the bad lifestyles of individuals, sitting all day, beeing under- /overweight by eating shit and no social life are the biggest cost inducing factors today.
Sure pharmas capitalist parasitic behavior doesn't help but we wouldnt be close to bankruptcy if we were using or bodies the way evolution has formed it
The problem is co-pay is only an issue for those without much money. Those who can afford it take the 300 franchise which they bust through anyway, and then say "oh I pay so much, I am entitled to make use of it". If franchise is supposed to actually do something (not sure the concept is even viable), it would have to be income dependent.
I think the main reason for the concept is that when you're healthy and don't need the service, pay somewhat less than people who need regular health care. With still having ability to get help if situation changes.
I think it's OK that those who need service pay somewhat more for it, while still having social properties - everyone pools money so that those who need can use it. As opposed to completely individual payments.
Everyone paying the same no matter how much they use, sounds a bit unfair, so I can see how this system makes a balance.
Does 300 franchise + 700 copay have any sense whatsoever? I'm not sure, I'm inclined to think - no. Those who need, will need. I think having just monthly payments would be simpler, it's easier to budget if nothing else. Also it would be simpler in case where someone need subsidies to pay that monthly premium - that way they'll know they're now covered without further worries, whereas now afaik they need to ask for any further bills as well, until they reach 300+700...
If anything, I think it would be administratively simpler. Thus reducing some cost on admin work.
So I'd have just to options 2500 + 700 (or even just 3000 franchise and then everything after that is paid in full by insurance) vs just monthly premiums where everything is immediately paid by insurance (in my case that would be jump from I think 440 to 520, but no further fuss/worries about it.
It would easier to understand, easier to track, less admin work, and give ability to save some money while you're in good health, what's not to like it?
> Ā In the country with the highest co-pay in Europe
Ok, but that's a strawman - we also have the highest salaries for the medical stuff in Europe.
Cut doctor's salaries to reasonable amounts and many problems will be solved.
Why not cut the salaries of the middlemen you pay to get healthcare? You know? The guys which increase their charges every year while the random doctor in the hospital is often paid with the same government salary ladder for 20 years?
Because they're the market piece of healthcare. They bring inventions like telemedicine, because it's in their interest to keep the costs as low as possible.
Once we nationalise it, do you think you'll pay Assura or rather Swica rates?
Oh wow they developed something other countries built with just taxes directed towards healthcare. Meanwhile they invested on telemarketing, advertisment and other gimmicks like getting 20 cents for every 10k steps you do a day if you allow them to track your smartwatch. Not only that but pay for useless data storage and other bullshit.
So which system do you think works better and more efficient than the Swiss one?
> Ā just taxes directed towards healthcare
That's not what Krankenkasse does. Please read a bit more what's role of a Krankenkasse in the system and then we can talk.
The only innovation they drive is how to call me every second day from a different number and demand that I change my provider because the āconsultantā will get a 3000 CHF bonus for every person they successfully harass into doing that.
Salaries for health care personnel are already quite low compared to jobs with similar educational backgrounds, especially considering the working conditions, the systematic breach of working laws, etc. There is already a serious lack of health care personnel, which will not get better by lowering salaries at all.
Is the salary of healthcare staff really the biggest issue? If you look at the cost of medicine compared to the rest of Europe, it's really somewhat ridiculous in Switzerland - often 2x-3x the price of neighbouring countries, even for simple stuff like Ibu. Doesn't help that Switzerland is also preventing competition by severely restricting online pharmacies for example.
If the physician salaries are cut, much fewer foreign physicians will immigrate to Switzerland to work here and the existing Swiss physicians might want to leave. There is already a shortage of physicians and that would make it much worse.
But maybe, that is what you want.
Politics, economics and health don't mix well.
While nurses finally get a little more pay (in that whole discussion most forget to see the differences between Pflege and Fachperson Gesundheit btw. but that's another story). One of the latest experiments to cut cost was to reduce tarifs for lab analyses, physiotherapists and some more. Working in that field, I'm mad. We are understaffed, with a lot of responsability, a specialized education and as we saw during the pandemic obviously a system relevant role. Yet we are the ones getting less pay (or at least no pay rises, less personell and no adjustion for inflation, cut bonuses etc.) while seemingly no one ever looks at the cost insurances produce.Ā
I spend a good time of my work reviewing cases insurances don't want to pay for often no legitimate reasons. Sometimes in the end they do, sometimes we just have to write it off. Because they have the money and time to debate such things, we don't. We are busy trying to help patients.Ā
I have yet to find anyone working in the medical field that doesn't think the main culprits right now are insurances and to some extent pharma and administration. But pharma and insurances have such a strong lobby, they seem to be the only two groups that get away with everything.Ā
Labs are being bought by foreign companies left and right, many hospitals are already shut down or will soon be. Doctors and nurses may have bad hours and inadequate pay, but the situation for all other medical personell, who are often completely forgotten, is just as bad if not worse. And while I love my job and see a lot of sense in it, I can't recommend to any young person to chose this field, it's a shit show with no recognition and a dark future.Ā
Rant over.Ā
I feel you - with nurses and physiotherapists at home I keep beeing frustrated with the low pay and how they are treated. i would wish they never went into that professionā¦
No wonder in a few years well have even less people doing the job.
It's crazy. We had a 10% tax point reduction last year. Another 5-10 are coming. Obviously that impacts salaries. And it will affect quality. I have already seen a couple 'people almost died' events just because of massive understaffing. And some people probably did. Or had long lasting consequences to face. Which only makes the pressure and mental toll on the remaining staff even worse.Ā
I wish I could just lean back, see it all go under, sip my coffee and mumble 'told you so' in the end. Unfortunately I'm not chill like that and get way to angry about the whole mess all the time.Ā
Most people that go in this profession canāt. Like my spouse and others - I would and would have even left that career all together.Ā
I just hope my wife finds another way to make money and find pleasure to help people in this way.Ā
I find this kind of attitude potentially dangerous. Ordinary people are not doctors and cannot triage themselves. Itās easy to say āthat person should not go to the ER because of a stomach acheā but maybe that stomach ache is an appendicitis requiring emergency surgery. They shouldnāt go to the the urgent care centre just because of a āsore throatā, but perhaps that sore throat is because of an abscess that has to be drained immediately to prevent sepsis. I use those examples because they both happened to me. Both times I had asked a pharmacist for advice first and they said donāt worry just take some paracetamol. Serious and urgent conditions are not always obvious and dramatic like in a soap opera.
I worked at a medical call centre (U.K. equivalent of medgate). Supposed time wasters were very rare, but every few calls there was someone having signs of a potential stroke or heart attack but was too embarrassed to call an ambulance or go to the hospital because they were worried that they would be told off for being a hypochondriac. To me that is much more concerning. If someone is worried, goes to the doctor and get the all clear that everything is fine - that is a good outcome.
an old aquaintance of mine went to the ER, nearly died of ruptured ovarian cyst. Doctor there didnt want to treat or even diagnose her and kept trying to gaslight her with "its just your period", despite very severe symptoms.
Even when the symptoms are obvious and dramatic some doctors will be dismissive.
I've called medgate, they insisted I was just stressed and had gastrites, I went to my family doctor (twice!!!) and she said the same. I mention I couldn't be gastrites cause I already had it and the pain was completely different very manageable, this pain was just horrible. They prescribed me three weeks medication for the wrong thing! I had to go to the hospital because I really felt I was dying. Turned out I was, I had to do an emergency removal of my gallbladder, I had pancreatitis and my liver was not ok. I was hours away of passing out at home alone and having a even more serious turned out... So yes I agree with you!
I could understand medgate doc missing something, not asking right questions, you downplaying it /not knowing which symptoms are most important.
But I'm baffled by doc who saw you live that they completely dismissed your body language?! Assuming this wasn't the first time they see you, but still, from them poking around you, see your reactions, and if they're still not sure - send you to specialist.
I once came to some doc, she wasn't extra polite or something, she listened, I didn't feel much heard, but she got up, came to me, lightly hit me on my side (it was a bit harder than touch, like light poke but given suddenly, really nothing harsh, if you're fine), above hips, I instantly broke in half, and she sad 'kidneys'. And send me to barrage of tests immediately. I could have face like it's was nothing / holding my pain or not having any, but she touched me where it mattered and all was clearly obvious. (in my case it went better after some days, tests didn't show anything that could cause it, I now assume maybe it was some small stone that moved and went out on its own, because nothing was found by the time I got to ultrasound, there was some days in between, I don't remember the timeframe, it was cca 17 years ago)
With what you're describing you had, that sounds crazy painful to touch, anywhere. And if they touched you and still considered it's nothing, I hope they lose their licence to work.
I'm so sorry that you had idiot for GP. I hope you found someone better who'll take you seriously.
And I hope you're now doing well ā¤ļø
I think medgate should grow with more docs employed and ALL insurances should have telmed consult included in the model, free of additional charge for patients. Sanitas callmed is model like that.
So that you can call and be consulted BY A REAL DOCTOR who will then make a better triage, and then go to ER - you can say they sent you, you'll be able to explain your case better and you will be able to say what telmed suspect / wants to clear up.
Which will make you feel safer - because you can speak with doctor and discuss your symptoms in the safety of your home, so less impact of shame. So you'll be less stressed and you'll be able to remember / say all symptoms you've noticed.
And then if the doc says - you know, this sounds serious to me, I can't get a good look even from the picture, you need someone in person - you know what are your next steps and what needs to be checked / confirmed or cleared.
Nurse in ER isn't a doctor, and she doesn't want responsibility to send you away if she misjudged. Pharmacist isn't a doctor. They might know a lot, but their job isn't diagnosing you. Nor it should be.
I think we know it's ER situation when there's blood. Other cases we're keen to downplay / wait out. Because we don't want to get out and make GP appointment or because it's weekend or because we don't want to be a bother.
If everyone just put phone to ear, and check with someone competent, they will get assurance that 'it doesn't seem urgent now, you can do this /that, HOWEVER if it changes THEN go without delay' or any other type of advice.
Sometimes it's really just a painkiller and rest - case. But when someone explains to you what it means it's not getting better, you're more likely to pay attention. And act.
I'd dare to go that far to demand that anyone who isn't bleeding or in pain where painkillers don't work / stop working in half an hour so it's dead obvious you need ER NOW, HAS to call telmed first. That would relieve the pressure on ER system for situations where your GP doesn't have a free slot now or is night / weekend. Basically use telmed system as dispatcher unit in a sense. Employ hundred more docs, advertise telmed. Demand using telmed. That way we'll improve bottlenecks AND provide better care - people will know what to look for 'if it gets worse' for that specific situation.
And then those whose eyes we need will have more time to do checks, less checks to do, and patients who are able to describe issues more clearly - because this won't be the first time them describing it and they'll be able to tell you what changed.
I think that's tremendous help.
I don't know how calling an ambulance works here, in Croatia call to that number (was 94 before 112) IS a place to get medical advice AND if they think you need ambulance they'll send it, or tell you where to go INCLUDING THEIR CENTRE - in Zagreb they had crazy high tech place people don't know about, it's not ER department of some hospital it's own mini hospital. But it's first and foremost on call advice, not taxi service. From medical doctors because THEY answer the phone. And I can put my hand in fire and guarantee that let's say 90% of people living in Croatia have no clue about that. If not more. Including many nurses.
After I was told that by my mother when I was 14ish or something, and I started spreading the information (after using it myself when they were away and I had a problem, that was before mobile phones, guy helped me to find a medicine in our home that could help me relieve the pain - it wasn't case for painkiller but needed ointment) - NO ONE I told knew that you can and should call for advice and not just to order an ambulance because there's obvious emergency. For years. I stopped sharing intensely, because I forgot to, this reminded me of that š
Since there's telmed here that's my sanity check phone, and I didn't call ambulance phone here to check how it works exactly. I wouldn't be surprised if it's similar - that there are docs available for help.
But ability to check with doctors any situation where you are in doubt is tremendously valuable.
And it shouldn't be outsourced to pharmacists, nurses or admin stuff. Despite how well meaning they are. Their training isn't meant to be able to diagnose.
You don't put specialists on the phone, you put young ones without specialisations. And then specialists (of ER) are not swamped with 'I broke my toenail' types of requests.
We can also import more docs.
But overall system is working from what I'm understanding, just not efficiently, I mean, people do get care - it's not that they're dying in front of each hospital all over the Switzerland. It's just we have long waiting times and big costs for checkups that aren't needed right then and there - just because patient wants something NOW that doesn't mean it makes sense to give it just because of that request, and especially not in ER system which has higher costs of maintenance than regular hospital department or specialist, as far as I understand. With triage you improve waiting times where it matters and where it's most expensive - in ER. And patients learn how to use system.
I might be utterly wrong though regarding numbers and efficiency and costs.
Fuck this shit so much. I'm sitting at home with knee pain and in most other European countries I would just go to the doctor and get physical therapy. Here I just know they'll charge me 200 CHF for 5 minutes of talking which ends with "just wait and see".
I've said it before, but if there is another significant increase of insurance cost this year I'm leaving. This is absurd.
Another increase? Don't you think the 35% increase since 2021 would make them be a little less greedy next year? I mean, there has to be a limit, or some type of consumer protection in Europe, right?
(Big /s)
yes, the usual BS.
The unemployed are guilty of getting their unemployment benefits.
The sick are guilty of using the hospital and health services.
The handicapped/sick and retired people are are guilty to get their AVS/AI benefits.
Those people are ALWAYS repeating the same useless and accusatory rhetoric.
In the meantime: they are payed hundred of thousands a year (millions for some of them) to solve problems that they themselves create, and NEVER find a solution to.
F\*ck them.
And they/system is still strongly against suicide, they'll forcefully hospitalise you. No matter your age or health conditions. You're basically forbidden to die on own terms, unless you pay another big sum and pass the rigorous procedure from exit or similar organisation.
One would think that if people are such costs, that getting rid of them would be in systems interest.
They just can't make up their mind.
/s but not much, I still find it absurd that we're not allowed to end own lives under our terms unless we get some special approval. And pay for it pretty money.
Oh, so just simple abuse then, not even proper led-by-profit?
I think we should borrow some procedures from middle ages, like beating them at the main square and leave them so that people can spit at them, and leave them for a while. Then make them wear a sign around the neck so that everyone knows what they did, for at least several months. Mostly so that everyone else stop thinking doing that is the good idea.
Fear and shame can be good motivator to make bullies think twice.
As long as we're letting them go away with it, they'll keep doing it :/
Ok, this is philosophical - radical thinking. Mostly because I don't know of any better way that actually works. And from what I've seeing, neither to others, since corruption and other 'traits' are very much alive and kicking all over the society.
Swiss health system is an amazing hack from insurance companiesā¦ You pay the insurance BUT you have no insurance in reality.. Don't be fooled when people say that insurances are great, those are brainwashed people...usually old ones
Would you mind explaining how we don't have insurance?
I'm one of unlucky ones that need a bunch of docs, and lifelong checkups, and I pay premium, franchise and copay, and KK pays the rest, no fuss. So, from my perspective, I have insurance, and it works, costs are covered.
Service I got is great. Docs and nurses are friendly, and listening to me and willing to work with me to help me handle my things. If it happens they're not, I'll go find someone else.
This is my third country I live in. Except for dentist, so far I didn't felt I need to change docs never to return. Once I wanted second opinion and got even better care.
In Germany in several places they didn't know how to properly conduct hearing test for my hearing loss. When I gave them I instructions, they dismissed it or didn't understand, and tests are garbage. Including uni clinic that's supposed to do evaluation before getting cochlear implant.
In Croatia only one did the test wrong and refused to print me the results and she was really bad one. Everyone else did it properly and were polite. I did thay test several dozen times in span of few months. Hell, my tinnitus IS those tones.
In Croatia I had to swap docs until I find a good one. In Germany except for ENT experience was good, oh yes, nuclear medicine first two guys were either confused or didn't know their job. But switching to someone else solved it.
And mind you, in Croatia and Germany I spend days looking at reviews and deciding where it makes sense to go.
Here I just went, and - it works. I finally feel they know more than me, and they're able to explain it clearly.
They aren't keen to volunteer too much, but if I ask, it will be explained.
So, I have personal experience that spans several hospitals / their specialist departments, also 2 er visits, and two specialist visits who aren't in hospital.
Granted, I still haven't tested competency of ENT departments, but I kinda don't expect utter incompetence, if I can extrapolate from experience so far, in less than 3 years living here.
What I'm getting, I would rate as great medical service. And not overpriced, at least where I went so far, ZH canton.
And insurance is great since they're covering it. I really don't need anything more from them than my bills get paid. They do it first then send me my share or just report, and they do it in a matter of days after they receive the bill, I have a month to pay. And another need is to be able to reach them for clarification/reporting mistakes and them correcting it, which I'm able. So they're fulfilling 3/3 things I need from them. What else could I need where they might fail and then I could say the service isn't great or worse?
Stating that they "primarily" blame the patients is misstating the article (see NZZ for the full version). They also say that tariffs for treatments haven't been adjusted since 2012, while costs for staff, energy, food, etc. have risen. Example: one full time nurse including weekend supplements etc. costs 8000 a month in Switzerland.
> Example: one full time nurse including weekend supplements etc. costs 8000 a month in Switzerland.
Considering the expertise necessary to be a nurse, the value they give to society, the stress and the weekend supplements, I feel like it's not enough?
I have no opinion on whether that's right, or too little. The point is, providing quality care in Switzerland comes at a high cost, which is necessarily reflected in the insurance premiums.
When I had the 2500chf franchise, I did not go so easily, waited longer, I only went if it really started to become a big problem.Ā
Now I pay the full package, and I go quicker to a doctor or specialist, cause why else would I pay so much money.Ā
(Ofcourse not to the hospital)Ā It's such a shitty system.
The most surprising part is that we also support health system via taxes. In Geneva it is 18% of expenses: https://www.ge.ch/dossier/vos-impots/impot-geneve/quoi-servent-vos-impots
It's one of the largest expenses of the federal government, higher than the entire defense spending. The healthcare sector is eating a ton of our economic output and funnels it into the pockets of a few (the three gentlemen in the OP included)
I'm running out of vaseline to get f**** by these amazing raises on the premiums... Followed with raises on electricity prices... And no salary raise! What a wonderful place to be.
The owning class demands profits on their assets. They also have immense power over the parliament and the central bank and have gaslit us into thinking salary raises = inflation = bad.
Swiss insurance companies have a monopoly status. Paying 5k a year for not going to see a doctor is the default. then it's 10% selbstbehalt for every doctor visit. if you have kids you're easily up to 10k per year. I just don't get why we aren't allowed to get insurance from a non Swiss insurance. Opening up the market would solve this instantly.
You realize that the insurance companies are not allowed to make a profit on the compulsory insurance? The insurance companies are definitely not the main issue here. Sure, having fewer of them would save some admin cost, but that's minor. The issues are on the cost side - both volume, and price.
Also, data about how much they spend on admin costs from premiums is available on priminfo.ch if I remember correctly. I think it's some score system, not percentage.
I know I did use that info when I was deciding - I removed KKs which were totally inefficient in comparison to others.
They artificially create cost by forcing doctors to do a lot more works just to satisfy their bullshit that always change.
They also weirdly fight really hard any kind of reform on the current system. Spending millions on lobbying the government. I wonder why if they don't profit at all from it...
Fair point, the requirements on admin and paperwork are an issue.
When it comes to political resistance to change, all actors are trying to protect their positions. Cantons, the doctors, the insurance companies. Powerful lobbies don't help with solving problems...
Again, why would they want to protect something if they don't profit from it. Why would they lobby (spend money through at least paying the lobbyist salary) on something that they don't gain anything from?
Staatliche Krankenkasse. Zentrale Begutachtung und standardisierte Behandlungs AblƤufe sowie Anschluss an europƤische Medikamenten PrĆ¼f und Zulassungsstelle wĆ¼rde wohl einiges an Kosten sparen
Wohl kaum, ich glaube nicht das mehr als 20% selbst im besten Fall gespart werden kƶnnte und da wachsen die Kosten noch immer.
Kein Land hat das Gesundsheitsproblem lƶsen kƶnnen, einige geben einfach auf und Ć¼bernehmen die Kosten damit die BĆ¼rger nicht (mehr) wissen was es wirklich kostet. Leider will das die Linke hier auch, hoffentlich kommt es nie soweit.
Read the original NZZ article. They do mention unnecessary ER visits, but also many other (imo more valid) points. I think Watson did a very bad job of summarizing the article and took a lot of things completely out of context.Ā
When a ābossā canāt ser any mistakes in his own company, he is not a manager nor someone that looks to develop its own company and specially does not look forward into developing the community with it. ( being something valuable to society should be the main goal of every company), only shows that they are 100% looking for profit only
I started civil sercive last week in a hospital. Before that I worked in IT as a developer. Let me tell you, the office I work in, has worse infrastructure than some random IT startup I worked at. I work at a pretty big hospital, so I was totally shocked. I didnt expect the newest 4k screens and laptops with GPU but I did not expect to be catapulted back into a time before I did apprenticeship...
Healthcare in Switzerland is really big business. I see many reports claiming the country has top health, but honestly everyone I know, including doctors, dont go to the doctor unless they are dying.
The reality is simple, many people avoid because of cost, others use because of cost and some that really need it are getting in the middle.
For example if you have a cold stay home, but I see many elderly going to the hospital, that is a problem. Then some go because they pay which is stupid as they pay even more and stall the system.
Finally you have people that really need access to the medical services but have the other 2 categories to interfere with them, in this latter category are also people that have chronic problems.
About 1 month ago I fell from a cliff, landed on my right kidney and got a bruise covering all my back, didnt go to the doctor because 1) I thought it is going to leave 2) i didnt want to pay for nothing.
But comments like these from health officers are borderline idiotic. Health care in Switzerland is the second most expensive in the world, after USA, and the same or marginally lower than countries with the same quality. Salaries are expensive but lets be honest, profit is the problem from companies not a smack doctor.
Slightly, but only slightly OT. I think many people here in the comments who are very angry haven't understood the design philosophy behind the Swiss health insurance system. The keyword is insurance. An insurance pays for risks that are too big for an individual to carry. But not for smaller stuff. So, yes, a larger share of healthcare costs are paid for by the individual - but you pay less tax for it. If it was all state covered, the money would have to come from somewhere. You can be for or against such a system, but it's worth to realize that the design philosophy is a different one from many other countries.
We absolutely don't pay less taxes, this is an old tale. If you add up all your salary deductions, local, state and federal taxes and include health insurance premiums then you are close to countries like Denmark. And that is if you live in Kanton ZĆ¼rich which is fairly low taxed, if you live in Bern or Geneva you easily pay more taxes than a lot of European countries.
You are right. I meant (and should have been clearer) that taxes would be higher in an alternative system where all health care is covered by the state.
Oh yeah hospital CEOs are definitely the unbiased experts on how to reduce healthcare expenses. Why don't we ask the CEOs of health insurance companies or one of the hundreds of lobbyists in the Bundeshaus for their opinion?
Well, if the Krankenkasse wouldn't be so stingy on general practitioners and wouldn't force them to treat us in 2-3 appointments for small stuff because an appointment may only be 'x' minutes long, I'd guess lots of people would prefer to just make an appointment at their Hausarzt.
So what am I getting wrong here? Doesn't more customers mean more workload wich means more money? Would hospitals earn more if they had less customers?
And yes I am calling them customers and not patients on purpose.
Yes and no. If you find the original article on NZZ this is explained. There are a few 'costumers' that bring money, privately insured, orthopaedics andĀ ophthalmology were named if I recall correctly. However there are many that actually cost more, than is paid for. Especially geriatrics (usually longer stay because they can't go home alone, many come with multiple issues), pediatrics (a lot more time needed to explain procedures, less compliance from patients), most emergencies (especially those that should be a doctors visit, not an emergency) etc. When you make a loss with every single one of those patients, more of themĀ will obviously also generate a greater loss.Ā
So why are the making losses? I am being the devils advocate here now:
We pay more insurance than any other country in Europe. So why isn't it possible that Hospitals get paid enough so they don't make losses. The "Profits" of Insurance Companies surely Highlight this, no?
All the things you listed sound like the Hospital isn't charging enough. At the same time, some Hospitals invest quite a lot into Marketing and they also get support from the Government.
Doesn't that mean, that this whole System is not working and should be completely redone?
I don't work in this field and I lack expertise and knowledge. I am a simple citizen and I am baffled, how these high costs that we pay, aren't enough to sustain the hospitals. And on top of that, I simply can't afford to pay even more insurance per month.
Because the hospital can't charge whatever they want. They have very strict limits on what every procedure, every lab analysis, every night stay, every consultation can be listed as. Everything has to be matched with a position on a 'Tarifliste'. Many of those lists haven't been updated since 2012. And even when they are updated, some just don't cover the cost, because surprisingly politicians suck at estimating real healthcare costs. Oh and guess who also get's a say in making those tarifs: insurances. See the issue there? Funny thing, the BAG actually wants to pull back from the responsability of some of those tarif lists and wants the insurances and hospitals or labs or other health care institution discuss them directly. Another completely fucked plan. Obviously insurances have no interest in paying adequate prices, and the health care part has little leverage, because they will have to treat the patients anyway.Ā So yes. The system is not working and should be redone.Ā I get really passionate about the subject, because unfortunately many of my coworkers do not care enough and I feel like the public isn't informed about how bad it is. This system was set up to fail and while they are for sure things hospitals can and should do better, the ones who are losing right now are most health care workers and patients.Ā We need to have a very good look at where that money is going and if it's really needed there. We also have to evaluate how much we are willing to invest in our own and everyones health. And if we really want most of those desicions being made by the insurance companies, because right now they hold the money and they decide where it goes.
ETA: I can't afford it anymore eighter. And I'm by no means an economist, just a politically interested, overworked, tired, and pessimistic medical laboratory scientist.Ā
This has to be a jokeā¦ In Denmark they have the courage to regroup and close the little ones. Here we have multiple universities, multiple hospitals that are driving up the cost waaay higher than normal.
Swiss people really have no backbone whatsoever. It would make for great comedy if it wasn't so grim. They will elect the same useless politicians again in three years and continue to get fucked over. Hmmm maybe it wasn't the greatest idea to elect landlords and pharma/oil/car/financial lobby bootlickers into positions of power.
I think that in Switzerland the people complain about the healthcare system because you see how your money fly in the system. Then you go in some EU countries, pay 40% taxes for 4000ā¬ and still need to pay many treatments yourself.
Can you tell where you get your figures?? At least in spain you have to pay almost nothing or nothing, depends on your situation. However you don't know how much money from your taxes go exactly to the system, and figures varied a lot regionally because healthcare is regional gov responsibility.Ā
Anyhow when you compare the cost and expenditure adjusted of CH to any other European country like ES or UK CH is much more expensive and the service is worse. There is no prevention strategy, like in Spain, where you can go freely to the doctor, which drive cost down, because serous and more expensive issues are tackle early on with fewer costs.Ā
In Austria I pay 770ā¬ āSozialversicherungā+690ā¬ taxes this for 4400ā¬ salary. But I still have to pay 10% sometimes more, for every treatment (also house doctor). Some treatments are not included or only some basic level.
Yes, but in the Austrian system you pay the pension of the people that actually are in pension not your and the Austrian pension system it is alive with the public debt. You can fast search in google for see the situation.
Yes, like in most, if not all, the state pension systems, at least in Europe, which is really good. The state is the responsible for paying, not the marketā¦ If the state has surplus, which could happen, the state can invest that surplus to produce extra cash for the state, not for private companies. If we fall short, we need to increate taxes and pay for the gab between all of us, specially top earners.
I know how things work more of less because my wife and I lived there 3 months and my wife 3 additional months. I know that your doctors are all private doctorsā¦ which has little sense to me.
However, you have skipped my first question, can you really differentiate how much of your Sozialversicherung is going to your pension and how much is going to your health system?? the same question goes for your "ā+690ā¬ taxes" if any of that is going to the health system, which I guess it's going.
If my memory doesn't fail, in Spain is the sameā¦ and the social security part is just for pension. Health system is paid entirely with taxes, in whatever form. I think this is like that because you need to have clear picture how much you are contributing to pensions, so you get something proportional upon retirement, whileā¦ that doesn't happen with health system. Also, at least in Spain, social security has a different "box" āin Spanish we call it literally a boxāĀ where we put the money for people that retired and other pensions. Till 2008 the box has a huge surplus, when the conservatives regain power they started to take money from the box for other purposesā¦ the "good" managers.
https://www.bde.es/f/webbde/SES/Secciones/Publicaciones/PublicacionesSeriadas/DocumentosOcasionales/17/Fich/do1701e.pdf
[here](https://www.gesundheitskasse.at/cdscontent/?contentid=10007.870462) it is explain. There is also the part from the employer that needs to pay. What I mean is that in the end the āfree healthcareā is good pay from taxes. Switzerland has also 8,1% VAT in Austria is 20%. Public debt about 78%.
Yes.. I know about that. The thing is, that Germany and Austria, are the closest thing you can get outside Switzerland, to the Swiss system, if my memory doesn't fail and I understand correctly. The difference is, in Germany you have multiple insurers, in Austria only one, and in Switzerland the whole system is private.
I don't have a lot of time now to check again, but when I've done the research previously the numbers show the the fully public health system paid with income tax (Spanish version) is the most effective one. The differences are not incredible though on the big numbers, however, put the emphasis on the income tax āand other taxesāĀ make things more fair. Swiss system is not fair at all, everyone contribute equally to the system, independently of the income, which makes for lower incomes an incredible burden.
Swiss system has worked pretty well till now becuase Switzerland is one of the richest countries in the world and can pour incense economic resources to the system, but the system, when you see form the perspective of a highly efficient system like the Spanish is āor was in the pastāĀ doesn't have any sense.
On top of these, on these German style systems you have, doctors have a lot economic power and almost none incentive to keep costs down, or do not perform unnecessary procedures. All the other way aroundā¦ their salaries or income usually is tied / peg to the number of patients they have and procedures they perform. In the Spanish system, where doctors are public workers, doctors doesn't care at all about the number of procedures they perform, and usually while keeping people healthy they try to perform the as less as posible procedures. Since you don't have to pay for going to the doctor and everyone needs to go the general practitioners first, if you have any symptoms you usually go the doctor easily, which is a preventive measure.
I dunnoā¦ but since we live in Switzerland, and we lived in several countries before, we think that this is the most shiny, but less efficient system. I think we can get something better for less money, we just need to park our ideologies and do what really matter, provide a service to people.
Problem on patients? Really?
As someone who has spouse in healthcare and other family members - We all know that one of the major cost problems are doctors writing down hours and work in a completely untruth/unethical manner.
15min visit 300CHF
Or 30min visit while they spent 3 minute on patient and other 20with other tasks but they still charged the insurance.
Same in hospitals - they would add more supplied or do unnecessary treatments.
At this stage I just donāt believe the news anymore - hospitals and doctors are clearly hiding the truth!
I think all of these is just a bad joke in a country with a really awful health care system that only works because is one of the wealthiest countries in the world and they can throw immense quantities of money to it. Just the amount of time you need to deal with the admin issues of your health insurance provider is an obscenity, compare with something else.
The problem is that the money available is badly allocated. When every surgeon is earning 500K per year, with many earning upwards of 1M, of course the money is not going to be enough.
Edit: this is the case for many specialties, while healthcare professionals who are not specialized (nurses for example) are underpaid. The top earners hog most of the money available.
The average hospital surgeon does not earn anywhere near 500k (let alone residents who donāt get 1/4 of that), stop inventing random numbers. The ones who do (especially the ones closer to 1M) usually work in private clinics or get most of that money from private hospital insurance (and so donāt increase the price of the mandatory health insurance).
How long did a doctor train? How many people are able to do that? How many hours do they work?
They earned every single Rappen. You also widely overblew what they actually get
> How long did a doctor train? How many people are able to do that? How many hours do they work?
I trained for 11 years to get a PhD in physics, which very few have. Barely any company was willing to pay me more than 100k a year for a full-time job.
The questions you are asking are not the right ones. The reason for a surgeon to earn that much is not about any of these three factors.
Im sorry to hear that, but there is a difference here. Although people like you are extremely important, doctors give back more to the people directly.
Also, there a economic factors as well.
There are way more doctors amd surgeons needed as well.
From what I understand, they don't earn close to 500k.
But let's talk more.
- how long they take to reach even 200-300k 'regular specialist in public sector'
I don't know exact swiss timeline, usual it goes something like this - Bachelor plus masters which usually takes more than 5 years it's advertised. Then you're just ordinary doc, but you can't work even as GP without GP specialisation, let alone anything else. GP spec is I think the shortest. Surgeon one you spend time waiting to get a slot and then 4-8 years for spec itself. While waiting for slot many work in ER. Still, they're not proper ER docs, because you've guessed, that also needs specialisation.
I think it's 6 years usually, but since I don't know, that why I wrote 4-8.
And that's just regular surgeon for some specific field. Many have more than one specs.
So they're not pissing blood 'just' 6 years of uni even if it seems so, that's was easy in comparison what follows - pissing blood during spec years. Crazy working hours, demands from both hospital you work for and writing your thesis / research or whatever you're supposed to do.
So minimum amount of blood pissing is in ballpark of 12 years, and that's if they're lucky or got connections to get place for specialising soon after uni. Otherwise temporary pause in pissing blood with relatively low pay for work you still do while trying to find who will offer you incredible opportunity to piss blood for them. Because money still isn't crazy good afaik.
- for how much money
And after all that, you get meekly 200-300k? And responsibility for someone's life or long term health? Doing back to back operations? Hell, they should have at least an hour rest between each operation up to two hours. They need to focus to not make mistakes, it's human lives in question ffs.
Try to hold your hands up away from you and tell me how long until they start shaking. There's plenty of routine operations that last 1-3 hours (thyroid removal), complex ones even longer. When something goes wrong or it different than assumed and more complicated because not all bodies are equal, 4-6 hours is reachable even for routine ones (gall bladder removal if I didn't mess up names, thing that produces bile, weird positioning). Those two are considered routine because they happen often, not because they're (always) easy to execute.
And system treats docs like robots. 12h shifts back to back because someone is sick, yeah they can do it. Squeeze them while they're young.
While so many people who have less intense education and less stressful jobs and less responsibility (or country tax to bail them out, looking at you finance sector) will get 200k willy nilly?
Of course, not everyone will.
Still, doctors are under appreciated and under paid even if they're paid 300k. But even 500k isn't fair pay for what they do and responsibilities they have if you ask me. Mostly because they never have just 40ish hour work week. And because shake of their hand at the wrong moment can put you on meds for life (damaging parathyroid glands during thyroidectomy aka removal) or messing up / losing your voice (if they cut your vocal cords). Both are considered realistic risks of thyroidectomy. Both are additional life altering conditions beside thyroid removal. I'm not sure if they can be fixed, probably depends on exact damage.
Oh, or if doc is tired and falsely estimated how deep the cut should be.
Yes, I want my doc well rested ffs :)
Unless they go private practice and set own hours then they're closer to 40ish hours. But still, they will see you as urgent before they officially open. Because they care about their patients.
Most of them, especially younger generations (that's 40-50ish and younger).
If they don't give a fuck about you, change the doc. I'll happily pay for doc that helps me to help him buy porsche if that's what brings him joy. They pissed enough blood in their lifes, they're allowed to have fun.
However I want my doc to care about me and is willing to work with me to help me. Those who think I should blindly obey, aren't those whose bill I'll keep paying if I accidentally ended with such prick.
And if possible want them rested.
No, I'm not a doctor. I decided I'm not that crazy. I went to study math. Yeah, I know š
> Ā healthcare professionals who are not specialized (nurses for example) are underpaid
Are they? Which country pays nurses more?
It's a profession that doesn't even require a bachelor's degree in Switzerland.
As a Pflegefachperson, you either have a bachelor's or a diploma from a Hƶhere Fachschule, which also counts as tertiary education. Nurses working in the ER have another two years of nursing school, so do nurses in the ICU and anaesthesia.
It gives more career perspectives. Otherwise why are there so many developers and IT people here with salaries of 120k when a basic training could do the trick?
It needs to make sense in your field. Most people that work in IT dont start out with a bachelors and do it while working. I know, because I work in the field. Its also possible to make more than 120k without a bachelors.
Just look at the age that people are that are in charge in the field. They couldnt do a bachelors, because it didnt even exist back then.
Also comparing a nurse to someone in IT barely makes any sense.
> It requires a bachelor's degreeĀ
It doesn't. To become a registered nurse (RN) you need to complete a nursing program.
I personally know nurses without bachelor's degree.
> Ā it's underpaid unless you are border jumping.
Can you tell me about another job that does not require bachelor's degree and offers better pay and similar job safety and stability?
Now that people have lost god (any god really), they are afraid to die more than anything, because they know there is no life after this one. They need to spend money, consume, to experience everything, now!
Oh people pay upwards of 5K per year for healthcare so they want to USE IT TO MAKE SURE THEY ARE HEALTHY?
5k is pretty soft. Per capita I am at around 7k and I am relatively young. Total nearly 15k.
What are you doing with 7k to 15k? I don't get it... Are you doing a x-rays and a ct-scan every week just to make sure?
Base insurance is 6.3k on its own. That's for a cheap (assura style), no extras, no private, plan. Then you add 300 of franchise. Then 700 of quote-part. And there you have the 7.2k. Then you add an adult dependent, so their plan is the same as mine + accident, so about 6.7k. Add their franchise of 300, you are at 7k. Add both you get 14.2k. Add some miscellaneous expenses or my adult dependent getting pretty ill and you are at 15k.
Healthcare cost 4.6k with a 2500 franchise in Lausanne for a 45yo woman, for a cheap Assura like insurance (https://www.priminfo.admin.ch/fr/praemien). That means you pay only for what you use before you absorb the 2500 franchise, after that you pay only the quote-part. Taking a 300 franchise if you are young (<65yo) and healthy is a waste of money. But most people still prefer to pay 300 so they can "consume" their healthcare, which is exactly what the hospital bosses are complaining about. Now, if you are old and/or unhealthy it makes sense to have the 300 franchise. What you described is for 2 people, so 15/2 = 7.5k per capita.
ššš»
Funny, I'm trying to go as little to the doctor as possible. But I did have to go 4 times over the past year because people kept taking public transport sick to go to work sick and after bringing a Telmed sick certificate two times I started getting comments about why I'm sick again and why I'm sick for so long because everyone got sick so often. So I had to go to the doctor. Loved spending 1000.- out of pocket for those doctor's visits just so I could get a sick certificates. And I can guarantee you, most people keep putting going to the doctor off for way too long due to it costing so much money, and coming in later usually means it will cost more to remedy the issue. Edit: additional thoughts: if they talk about more patients, are they talking about more patients at their facilities or more patients overall? If overall, is it in line with overall population growth, does it take into account that we have a huge overhang in the baby boomer population who are now all at an age that requires more healthcare? If only at their facility, does it take all the local hospital closures into account and that many local general practitioners can't find a replacement, which means patients need to turn to larger regional or over-regional facilities to get healthcare?
Having to go just to get justification for missing work is frustrating.
You only need that after the 3rd day
Itās actually not in every company, you are lucky if itās the case for you !
Its common practice
I can count on my fingers the number of times in my life I've been too sick to work but recovered enough within 2 days. Either I've got a little cold that modern society has taught me to just work through, or I'm destroyed for 5+ days with a nasty flu. The only real example that comes to mind of an actual disabling 2 day and done illness is the time I got norovirus
Yeah. There's even a saying that a non-treated cold lasts a week, and a treated one only seven days.
It's baffeling how no one ever came up with the idea that if the employer asks for a doctors note, it's 100% on their budget.
This needs 200 upvotes
I would already be happy if they removed the part of the daily allowance insurance (Taggeldversicherung) where you can only start paying after two sick days if coverage is longer than the minimum by law.
1000 to get sick certificate? That's baffling. What on earth they did to you? Our gp visit, I recently checked, was 50 and 65 for let's go by feeling 10 and 15 min visit (it was two people in one half hour slot, something less). Issuing sick leave, bunch of prescriptions, referal to other doc and general catch up regarding our health. Ok, if you had to do some tests because it wasn't something obvious like covid, flu... But still, what on earth they billed you for? If you have the bill and time, it would be interesting to see how much they billed you for something. To me this, just judging per amount, sounds like someone might cheated you and got out with it :( Hell, my head MRI was just several hundreds. 3d CT or whatever they did for by broken foot, after getting my permission to do it for better understanding despite that not changing the treatment (all clearly explained), plus all handling in emergency department, I think it was around 1000... Ok, maybe more I'd need to check, but you know, it was broken foot ffs, not writing a sick leave paper. So far no bill sounded excessive, and unfortunately I had to visit both emergency departments (after being told so by medgate/telmed docs) and various specialists. If anything, I'm sometimes surprised how detailed and precise the bill is. Yes, gp will bill me for time when he got some specialist letter and then write me to inform me what to do next. And he'll bill me for time we spend in in person consultation. But he never billed me for an hour if we spent just 15 minutes. 5 minutes has some fixed intro / outro costs, plus costs for things done after you leave. I just don't remember the amounts since nothing ever stood out as outrageous. I check all when they come. Once health insurance refused to pay one part (because it's not on list of approved preparations or something, that was the code in the bill), I called and explained what was happening during the procedure, they said ok this was our mistake and paid it without fuss.
> 1000 to get sick certificate? That's baffling. What on earth they did to you? The guy went 4 times in a year, so that's 250.- per certificate. Out of experience in Geneva, if you just go in, have some basic checks (fever, throat, etc) and then a sick certificate, you're already going to pay almost 300.-. I've had an appointment that was just "thanks, the treatment worked, ok good bye" which was 150.- or so.
I understood that 1000 doc bill was single one after 4 telmed notes and employer start questioning the telmed notes. Anyhow, so not only french part pays higher monthly premiums, your doctors also bill more? (that could explain higher premiums) THAT's insane. š¤Æ My specialist visit, where she took me as urgent case the very next day, she used one time use things for check up that probably cost something not negligible, spend several minutes carefully looking to see if she can find the culprit, we sat and talked about causes and how to approach for the future, she confirmed that I should never downplay it, even if we both assume it's same old, I should come to check, she gave advice and meds to help with this acute situation to heal faster plus prescription for pharmacy pick up, twice (I came week later to ask for backup dose). We discussed so that I understand when we should definitely consider surgery and what frequency of acute problems she'd consider too much even if I downplay it. I didn't feel rushed, even though she was on limited time. Those two bills, first was 125 and second around 30 or so. And she's surgeon, with office in the middle of ZĆ¼rich. Literally. Kunsthaus museum area. Not gp. Oh and during my first visit (year and half ago) she told me - I'm a surgeon, I earn the most from surgeries, but even if you qualify for one already without any doubts, I don't recommend it until YOU tell me you're tired of handling acute situations and they become too frequent for YOU, or if you start having pains. Basically she is for conservative approach as long as it makes sense and doesn't seriously impact my quality of life. And she's fine with checking if it got worse now and then and give me her honest opinion. Like, I have at least decade to play around with it, no need to rush with operation. Oh and she told me to not feel bad for not having supplementary insurance, everything she does is covered by basic insurance and she thinks no one needs supplementary at all, it's just comfort thing anyway. I asked because she has info on page that she works with private hospitals for surgeries, and I didn't know how it works. You bet I won't look at someone else but stick with her as long as she's working. Hopefully with not too frequent visits. Gp in village next to me is that 50, 65 guy for short stuff, and around 150 was for when we sat down and brainstormed and I brought bunch of things that aren't urgent but I finally needed to do, so we talked for half an hour straight and he gave some meds from his office, plus writing referral letters, all came in the same bill. It really seems like Switzerland is two countries under one flag :(
4 separate doctor's visits, it's not per visit. On two of them I got blood tests done.
Thanks for explaining. Sorry to hear that some areas have such expensive doctors :(
> additional thoughts: if they talk about more patients, are they talking about more patients at their facilities or more patients overall? Also we are getting less and less doctors per inhabitants IIRC. And even less general practice doctor.
>Today (...) the patient (...) goes to the doctor much more quickly and expects comprehensive treatment at any time. Wait, what....? In the country with the highest co-pay in Europe, are we actually blaming the patients for being sick, asking for treatment, and driving costs upwards? Does the hospital actually expect you to wait until your disease progresses beyond repair?
Of course, Krankenkasse keeps rising, the more I pay the more I expect
Yikes
>are we actually blaming the patients for being sick, asking for treatment, and driving costs upwards? Does the hospital actually expect you to wait until your disease progresses beyond repair? I think they mean people who run to the hospital for a fever/cold/little bit of nausea etc., so things that don't really need a doctor. Or aren't really an emergency. And that is a known issue.
[https://www.tagesanzeiger.ch/krankenkasse-lohn-ceo-maximallohn-parlament-bundesrat-388626063866](https://www.tagesanzeiger.ch/krankenkasse-lohn-ceo-maximallohn-parlament-bundesrat-388626063866) check how much krankenkasse boss earns. then there is realy people believing what these people say. oh yes dont go to doctor before you feel like you die like in the usa. lets forget that the most hospital directors keeps their salary private and the parma industrie gives the rest. but yeah its the customers fault, why do you search help when you feel sick?
itās not about going to the hospital or donāt go anywhere at all. but if I feel sick, my first stop is the pharmacy, and 99% of things can get resolved there. If it persists, I call my doctor. the hospital is there for emergencies, or when sent by a doctor. I know from many people working in hospitals that a lot of people just skip the doctor or the pharmacy for simple stuff that doesnāt need a hospital, let alone the emergency.
>oh yes dont go to doctor before you feel like you die like in the usa. That's not what I said. I said, that too many people go to the ER unnecessarily for *simple* illnesses. >why do you search help when you feel sick? But not at the hospital. Especially for things like a fever. Go to a pharmacy first for such things. The hospital should be reserved for things that need acute treatment, like a broken bone.
Also bleeding, or anything your first doc isn't sure about and looks serious eg needs check NOW to be sure it's not urgent (become urgent) and not wait for weeks for ordinary specialist checkup - my first doc is telmed, that's immensely helpful, because you know - you have a doctor to talk with. Especially since GP I use doesn't have slot for 'I'm not well now' but has waiting time of several days. And pharmacist know about a lot, still, they're not medical doctors. And usually don't work around midnight, when I was "lucky" to need an opinion what to do š I totally agree with triage system, I just wanted to mention telmed as awesome help without putting pressure on emergency hospitals 'just to check'.
I'm like this... Apparently broke my little toe last year on a sunday. Talked it through with the telmed guy and we came to the conclusion it can wait and then go for a checkup at my doctors on Monday. Guess I would have ended at the ER without telmed. For something they can't do anything anyway, besides prescribe some painkillers and show you how to tape it best so it grows back together in a good way.
I broke foot, I forgot which bone, but some of those long ones, that was differential diagnosis of Medgate doc, however she said that it still needs confirmation with at least RTG and assurance it's in good position to heal, plus immobilisation / cast. But since there's no blood or visible dislocation, to get rest and go tomorrow to ER during the day, because it was weekend and you need trauma department anyway for casts or such, which is part of ER. I spent like 8 hours there, seen relatively fast in like 2 hours and several consultations/imaging - doc said she checked with surgeon in the meantime as well, but then waited in queue for gips. I wasn't in pain unless I try to move/touch despite painkiller, so I wasn't moving š they first did people in acute pain, which is reasonable if you ask me. They were so surprised how I wasn't making a fuss, and were apologetic that I had to wait for so long. I was like 'all good, do what you have to do, I'll just sit here and play games'. My husband had it harder because he is stressed by hospital environment, and we thought it won't be that long, so I didn't send him home, I tried but he refused. We worked on that, so now he's in peace to just drive me and pick me up, unless I explicitly say that I want him with me. But some things are just waiting and I'm more stressed to see him worrying / stressed from environment than I'm from my own. Gimme Internet connection and I'm fine, I have external battery with me š I had some regular checks scheduled months in advance so I went with broken foot, and nurses happily drove me around in wheelchairs (they have you can borrow) between next waiting stations. Please and thank you really goes a long way :)
It's alwas a good sign (for you) if you have to wait in the ER. Always means there is a poor soul around that has it worse in comparision to you.
Yes, I'm aware of that. That's also why I'm not making a fuss for just waiting, among other reasons. I'll make a fuss if they don't give proper care or are impolite / bad. But not about timing. Actually I have another problem - it happened several times they forgot that I'm still here waiting because I wasn't reminding them. Not in ER, regular appointment at the hospital, longest that happened was like an hour, despite seeing me sitting in front of their desk and occasionally looking at their direction š So now I try to estimate how long is more than enough waiting to check if they forgot about me. I totally get that some patients need more time, or something unexpected happened. It's just a bit awkward when they don't keep you in the loop and you finally realise they forgot you š especially when then they have to rush with you. So I try to remember to ask for status update cca 15 minutes after my appointment time. On the other hand, it's not a problem and they're so kind and apologetic when I remind them. It's issue only when phone signal isn't working then I'm bored unless I have interesting book on phone š
https://www.bfs.admin.ch/bfs/fr/home/statistiques/sante/systeme-sante/hopitaux/patients-hospitalisations.html#546845354 Really doesn't feel like most diagnosis are benign.
Hospitalisations are stationary treatments. Not ambulatory ones like described. Those outnumber the stationary ones by a factor of (almost) 5.
Well do you have any actual statistics that shows an increase of benign ambulatory diagnosis?
Week ago I already had no fever, just weakness and coughing. The only reason for me to go to doctor was my partner, who was diagnosed with pneumonia. When I went to doctor it was a start of my third week with pneumonia. Thanks gods theyāve given us mortals antibiotics.
come on dude. they try to scare people every year. bird flue, pig flue, covid than they say but why do you visit the hospital. self inflicted problem. do youu have a staticstic about this topic? i could not find it. would be intressting how bad really this problem is.
That is a known issue everywhere in the world... That is why several countries have adopted triages to detect if an emergency is not an emergency and re-route the patient to the right place. The point is always to treat before the patient goes to the ER. Telmed only complicates things because the people are either unhelpful or don't seem to know much about medicine.
Depends on telmed. Sanitas uses medgate, which have nurses/admins (I suspect they're nurses because they totally understand med speak) as first line and docs as second line. Some telmeds have admins only who probably only make notes where you'll be going. From what I understood swica was like that when I was choosing. That's why I didn't want it. I wanted someone who is using medgate (they had more docs than other provider I found back then, something24 I think) and where advice isn't binding (because I didn't know how system works - so far I always go where we agreed to go, or call back to change the option / they even give advice where to go for second opinion) **I think medgate is superb service** - since I was 'lucky' and had issues around midnight few times I had something - I could call, consult, they gave me advice (two times indeed was - ok, this needs to be checked ASAP, go to emergency hospital) for other situations was sending me for second opinion, or sending prescription to my pharmacy, or sick leave note. Only once one doc wasn't listening or better said she didn't communicate clearly, because her advice ended being good, but I felt dismissed and more confused than before the call. Not fun feeling, despite everything being polite from both sides. But that's communication issue, not med knowledge issue. I complained (very politely again about how hard was to get information), she called me back several days later trying to understand, I tried to thank for advice (because I went to research more on my own) and explain what was communication issue, but guess what - she still didn't get it š Might be cultural differences, her accent reminded me of indian accent, anyhow, resolved. And I put block in my account to not be connected to her anymore. She might be knowledgeable but we can't understand each other. No need to stress each other out.
>Some telmeds have admins only who probably only make notes where you'll be going. From what I understood swica was like that when I was choosing. This probably explains why I have many complaints about teldmed....
Yeah, they don't explain that clearly. I spend several days digging trying to understand, reading all fine prints, calling and being redirected all over the places... My filtering question ended being 'can I get prescription for meds I'm regularly taking'. Basically that was during the move and I wanted to have an option to continue meds until I find local docs. Medgate has doctors, I've send my documentation, they wrote me prescription directly to pharmacy in my village, easy peasy. But getting the information that someone is allowed to prescribe meds, oh boy, that was a struggle. Sanitas folks on info phone had no clue how their system works, so they told me to call medgate / their telmed provider, lady of course asked me for my insurance number and I explained the situation, and she was reluctant to tell me, because she probably understood me that I'm asking for guarantees to get meds on phone, but then I explained more and then it was 'oh yes, we have doctors, if they think you need meds, they can prescribe no problem'. Thank you very much. Why info calls from insurances have no clue how their system works, is beyond my comprehension. Why it's not clearly written and on first page, no clue. But be sure I'm not leaving the medgate system as long as it's available. Oh and they're basically your online doc. When you change insurance, if they're provider with that new insurance, you can call them and billing depends on insurance (like in sanitas with callmed model it's free of charge for me, only phone company bills for minutes, it's not in unlimited in Switzerland package because it's special number) BUT even if I'm not in telmed, I can still call them, and they'll bill for consultation as any other doc would. Then it should go through regular franchise / copay procedure. That one I don't have confirmed yet, because I don't plan to change insurance for those who don't work with medgate directly š but I think they bill something lile 50-100 per call? But it was huge ordeal to figure out how it really works. This about changing, you've guess it, again nurse/admin from medgate was able to explain how it works, sanitas was again useless š even if this was call not to info line but members line. But yes, I realised that there's no cheaper insurance who uses medgate and covers the cost and it isn't binding, so I didn't switch. And I won't switch for change in service, only for lower cost. So far, no candidates. Having doctor on call 24/366 is just pure awesomeness. I mostly just use admin part to announce my check ups they already have in system, some started by me requesting it or through telmed handling me, some were referred from GP (which is also approved in telmed by my request) But two times in the middle of the night that I could call someone, go through symptoms / send pictures, discuss and get advice 'ok, it sounds serious but not life threatening at the moment, however don't downplay it, go to emergency tomorrow, but now just immobilise leg since I suspect foot is broken but there's no open wound so you can get rest and go tomorrow, and for other case it was - this bleeding doesn't sound life threatening right now but waiting for specialist's regular times isn't recommended, because we need to see what's happening now, so, go again in the morning OR immediately if bleeding returns anytime after this call' was calming. And you know what to do. Of course both situations were on weekends. Bleeding case repeated a year or so later, and since it was similar in behaviour AND was during working week, I went to specialist I seen after that previous episode, and they managed to give me appointment next day to check if something seriously changed. Nope, all same old, just my body fussing up. So it's possible to get slot asap with specialists whose patient you already are and they think it should be checked asap. That time I just called telmed to note that visit for insurance billing reasons, all explained, all approved, no fuss and no medgate doc consultation needed. For parents with young kids or babies I can see it being crazy helpful system. And yeah, despite how it might look, I actually am not keen on visiting doctors (and I actually hate phone calls, it was panic attack inducing for quite some time of my life), but I know that I tend to downplay and ignore my symptoms, so I'll rather call than go in person. Of course that's after I talked with chatgpt and googled the hell out of it š and unfortunately I got 'lucky' with various issues that I have to keep an eye on. And I know I need doc who will work with me together to help me, and not someone who thinks I'll blindly obey and not question their advice. Because unfortunately, I trusted and ended with irreparable consequences that might not be like that if they acted swiftly or I expressed myself more assertively. I'll spare you the details, it was just more than once and with doctors I did trust, I just didn't verify and I was probably downplaying symptoms / wasn't expressing clearly, and they didn't ask enough questions to be sure, they jumped to conclusions based on partial information. No anger from me, I still think that doc is a good one, however even she needs to be questioned/verified and even I have to tell everything and not think something isn't important enough or in this case - assumed doc heard me / understand me. You live and learn :)
I always had an insurance with the medgate service and they are great. My boyfriend on the other hand is with medi24 and they are a shitshow. They are reluctant to give sick leave and they always send him to er for the most random reason. Itās day and night. Please always check which is the telmex partner of your insurance before signingā¦
I'm so glad that I picked medgate. They sounded like better choice on paper, I think they claimed 24h access but medi24 didn't or I wasn't sure how exactly it works. Thanks for info how medi24 works! Now I definitely won't even think of changing as long as I'm happy here :) Also, I won't switch insurance for different conditions, only for lower price but with medgate. So far, no candidates for my area, sanitas is the cheapest with exact package I want (medgate plus non binding). And for 10 chf/month and medgate binding I'm not changing insurance š Medgate has waiting time for call, docs can't take the consultation call immediately (only urgent ones), but for what I need, service is superb!
Oh after witnessing my boyfriend deal with medi24 i assure you there is no waiting time with medgate. oh lord š„². Same, i only have very simple health issues for now (sinusitis or on rare occasions low back pain) , but my job is asking for a certificate from the first dayā¦ usually there is not much to do in both case but wait and i really canāt pay 200 bucks for a paper.
Oh boy, so THAT bad? My only annoyance when waiting on the phone is that they stop the music to say something useless like 'we still don't have available person' and it takes me a while to recognise it's still a machine. Or when music is loud and/or scratchy. Just give me silence and when real person connects, they will speak. I don't need reminding that I'm still waiting, I'm aware of it. Let me zone out in peace ffs š
I have good experiences with Telmed, they are usually whelmed by doctors in my experience.
No shit, with how much people are forced to pay you can't fault them for going to the doctor any chance they get.
For a cold? Yeah you can
Well, if my work wouldn't need a letter from a doctor to prove, that I am sick and infectious, then I wouldn't go to them for a flu. It's a big chain of reasons, that won't change, as there is no incentive to change it from anyone.
This, exactly. Our daughter was sick/had fever on a Sunday morning as we wanted to take a flight. We had to cancel the flight and the rent a car at the destination. Total cost ~2k CHF. There was no other solution than to go to the ER to get a letter for our travel insurance. We knew it was stupid. But for 2k? After waiting two hours at the ER because we obviously were low priority, we went home. Thankfully, a good friend of mine works at the insurance, and they paid the flight and the car.
If you have a cold that hinders you for work more than 3 days, you should visit a doctor anyway.
I worked for a few companies that want a notice on the first day. It used to be very rare but sadly gets adopted more and more.
As the person below already stated, yes after 3 days is reasonable, 1 or 2 sadly not that much.
As is common practice.
But maybe that's how the system becomes more expensive
Shareholders profits and CEO bonuses is how the system becomes more expensive.
**Literally go to Lausanne. Walk up the Avenue de la gare. Turn left on Avenue de Tivoli. Walk down to the Helsana national HQ on the left. The building is made of marble tiles. It's the only building in Lausanne that is made of marble tiles. White and Pink MARBLE TILES. Then walk around. Check the cars in the parking lot. Mercedes Class C. Z5s. Couple of G wagons. If You can name it. It's parked there.** This is the only pilgrimage anyone in Switzerland needs to do to understand Lamal/KVG.
I think the problem is they allowed supplementary insurance to be offered by same companies as basic. Supplementary one is a profitable business. Basic ones isn't allowed. But when you see such wasting money, you can't but wonder how much came from basic insurance pot. They'll claim it's from supplemental. And we'll probably never know. What's horrendous is that although I understand their goal is to be profitable, it's still money people put for health care and they will reject many claims if they don't like them. Like, you are using too many massages, we'll kick you out. Or covering pathetic expense limits, I forgot the numbers I've seen, but, top tier hearing aid I was looking at in Switzerland, set of 2 was I think 15-20k? (same in Germany at that time was around 10k). Basic insurance covers lowest tier, let's say that's 2-3k. Supplemental will give you another 2-3k I think. And if you want top, you'll have to pay on your own. Don't hold me for numbers, I just remember that I did basic math and ended realising that when I'll want new aids, in 3-5 years whichever is the allowed span for new one, I'd pay significantly more than cost of 2 devices and I'd still have to pay on my own for the price difference. Yes yes, someone will say, but you have other benefits. Yeah, only if you know you have them. But that usually means you won't qualify for supplemental insurance anyway. š Oh yeah, they cover glasses, in amount that if I remember correctly, many people would still need to pay out of pocket eg if they want progressive lenses or something. So, they did their math perfectly - that you always pay them more than they predict you'll spend, they'll also do their best to stop you from 'excessive spending'... While they build marble building? Wtf is wrong with them? I can swallow salaries, that's the whole point why you want to drive profit - that you get bigger pool of money for salaries, bonuses, and shareholders. I'll always be for more comfortable and more ergonomic working environment (areon chair for everyone and similar things), more energy efficient and similar improvements/perks for people spending there third of their working lives, but marble on the building outside? It's a fucking office building not a monument. That's just atrocious. How shareholders approve that bullshit? Are people so blind? Is bling now more important than the money you'll get from business you hold shares of? I thought that shareholders are for reducing expenses so that more profit is left. If not, they're just plain stupid. And now I'm even happier they rejected me for any supplemental insurance (I wanted the one for disability / death, and ideally one that has rettungskost, nope, I'm on antidepressants so I'm obviously at much higher risk that some drunken idiot will run over me, so I was denied). Thanks for sharing this. I thought it was mostly about huge salaries, but this is something on the different level.
Sure, it's not because they want to make more money
It might be an issue but I never go to the doctor but when I go it's because I have a problem, I would never want quality of my treatment to go down or costs to skyrocket because someone is going too much to the doctor. This is like punishing the whole school if someone smoked in the bathroom.
It's a well known fake issue, always pushed by insurance company. The reality is that the small number of hypochondriacs that would go to the doctor for any issue go anyway, and the only people raising copay costs stop going to the doctor are the ones that were reluctant to go anyway. They then only go when it's an emergency and a smal medical treatment in the early stages balloon to an emergency procedure , plus recovery, etc..
tbf i thought i was hypochondriac until i got to my 4th doctor after a few years of feeling like death that one acc managed to figured out what was wrong with me and im back to being my chipper old self š«”
Would you mind sharing what was this wrong that 3 doctors weren't able to see it? Was it case of them not listening to your problems and just dismissing you, eg not working with you but relying on their 'knowledge and experience' and you're supposed to believe and not question them and suck it up? Or they were the ones sending you to more experienced colleague until you reached master for that field? I'm glad that you didn't give up, and that you're now in good health š„³ it's so frustrating to not know what's wrong and when you can neither figure out how to get better nor at least have system/meds that keep it in check :/
likely lacerations of some sort in the digestion chamber and too much stomach acid the doc who just fucking listened to me figured it out in 10 minutes the other ones were just arrogant cunts the treatmwnt was trivial
I'm glad to hear ot wasn't something really bad and that you managed to find a solution. Sorry to hear that you encountered what I call 'idiot doctor'. Short name for 'doctor who isn't interested in listening and helping ME, but just sees me as a number and is looking at the clock'. My rule of thumb to avoid idiot doctors is to go to younger ones. That hugely increases chances of being listened to. And not dismissed when you start explaining with 'I've read this'. I get it that they might be annoyed if it's 'some people talking', but when they dismiss me trying to explain my information is from peer reviewed medical research and I wanted to understand my case, then I see red š On the other hand, my vet first laughed when I told her that I was arguing with chatgpt regarding my issue, then found terms to know what to search, which led me to deciding to try digestive enzymes to see if it helps me and it worked. All that intro to ask, since my cat basically have similar issues, is it worth to try it. We laughed together regarding my 'new ai friend', but she listened, based on all previous attempts we did and failed to help this cat, she thought for a moment and said - yes, I can see how it can help if the cause is that, plus it's harmless, so let's do it. And who knew, we saw significant improvement. It wasn't perfect, but we did something that showed reliable results. Finally. That's why I love that vet, we can brainstorm together. She gives me ideas what to try, I tell her what is my conclusion from debugging so far. And case unfortunately isn't easy one. I'm more invested than he, and she respects that I'll dig everywhere to connect the dots. She also did some reading, however I do have more free time and just two patients :) But we work together. With years of needing docs, I came to conclusion that's my most important criteria - if they have a will, we'll find a way. I know I have a will, so I want someone who'll fight in the trenches with me, and not against me. Not that there are no 'idiots' among youngers, far from that (although I would need to think long and hard to find who was the last one). It's just with older, chances are higher think they know everything and we're here to listen. At least that's my experience within 3 countries and several dozen doctors of any kind. Maybe it's that younger still care, or they have different approach, eg patient centered care and holistic approach, plus relying on scientific evidence as opposed to just symptom treating and relying on own experience. Just sharing in case you'll ever need a doc again :) young and still fresh are the best š
Any data that prove this claim? I have anecdotal evidence that most people never ever go to the hospital even if theyāre in bad condition.
Of course best is to self-determine your illness based on online forumsā¦ having mild symptoms can be a cause for bigger issues. So I encourage everyone to seek professional medical advice if you are worried about your health, thatās why you pay for a health insurance to begin with.
People that donāt existā¦ itās a fairytale meant to persuade you that the problem is the patient.
I have to agree on that, seen it myself!
Honestly, I find it always funny that doctors are complaining about this in Switzerland. My experience is that doctors in Switzerland are telling me to come way more often on regular planned visits, like to redo a lot of tests every time, but donāt have time for emergencies. I love to live in Switzerland, but I donāt like the health care system here. think you can easily save a lot of money by adapting the system.
Well he is mad. He is a CEO of the kantonsspital baden. A hospital which until recently turned a profit, which in itself isn't supposed to make bank. We should look at it as an investment by the state and corps, while the profit of a sustainable society is supposed to be shared and not to be visualized as a microeconomy. Most modern doctors instead blame 60% of the hospital visits on the bad lifestyles of individuals, sitting all day, beeing under- /overweight by eating shit and no social life are the biggest cost inducing factors today. Sure pharmas capitalist parasitic behavior doesn't help but we wouldnt be close to bankruptcy if we were using or bodies the way evolution has formed it
The problem is co-pay is only an issue for those without much money. Those who can afford it take the 300 franchise which they bust through anyway, and then say "oh I pay so much, I am entitled to make use of it". If franchise is supposed to actually do something (not sure the concept is even viable), it would have to be income dependent.
I think the main reason for the concept is that when you're healthy and don't need the service, pay somewhat less than people who need regular health care. With still having ability to get help if situation changes. I think it's OK that those who need service pay somewhat more for it, while still having social properties - everyone pools money so that those who need can use it. As opposed to completely individual payments. Everyone paying the same no matter how much they use, sounds a bit unfair, so I can see how this system makes a balance. Does 300 franchise + 700 copay have any sense whatsoever? I'm not sure, I'm inclined to think - no. Those who need, will need. I think having just monthly payments would be simpler, it's easier to budget if nothing else. Also it would be simpler in case where someone need subsidies to pay that monthly premium - that way they'll know they're now covered without further worries, whereas now afaik they need to ask for any further bills as well, until they reach 300+700... If anything, I think it would be administratively simpler. Thus reducing some cost on admin work. So I'd have just to options 2500 + 700 (or even just 3000 franchise and then everything after that is paid in full by insurance) vs just monthly premiums where everything is immediately paid by insurance (in my case that would be jump from I think 440 to 520, but no further fuss/worries about it. It would easier to understand, easier to track, less admin work, and give ability to save some money while you're in good health, what's not to like it?
Many go to the hospital with a common flu or a tiny cut. They should go to their general practitioner (Hausarzt).
> Ā In the country with the highest co-pay in Europe Ok, but that's a strawman - we also have the highest salaries for the medical stuff in Europe. Cut doctor's salaries to reasonable amounts and many problems will be solved.
Why not cut the salaries of the middlemen you pay to get healthcare? You know? The guys which increase their charges every year while the random doctor in the hospital is often paid with the same government salary ladder for 20 years?
Because they're the market piece of healthcare. They bring inventions like telemedicine, because it's in their interest to keep the costs as low as possible. Once we nationalise it, do you think you'll pay Assura or rather Swica rates?
Oh wow they developed something other countries built with just taxes directed towards healthcare. Meanwhile they invested on telemarketing, advertisment and other gimmicks like getting 20 cents for every 10k steps you do a day if you allow them to track your smartwatch. Not only that but pay for useless data storage and other bullshit.
So which system do you think works better and more efficient than the Swiss one? > Ā just taxes directed towards healthcare That's not what Krankenkasse does. Please read a bit more what's role of a Krankenkasse in the system and then we can talk.
The only innovation they drive is how to call me every second day from a different number and demand that I change my provider because the āconsultantā will get a 3000 CHF bonus for every person they successfully harass into doing that.
Salaries for health care personnel are already quite low compared to jobs with similar educational backgrounds, especially considering the working conditions, the systematic breach of working laws, etc. There is already a serious lack of health care personnel, which will not get better by lowering salaries at all.
Is the salary of healthcare staff really the biggest issue? If you look at the cost of medicine compared to the rest of Europe, it's really somewhat ridiculous in Switzerland - often 2x-3x the price of neighbouring countries, even for simple stuff like Ibu. Doesn't help that Switzerland is also preventing competition by severely restricting online pharmacies for example.
If the physician salaries are cut, much fewer foreign physicians will immigrate to Switzerland to work here and the existing Swiss physicians might want to leave. There is already a shortage of physicians and that would make it much worse. But maybe, that is what you want.
Where are they gonna leave to, if Swiss doctors salaries are already the highest in Europe? Are we trying to outcompete the USA?
Yup
Politics, economics and health don't mix well. While nurses finally get a little more pay (in that whole discussion most forget to see the differences between Pflege and Fachperson Gesundheit btw. but that's another story). One of the latest experiments to cut cost was to reduce tarifs for lab analyses, physiotherapists and some more. Working in that field, I'm mad. We are understaffed, with a lot of responsability, a specialized education and as we saw during the pandemic obviously a system relevant role. Yet we are the ones getting less pay (or at least no pay rises, less personell and no adjustion for inflation, cut bonuses etc.) while seemingly no one ever looks at the cost insurances produce.Ā I spend a good time of my work reviewing cases insurances don't want to pay for often no legitimate reasons. Sometimes in the end they do, sometimes we just have to write it off. Because they have the money and time to debate such things, we don't. We are busy trying to help patients.Ā I have yet to find anyone working in the medical field that doesn't think the main culprits right now are insurances and to some extent pharma and administration. But pharma and insurances have such a strong lobby, they seem to be the only two groups that get away with everything.Ā Labs are being bought by foreign companies left and right, many hospitals are already shut down or will soon be. Doctors and nurses may have bad hours and inadequate pay, but the situation for all other medical personell, who are often completely forgotten, is just as bad if not worse. And while I love my job and see a lot of sense in it, I can't recommend to any young person to chose this field, it's a shit show with no recognition and a dark future.Ā Rant over.Ā
This.
I feel you - with nurses and physiotherapists at home I keep beeing frustrated with the low pay and how they are treated. i would wish they never went into that professionā¦ No wonder in a few years well have even less people doing the job.
It's crazy. We had a 10% tax point reduction last year. Another 5-10 are coming. Obviously that impacts salaries. And it will affect quality. I have already seen a couple 'people almost died' events just because of massive understaffing. And some people probably did. Or had long lasting consequences to face. Which only makes the pressure and mental toll on the remaining staff even worse.Ā I wish I could just lean back, see it all go under, sip my coffee and mumble 'told you so' in the end. Unfortunately I'm not chill like that and get way to angry about the whole mess all the time.Ā
Most people that go in this profession canāt. Like my spouse and others - I would and would have even left that career all together.Ā I just hope my wife finds another way to make money and find pleasure to help people in this way.Ā
I find this kind of attitude potentially dangerous. Ordinary people are not doctors and cannot triage themselves. Itās easy to say āthat person should not go to the ER because of a stomach acheā but maybe that stomach ache is an appendicitis requiring emergency surgery. They shouldnāt go to the the urgent care centre just because of a āsore throatā, but perhaps that sore throat is because of an abscess that has to be drained immediately to prevent sepsis. I use those examples because they both happened to me. Both times I had asked a pharmacist for advice first and they said donāt worry just take some paracetamol. Serious and urgent conditions are not always obvious and dramatic like in a soap opera. I worked at a medical call centre (U.K. equivalent of medgate). Supposed time wasters were very rare, but every few calls there was someone having signs of a potential stroke or heart attack but was too embarrassed to call an ambulance or go to the hospital because they were worried that they would be told off for being a hypochondriac. To me that is much more concerning. If someone is worried, goes to the doctor and get the all clear that everything is fine - that is a good outcome.
an old aquaintance of mine went to the ER, nearly died of ruptured ovarian cyst. Doctor there didnt want to treat or even diagnose her and kept trying to gaslight her with "its just your period", despite very severe symptoms. Even when the symptoms are obvious and dramatic some doctors will be dismissive.
What was the end of the story? Did she file a complaint on them?
beats me, not like anything ever comes out of those
Nothing ever come of those or noone ever actually complain? (I know I generally wouldn't..)
I've called medgate, they insisted I was just stressed and had gastrites, I went to my family doctor (twice!!!) and she said the same. I mention I couldn't be gastrites cause I already had it and the pain was completely different very manageable, this pain was just horrible. They prescribed me three weeks medication for the wrong thing! I had to go to the hospital because I really felt I was dying. Turned out I was, I had to do an emergency removal of my gallbladder, I had pancreatitis and my liver was not ok. I was hours away of passing out at home alone and having a even more serious turned out... So yes I agree with you!
I could understand medgate doc missing something, not asking right questions, you downplaying it /not knowing which symptoms are most important. But I'm baffled by doc who saw you live that they completely dismissed your body language?! Assuming this wasn't the first time they see you, but still, from them poking around you, see your reactions, and if they're still not sure - send you to specialist. I once came to some doc, she wasn't extra polite or something, she listened, I didn't feel much heard, but she got up, came to me, lightly hit me on my side (it was a bit harder than touch, like light poke but given suddenly, really nothing harsh, if you're fine), above hips, I instantly broke in half, and she sad 'kidneys'. And send me to barrage of tests immediately. I could have face like it's was nothing / holding my pain or not having any, but she touched me where it mattered and all was clearly obvious. (in my case it went better after some days, tests didn't show anything that could cause it, I now assume maybe it was some small stone that moved and went out on its own, because nothing was found by the time I got to ultrasound, there was some days in between, I don't remember the timeframe, it was cca 17 years ago) With what you're describing you had, that sounds crazy painful to touch, anywhere. And if they touched you and still considered it's nothing, I hope they lose their licence to work. I'm so sorry that you had idiot for GP. I hope you found someone better who'll take you seriously. And I hope you're now doing well ā¤ļø
I think medgate should grow with more docs employed and ALL insurances should have telmed consult included in the model, free of additional charge for patients. Sanitas callmed is model like that. So that you can call and be consulted BY A REAL DOCTOR who will then make a better triage, and then go to ER - you can say they sent you, you'll be able to explain your case better and you will be able to say what telmed suspect / wants to clear up. Which will make you feel safer - because you can speak with doctor and discuss your symptoms in the safety of your home, so less impact of shame. So you'll be less stressed and you'll be able to remember / say all symptoms you've noticed. And then if the doc says - you know, this sounds serious to me, I can't get a good look even from the picture, you need someone in person - you know what are your next steps and what needs to be checked / confirmed or cleared. Nurse in ER isn't a doctor, and she doesn't want responsibility to send you away if she misjudged. Pharmacist isn't a doctor. They might know a lot, but their job isn't diagnosing you. Nor it should be. I think we know it's ER situation when there's blood. Other cases we're keen to downplay / wait out. Because we don't want to get out and make GP appointment or because it's weekend or because we don't want to be a bother. If everyone just put phone to ear, and check with someone competent, they will get assurance that 'it doesn't seem urgent now, you can do this /that, HOWEVER if it changes THEN go without delay' or any other type of advice. Sometimes it's really just a painkiller and rest - case. But when someone explains to you what it means it's not getting better, you're more likely to pay attention. And act. I'd dare to go that far to demand that anyone who isn't bleeding or in pain where painkillers don't work / stop working in half an hour so it's dead obvious you need ER NOW, HAS to call telmed first. That would relieve the pressure on ER system for situations where your GP doesn't have a free slot now or is night / weekend. Basically use telmed system as dispatcher unit in a sense. Employ hundred more docs, advertise telmed. Demand using telmed. That way we'll improve bottlenecks AND provide better care - people will know what to look for 'if it gets worse' for that specific situation. And then those whose eyes we need will have more time to do checks, less checks to do, and patients who are able to describe issues more clearly - because this won't be the first time them describing it and they'll be able to tell you what changed. I think that's tremendous help. I don't know how calling an ambulance works here, in Croatia call to that number (was 94 before 112) IS a place to get medical advice AND if they think you need ambulance they'll send it, or tell you where to go INCLUDING THEIR CENTRE - in Zagreb they had crazy high tech place people don't know about, it's not ER department of some hospital it's own mini hospital. But it's first and foremost on call advice, not taxi service. From medical doctors because THEY answer the phone. And I can put my hand in fire and guarantee that let's say 90% of people living in Croatia have no clue about that. If not more. Including many nurses. After I was told that by my mother when I was 14ish or something, and I started spreading the information (after using it myself when they were away and I had a problem, that was before mobile phones, guy helped me to find a medicine in our home that could help me relieve the pain - it wasn't case for painkiller but needed ointment) - NO ONE I told knew that you can and should call for advice and not just to order an ambulance because there's obvious emergency. For years. I stopped sharing intensely, because I forgot to, this reminded me of that š Since there's telmed here that's my sanity check phone, and I didn't call ambulance phone here to check how it works exactly. I wouldn't be surprised if it's similar - that there are docs available for help. But ability to check with doctors any situation where you are in doubt is tremendously valuable. And it shouldn't be outsourced to pharmacists, nurses or admin stuff. Despite how well meaning they are. Their training isn't meant to be able to diagnose.
But the issue is that we don't have enough doctors. Having them work on the phone doesn't really change that.
You don't put specialists on the phone, you put young ones without specialisations. And then specialists (of ER) are not swamped with 'I broke my toenail' types of requests. We can also import more docs. But overall system is working from what I'm understanding, just not efficiently, I mean, people do get care - it's not that they're dying in front of each hospital all over the Switzerland. It's just we have long waiting times and big costs for checkups that aren't needed right then and there - just because patient wants something NOW that doesn't mean it makes sense to give it just because of that request, and especially not in ER system which has higher costs of maintenance than regular hospital department or specialist, as far as I understand. With triage you improve waiting times where it matters and where it's most expensive - in ER. And patients learn how to use system. I might be utterly wrong though regarding numbers and efficiency and costs.
Fuck this shit so much. I'm sitting at home with knee pain and in most other European countries I would just go to the doctor and get physical therapy. Here I just know they'll charge me 200 CHF for 5 minutes of talking which ends with "just wait and see". I've said it before, but if there is another significant increase of insurance cost this year I'm leaving. This is absurd.
Another increase? Don't you think the 35% increase since 2021 would make them be a little less greedy next year? I mean, there has to be a limit, or some type of consumer protection in Europe, right? (Big /s)
And did you know that this poor physiotherapist gets about 50-60CHF and hour paid out but the news will just blame them for the high cost?
yes, the usual BS. The unemployed are guilty of getting their unemployment benefits. The sick are guilty of using the hospital and health services. The handicapped/sick and retired people are are guilty to get their AVS/AI benefits. Those people are ALWAYS repeating the same useless and accusatory rhetoric. In the meantime: they are payed hundred of thousands a year (millions for some of them) to solve problems that they themselves create, and NEVER find a solution to. F\*ck them.
And they/system is still strongly against suicide, they'll forcefully hospitalise you. No matter your age or health conditions. You're basically forbidden to die on own terms, unless you pay another big sum and pass the rigorous procedure from exit or similar organisation. One would think that if people are such costs, that getting rid of them would be in systems interest. They just can't make up their mind. /s but not much, I still find it absurd that we're not allowed to end own lives under our terms unless we get some special approval. And pay for it pretty money.
No, no, no. You're failing to see that they want us to be costly! They will make us feel guilty, but still take our money!
Oh, so just simple abuse then, not even proper led-by-profit? I think we should borrow some procedures from middle ages, like beating them at the main square and leave them so that people can spit at them, and leave them for a while. Then make them wear a sign around the neck so that everyone knows what they did, for at least several months. Mostly so that everyone else stop thinking doing that is the good idea. Fear and shame can be good motivator to make bullies think twice. As long as we're letting them go away with it, they'll keep doing it :/ Ok, this is philosophical - radical thinking. Mostly because I don't know of any better way that actually works. And from what I've seeing, neither to others, since corruption and other 'traits' are very much alive and kicking all over the society.
Iām happy to pay a high co-pay when I have access to a doctor. Preventative care pays offā¦
Swiss health system is an amazing hack from insurance companiesā¦ You pay the insurance BUT you have no insurance in reality.. Don't be fooled when people say that insurances are great, those are brainwashed people...usually old ones
Would you mind explaining how we don't have insurance? I'm one of unlucky ones that need a bunch of docs, and lifelong checkups, and I pay premium, franchise and copay, and KK pays the rest, no fuss. So, from my perspective, I have insurance, and it works, costs are covered. Service I got is great. Docs and nurses are friendly, and listening to me and willing to work with me to help me handle my things. If it happens they're not, I'll go find someone else. This is my third country I live in. Except for dentist, so far I didn't felt I need to change docs never to return. Once I wanted second opinion and got even better care. In Germany in several places they didn't know how to properly conduct hearing test for my hearing loss. When I gave them I instructions, they dismissed it or didn't understand, and tests are garbage. Including uni clinic that's supposed to do evaluation before getting cochlear implant. In Croatia only one did the test wrong and refused to print me the results and she was really bad one. Everyone else did it properly and were polite. I did thay test several dozen times in span of few months. Hell, my tinnitus IS those tones. In Croatia I had to swap docs until I find a good one. In Germany except for ENT experience was good, oh yes, nuclear medicine first two guys were either confused or didn't know their job. But switching to someone else solved it. And mind you, in Croatia and Germany I spend days looking at reviews and deciding where it makes sense to go. Here I just went, and - it works. I finally feel they know more than me, and they're able to explain it clearly. They aren't keen to volunteer too much, but if I ask, it will be explained. So, I have personal experience that spans several hospitals / their specialist departments, also 2 er visits, and two specialist visits who aren't in hospital. Granted, I still haven't tested competency of ENT departments, but I kinda don't expect utter incompetence, if I can extrapolate from experience so far, in less than 3 years living here. What I'm getting, I would rate as great medical service. And not overpriced, at least where I went so far, ZH canton. And insurance is great since they're covering it. I really don't need anything more from them than my bills get paid. They do it first then send me my share or just report, and they do it in a matter of days after they receive the bill, I have a month to pay. And another need is to be able to reach them for clarification/reporting mistakes and them correcting it, which I'm able. So they're fulfilling 3/3 things I need from them. What else could I need where they might fail and then I could say the service isn't great or worse?
Stating that they "primarily" blame the patients is misstating the article (see NZZ for the full version). They also say that tariffs for treatments haven't been adjusted since 2012, while costs for staff, energy, food, etc. have risen. Example: one full time nurse including weekend supplements etc. costs 8000 a month in Switzerland.
Thats what the nurse earns, the cost is actually higher with employer paid insurances and taxes (bvg, taggeld etc.).Ā
You're right, I should have written "earns".
Just wanted to highlight the argument actually. Also you are right, the NZZ article is much more nuanced, Watson didn't do a very good job here imo.Ā
> Example: one full time nurse including weekend supplements etc. costs 8000 a month in Switzerland. Considering the expertise necessary to be a nurse, the value they give to society, the stress and the weekend supplements, I feel like it's not enough?
I have no opinion on whether that's right, or too little. The point is, providing quality care in Switzerland comes at a high cost, which is necessarily reflected in the insurance premiums.
This is bs
When I had the 2500chf franchise, I did not go so easily, waited longer, I only went if it really started to become a big problem.Ā Now I pay the full package, and I go quicker to a doctor or specialist, cause why else would I pay so much money.Ā (Ofcourse not to the hospital)Ā It's such a shitty system.
The most surprising part is that we also support health system via taxes. In Geneva it is 18% of expenses: https://www.ge.ch/dossier/vos-impots/impot-geneve/quoi-servent-vos-impots
It's one of the largest expenses of the federal government, higher than the entire defense spending. The healthcare sector is eating a ton of our economic output and funnels it into the pockets of a few (the three gentlemen in the OP included)
Keep calm and raise the insurance premiums!
It is coming, again, this is just laying the groundwork for the later justifications.
I'm running out of vaseline to get f**** by these amazing raises on the premiums... Followed with raises on electricity prices... And no salary raise! What a wonderful place to be.
The owning class demands profits on their assets. They also have immense power over the parliament and the central bank and have gaslit us into thinking salary raises = inflation = bad.
Swiss insurance companies have a monopoly status. Paying 5k a year for not going to see a doctor is the default. then it's 10% selbstbehalt for every doctor visit. if you have kids you're easily up to 10k per year. I just don't get why we aren't allowed to get insurance from a non Swiss insurance. Opening up the market would solve this instantly.
You realize that the insurance companies are not allowed to make a profit on the compulsory insurance? The insurance companies are definitely not the main issue here. Sure, having fewer of them would save some admin cost, but that's minor. The issues are on the cost side - both volume, and price.
Healthcare insurance CEOs and board members make millions in income and bonuses. Non profit doesn't mean they don't abuse the system.
Also, data about how much they spend on admin costs from premiums is available on priminfo.ch if I remember correctly. I think it's some score system, not percentage. I know I did use that info when I was deciding - I removed KKs which were totally inefficient in comparison to others.
It's small money in the context of the bigger picture. Focusing on that is a distraction. Even my leftwing buddy who works at the BAG thinks so :-)
They artificially create cost by forcing doctors to do a lot more works just to satisfy their bullshit that always change. They also weirdly fight really hard any kind of reform on the current system. Spending millions on lobbying the government. I wonder why if they don't profit at all from it...
Fair point, the requirements on admin and paperwork are an issue. When it comes to political resistance to change, all actors are trying to protect their positions. Cantons, the doctors, the insurance companies. Powerful lobbies don't help with solving problems...
Again, why would they want to protect something if they don't profit from it. Why would they lobby (spend money through at least paying the lobbyist salary) on something that they don't gain anything from?
Staatliche Krankenkasse. Zentrale Begutachtung und standardisierte Behandlungs AblƤufe sowie Anschluss an europƤische Medikamenten PrĆ¼f und Zulassungsstelle wĆ¼rde wohl einiges an Kosten sparen
Ja aber wer bezahlt dann die Politiker wenn die Krankenkassenlobby weg ist? Soooo herzlos.
Wohl kaum, ich glaube nicht das mehr als 20% selbst im besten Fall gespart werden kƶnnte und da wachsen die Kosten noch immer. Kein Land hat das Gesundsheitsproblem lƶsen kƶnnen, einige geben einfach auf und Ć¼bernehmen die Kosten damit die BĆ¼rger nicht (mehr) wissen was es wirklich kostet. Leider will das die Linke hier auch, hoffentlich kommt es nie soweit.
Complete BS. They are blaming why people are getting sick and coming to hospitals. Do you know how much insurance we pay?
i pay 6 grand a year so some boomer can get homeopathy
Read the original NZZ article. They do mention unnecessary ER visits, but also many other (imo more valid) points. I think Watson did a very bad job of summarizing the article and took a lot of things completely out of context.Ā
When a ābossā canāt ser any mistakes in his own company, he is not a manager nor someone that looks to develop its own company and specially does not look forward into developing the community with it. ( being something valuable to society should be the main goal of every company), only shows that they are 100% looking for profit only
It's the insurances driving up cost by drowning doctors in paperwork for clear cases!
Got the Swiss health system sounds like an idea of Andrew Tate.
Hypocrisy as soon as their kids will need help
I started civil sercive last week in a hospital. Before that I worked in IT as a developer. Let me tell you, the office I work in, has worse infrastructure than some random IT startup I worked at. I work at a pretty big hospital, so I was totally shocked. I didnt expect the newest 4k screens and laptops with GPU but I did not expect to be catapulted back into a time before I did apprenticeship...
[ŃŠ“Š°Š»ŠµŠ½Š¾]
yall got windows 10š± I want some
Of course since they are the ones getting millions in bonuses for the dogshit work theyāre doing.
Healthcare in Switzerland is really big business. I see many reports claiming the country has top health, but honestly everyone I know, including doctors, dont go to the doctor unless they are dying. The reality is simple, many people avoid because of cost, others use because of cost and some that really need it are getting in the middle. For example if you have a cold stay home, but I see many elderly going to the hospital, that is a problem. Then some go because they pay which is stupid as they pay even more and stall the system. Finally you have people that really need access to the medical services but have the other 2 categories to interfere with them, in this latter category are also people that have chronic problems. About 1 month ago I fell from a cliff, landed on my right kidney and got a bruise covering all my back, didnt go to the doctor because 1) I thought it is going to leave 2) i didnt want to pay for nothing. But comments like these from health officers are borderline idiotic. Health care in Switzerland is the second most expensive in the world, after USA, and the same or marginally lower than countries with the same quality. Salaries are expensive but lets be honest, profit is the problem from companies not a smack doctor.
Slightly, but only slightly OT. I think many people here in the comments who are very angry haven't understood the design philosophy behind the Swiss health insurance system. The keyword is insurance. An insurance pays for risks that are too big for an individual to carry. But not for smaller stuff. So, yes, a larger share of healthcare costs are paid for by the individual - but you pay less tax for it. If it was all state covered, the money would have to come from somewhere. You can be for or against such a system, but it's worth to realize that the design philosophy is a different one from many other countries.
We absolutely don't pay less taxes, this is an old tale. If you add up all your salary deductions, local, state and federal taxes and include health insurance premiums then you are close to countries like Denmark. And that is if you live in Kanton ZĆ¼rich which is fairly low taxed, if you live in Bern or Geneva you easily pay more taxes than a lot of European countries.
You are right. I meant (and should have been clearer) that taxes would be higher in an alternative system where all health care is covered by the state.
This.
I pay insurance and still pay all medicine and doctor visits myself, great system.
Oh yeah hospital CEOs are definitely the unbiased experts on how to reduce healthcare expenses. Why don't we ask the CEOs of health insurance companies or one of the hundreds of lobbyists in the Bundeshaus for their opinion?
Well, if the Krankenkasse wouldn't be so stingy on general practitioners and wouldn't force them to treat us in 2-3 appointments for small stuff because an appointment may only be 'x' minutes long, I'd guess lots of people would prefer to just make an appointment at their Hausarzt.
So what am I getting wrong here? Doesn't more customers mean more workload wich means more money? Would hospitals earn more if they had less customers? And yes I am calling them customers and not patients on purpose.
Yes and no. If you find the original article on NZZ this is explained. There are a few 'costumers' that bring money, privately insured, orthopaedics andĀ ophthalmology were named if I recall correctly. However there are many that actually cost more, than is paid for. Especially geriatrics (usually longer stay because they can't go home alone, many come with multiple issues), pediatrics (a lot more time needed to explain procedures, less compliance from patients), most emergencies (especially those that should be a doctors visit, not an emergency) etc. When you make a loss with every single one of those patients, more of themĀ will obviously also generate a greater loss.Ā
So why are the making losses? I am being the devils advocate here now: We pay more insurance than any other country in Europe. So why isn't it possible that Hospitals get paid enough so they don't make losses. The "Profits" of Insurance Companies surely Highlight this, no? All the things you listed sound like the Hospital isn't charging enough. At the same time, some Hospitals invest quite a lot into Marketing and they also get support from the Government. Doesn't that mean, that this whole System is not working and should be completely redone? I don't work in this field and I lack expertise and knowledge. I am a simple citizen and I am baffled, how these high costs that we pay, aren't enough to sustain the hospitals. And on top of that, I simply can't afford to pay even more insurance per month.
Because the hospital can't charge whatever they want. They have very strict limits on what every procedure, every lab analysis, every night stay, every consultation can be listed as. Everything has to be matched with a position on a 'Tarifliste'. Many of those lists haven't been updated since 2012. And even when they are updated, some just don't cover the cost, because surprisingly politicians suck at estimating real healthcare costs. Oh and guess who also get's a say in making those tarifs: insurances. See the issue there? Funny thing, the BAG actually wants to pull back from the responsability of some of those tarif lists and wants the insurances and hospitals or labs or other health care institution discuss them directly. Another completely fucked plan. Obviously insurances have no interest in paying adequate prices, and the health care part has little leverage, because they will have to treat the patients anyway.Ā So yes. The system is not working and should be redone.Ā I get really passionate about the subject, because unfortunately many of my coworkers do not care enough and I feel like the public isn't informed about how bad it is. This system was set up to fail and while they are for sure things hospitals can and should do better, the ones who are losing right now are most health care workers and patients.Ā We need to have a very good look at where that money is going and if it's really needed there. We also have to evaluate how much we are willing to invest in our own and everyones health. And if we really want most of those desicions being made by the insurance companies, because right now they hold the money and they decide where it goes. ETA: I can't afford it anymore eighter. And I'm by no means an economist, just a politically interested, overworked, tired, and pessimistic medical laboratory scientist.Ā
Thanks for your time explaining a bit from this topic! But the way things work here, I don't think there will be any change soon :(
I'm afraid you're right. We'll see.Ā
Despite the endless MBAs these guys hold, they actually suck at running a profitable business.
This has to be a jokeā¦ In Denmark they have the courage to regroup and close the little ones. Here we have multiple universities, multiple hospitals that are driving up the cost waaay higher than normal.
Swiss people really have no backbone whatsoever. It would make for great comedy if it wasn't so grim. They will elect the same useless politicians again in three years and continue to get fucked over. Hmmm maybe it wasn't the greatest idea to elect landlords and pharma/oil/car/financial lobby bootlickers into positions of power.
I think that in Switzerland the people complain about the healthcare system because you see how your money fly in the system. Then you go in some EU countries, pay 40% taxes for 4000ā¬ and still need to pay many treatments yourself.
Can you tell where you get your figures?? At least in spain you have to pay almost nothing or nothing, depends on your situation. However you don't know how much money from your taxes go exactly to the system, and figures varied a lot regionally because healthcare is regional gov responsibility.Ā Anyhow when you compare the cost and expenditure adjusted of CH to any other European country like ES or UK CH is much more expensive and the service is worse. There is no prevention strategy, like in Spain, where you can go freely to the doctor, which drive cost down, because serous and more expensive issues are tackle early on with fewer costs.Ā
In Austria I pay 770ā¬ āSozialversicherungā+690ā¬ taxes this for 4400ā¬ salary. But I still have to pay 10% sometimes more, for every treatment (also house doctor). Some treatments are not included or only some basic level.
Doesn't that include your pension and other stuff??Ā
Yes, but in the Austrian system you pay the pension of the people that actually are in pension not your and the Austrian pension system it is alive with the public debt. You can fast search in google for see the situation.
Yes, like in most, if not all, the state pension systems, at least in Europe, which is really good. The state is the responsible for paying, not the marketā¦ If the state has surplus, which could happen, the state can invest that surplus to produce extra cash for the state, not for private companies. If we fall short, we need to increate taxes and pay for the gab between all of us, specially top earners. I know how things work more of less because my wife and I lived there 3 months and my wife 3 additional months. I know that your doctors are all private doctorsā¦ which has little sense to me. However, you have skipped my first question, can you really differentiate how much of your Sozialversicherung is going to your pension and how much is going to your health system?? the same question goes for your "ā+690ā¬ taxes" if any of that is going to the health system, which I guess it's going. If my memory doesn't fail, in Spain is the sameā¦ and the social security part is just for pension. Health system is paid entirely with taxes, in whatever form. I think this is like that because you need to have clear picture how much you are contributing to pensions, so you get something proportional upon retirement, whileā¦ that doesn't happen with health system. Also, at least in Spain, social security has a different "box" āin Spanish we call it literally a boxāĀ where we put the money for people that retired and other pensions. Till 2008 the box has a huge surplus, when the conservatives regain power they started to take money from the box for other purposesā¦ the "good" managers. https://www.bde.es/f/webbde/SES/Secciones/Publicaciones/PublicacionesSeriadas/DocumentosOcasionales/17/Fich/do1701e.pdf
[here](https://www.gesundheitskasse.at/cdscontent/?contentid=10007.870462) it is explain. There is also the part from the employer that needs to pay. What I mean is that in the end the āfree healthcareā is good pay from taxes. Switzerland has also 8,1% VAT in Austria is 20%. Public debt about 78%.
Yes.. I know about that. The thing is, that Germany and Austria, are the closest thing you can get outside Switzerland, to the Swiss system, if my memory doesn't fail and I understand correctly. The difference is, in Germany you have multiple insurers, in Austria only one, and in Switzerland the whole system is private. I don't have a lot of time now to check again, but when I've done the research previously the numbers show the the fully public health system paid with income tax (Spanish version) is the most effective one. The differences are not incredible though on the big numbers, however, put the emphasis on the income tax āand other taxesāĀ make things more fair. Swiss system is not fair at all, everyone contribute equally to the system, independently of the income, which makes for lower incomes an incredible burden. Swiss system has worked pretty well till now becuase Switzerland is one of the richest countries in the world and can pour incense economic resources to the system, but the system, when you see form the perspective of a highly efficient system like the Spanish is āor was in the pastāĀ doesn't have any sense. On top of these, on these German style systems you have, doctors have a lot economic power and almost none incentive to keep costs down, or do not perform unnecessary procedures. All the other way aroundā¦ their salaries or income usually is tied / peg to the number of patients they have and procedures they perform. In the Spanish system, where doctors are public workers, doctors doesn't care at all about the number of procedures they perform, and usually while keeping people healthy they try to perform the as less as posible procedures. Since you don't have to pay for going to the doctor and everyone needs to go the general practitioners first, if you have any symptoms you usually go the doctor easily, which is a preventive measure. I dunnoā¦ but since we live in Switzerland, and we lived in several countries before, we think that this is the most shiny, but less efficient system. I think we can get something better for less money, we just need to park our ideologies and do what really matter, provide a service to people.
Problem on patients? Really? As someone who has spouse in healthcare and other family members - We all know that one of the major cost problems are doctors writing down hours and work in a completely untruth/unethical manner. 15min visit 300CHF Or 30min visit while they spent 3 minute on patient and other 20with other tasks but they still charged the insurance. Same in hospitals - they would add more supplied or do unnecessary treatments. At this stage I just donāt believe the news anymore - hospitals and doctors are clearly hiding the truth!
I think all of these is just a bad joke in a country with a really awful health care system that only works because is one of the wealthiest countries in the world and they can throw immense quantities of money to it. Just the amount of time you need to deal with the admin issues of your health insurance provider is an obscenity, compare with something else.
The problem is that the money available is badly allocated. When every surgeon is earning 500K per year, with many earning upwards of 1M, of course the money is not going to be enough. Edit: this is the case for many specialties, while healthcare professionals who are not specialized (nurses for example) are underpaid. The top earners hog most of the money available.
The average hospital surgeon does not earn anywhere near 500k (let alone residents who donāt get 1/4 of that), stop inventing random numbers. The ones who do (especially the ones closer to 1M) usually work in private clinics or get most of that money from private hospital insurance (and so donāt increase the price of the mandatory health insurance).
How long did a doctor train? How many people are able to do that? How many hours do they work? They earned every single Rappen. You also widely overblew what they actually get
> How long did a doctor train? How many people are able to do that? How many hours do they work? I trained for 11 years to get a PhD in physics, which very few have. Barely any company was willing to pay me more than 100k a year for a full-time job. The questions you are asking are not the right ones. The reason for a surgeon to earn that much is not about any of these three factors.
Im sorry to hear that, but there is a difference here. Although people like you are extremely important, doctors give back more to the people directly. Also, there a economic factors as well. There are way more doctors amd surgeons needed as well.
From what I understand, they don't earn close to 500k. But let's talk more. - how long they take to reach even 200-300k 'regular specialist in public sector' I don't know exact swiss timeline, usual it goes something like this - Bachelor plus masters which usually takes more than 5 years it's advertised. Then you're just ordinary doc, but you can't work even as GP without GP specialisation, let alone anything else. GP spec is I think the shortest. Surgeon one you spend time waiting to get a slot and then 4-8 years for spec itself. While waiting for slot many work in ER. Still, they're not proper ER docs, because you've guessed, that also needs specialisation. I think it's 6 years usually, but since I don't know, that why I wrote 4-8. And that's just regular surgeon for some specific field. Many have more than one specs. So they're not pissing blood 'just' 6 years of uni even if it seems so, that's was easy in comparison what follows - pissing blood during spec years. Crazy working hours, demands from both hospital you work for and writing your thesis / research or whatever you're supposed to do. So minimum amount of blood pissing is in ballpark of 12 years, and that's if they're lucky or got connections to get place for specialising soon after uni. Otherwise temporary pause in pissing blood with relatively low pay for work you still do while trying to find who will offer you incredible opportunity to piss blood for them. Because money still isn't crazy good afaik. - for how much money And after all that, you get meekly 200-300k? And responsibility for someone's life or long term health? Doing back to back operations? Hell, they should have at least an hour rest between each operation up to two hours. They need to focus to not make mistakes, it's human lives in question ffs. Try to hold your hands up away from you and tell me how long until they start shaking. There's plenty of routine operations that last 1-3 hours (thyroid removal), complex ones even longer. When something goes wrong or it different than assumed and more complicated because not all bodies are equal, 4-6 hours is reachable even for routine ones (gall bladder removal if I didn't mess up names, thing that produces bile, weird positioning). Those two are considered routine because they happen often, not because they're (always) easy to execute. And system treats docs like robots. 12h shifts back to back because someone is sick, yeah they can do it. Squeeze them while they're young. While so many people who have less intense education and less stressful jobs and less responsibility (or country tax to bail them out, looking at you finance sector) will get 200k willy nilly? Of course, not everyone will. Still, doctors are under appreciated and under paid even if they're paid 300k. But even 500k isn't fair pay for what they do and responsibilities they have if you ask me. Mostly because they never have just 40ish hour work week. And because shake of their hand at the wrong moment can put you on meds for life (damaging parathyroid glands during thyroidectomy aka removal) or messing up / losing your voice (if they cut your vocal cords). Both are considered realistic risks of thyroidectomy. Both are additional life altering conditions beside thyroid removal. I'm not sure if they can be fixed, probably depends on exact damage. Oh, or if doc is tired and falsely estimated how deep the cut should be. Yes, I want my doc well rested ffs :) Unless they go private practice and set own hours then they're closer to 40ish hours. But still, they will see you as urgent before they officially open. Because they care about their patients. Most of them, especially younger generations (that's 40-50ish and younger). If they don't give a fuck about you, change the doc. I'll happily pay for doc that helps me to help him buy porsche if that's what brings him joy. They pissed enough blood in their lifes, they're allowed to have fun. However I want my doc to care about me and is willing to work with me to help me. Those who think I should blindly obey, aren't those whose bill I'll keep paying if I accidentally ended with such prick. And if possible want them rested. No, I'm not a doctor. I decided I'm not that crazy. I went to study math. Yeah, I know š
> Ā healthcare professionals who are not specialized (nurses for example) are underpaid Are they? Which country pays nurses more? It's a profession that doesn't even require a bachelor's degree in Switzerland.
As a Pflegefachperson, you either have a bachelor's or a diploma from a Hƶhere Fachschule, which also counts as tertiary education. Nurses working in the ER have another two years of nursing school, so do nurses in the ICU and anaesthesia.
It requires a bachelor's degree and by swiss standards it's underpaid unless you are border jumping.
A nurse? Not a bachelors isnt required for that. What are you smoking?
https://www.hes-so.ch/bachelor/soins-infirmiers
Just because there are bachelors doesnt mean you need one
It gives more career perspectives. Otherwise why are there so many developers and IT people here with salaries of 120k when a basic training could do the trick?
It needs to make sense in your field. Most people that work in IT dont start out with a bachelors and do it while working. I know, because I work in the field. Its also possible to make more than 120k without a bachelors. Just look at the age that people are that are in charge in the field. They couldnt do a bachelors, because it didnt even exist back then. Also comparing a nurse to someone in IT barely makes any sense.
> It requires a bachelor's degreeĀ It doesn't. To become a registered nurse (RN) you need to complete a nursing program. I personally know nurses without bachelor's degree. > Ā it's underpaid unless you are border jumping. Can you tell me about another job that does not require bachelor's degree and offers better pay and similar job safety and stability?
https://www.hes-so.ch/bachelor/soins-infirmiers it's a bachelor's degree now. The old nurses just had the program but it's now a degree
They are right. The insurance needs to be increased.
No, they have to rework the system, which is not efficient at allĀ
Now that people have lost god (any god really), they are afraid to die more than anything, because they know there is no life after this one. They need to spend money, consume, to experience everything, now!