So American goes to the hospital: Sir, we don’t take in people without insurance…

I’ve been complaining about this idiotic system ever since they created it. It’s impossible to comprehend why the municipalities cannot agree on intermunicipal compensations on patience costs. It’s completely retarded!

I was near Riihimäki few years back on sunday when all the sudden half of my body went numb and started to paralyse. I got shit scared because it included massive headache and tinnitus. Luckily my gf was there and she rushed me to the local hospital. She carried me with wheelchair to the reception, as i was unable to move at that point.

They took my wallet and checked me for id. They didn’t even check my current condition expect that i was still conscious. The minute they figured out that i was from Helsinki they threw us out, telling that i have to take a cab from there to Helsinki and report to hospital. After telling us that, they closed the reception and refused to talk to us any more.

We waited for three hours outside the hospital too scared to travel incase my condition would continue to radically worsen. Luckily after that i was able to limb back and curse at them for ten minutes.

Medical horror stories are not in any short supply in the U.S. Why do you think that the lawyers are specializing in malpractice suits over there, and making dough hand over fist?

4 Joseph also went up from Galilee, out of the city of Nazareth, into Judea, to the city of David, which is called Bethlehem, because he was of the house and family of David;

5 to enroll himself with Mary, who was pledged to be married to him as wife, being pregnant.

6 It happened, while they were there, that the day had come that she should give birth.

7 She brought forth her firstborn son, and she wrapped him in bands of cloth, and laid him in a feeding trough, because the Bethlehem Hospital told her to get her ass back to Nazareth.

Phil,

Although I kind of agree with you, I must point out this: The trip from Meilahti to Lohja takes 40-60 minutes. You waited for your operation for something like 6 hours if I remember correcly. I doubt they would have started the operation immediately even if Meilahti hospital was the correct one for the guy. Of course, experiencing a medical emergency is definitely better in the hospital than in an ambulance.

Though I agree that the system is idiotic and municipalities should agree on compensation, I don’t find US non-socialized system any better.

“You will not be covered by your company’s medical insurance ( by this I mean the company who employs you) for any medical occurance as a result of a road traffic accident-not even the ambulance which recovers you from the scene of the accident which cost us $700 for one person”

“Medical costs prove a burden even for some with insurance”
http://www.usatoday.com/money/industries/health/2005-04-28-medical-bills-usat_x.htm

“U.S. Spends 2x per person More on Health care than Other Nations”
http://mwhodges.home.att.net/healthcare.htm

“Americans spend considerably more money on health care services than any other industrialized nation, but the increased expenditure does not buy more care, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health.”
http://www.chiff.com/a/HLFH703cost.htm

This is not a problem of “socialized healthcare” or “welfare state”. It’s a problem of certain hospitals and local decision makers, and most likely if they’d run a private clinic, they would screw up something else in a similar way.

I agree it depends on the hospital. I was outside of the area where “my” hospital is (although within driving distance to my own hospital) and they made an exception and treated me there. They discussed the fact that I was from elsewhere first but in the end they took me there.

My experiences with Finnish healthcare have been for the most part extremely positive. I have had problems but I don’t see them as indictive of “socialized medicine” but rather of particular doctors or particular facilities. In any system, socialized or not, there are bad doctors or facilities that are too buearocratic. If you don’t beleive that you are living in la la land.

So American goes to the hospital: He is taken care of.. its the law, try reading up on it.

In a way, the USA does have socialized medicine, for the poor only.

The rest of us bill payers, get to go to the head of the line. Thats about the only difference between the two systems.

Not exactly. My employer ‘covers’ my health costs, but that actually means it splits the cost with me – I pay a significant chunk of my salary each week to a very rich health care company.

Then when it comes to getting a doctor, dentist etc. they must be part of my ‘plan’ – I cannot say, go the doctor across the street, I must go to one of the doctors in my plan.

Then if I have a procedure approved by my healthcare Gods – say having a crown put on a tooth – I must a) get approval from my health care Gods, b) pay again (perhaps $300 on top of the money I already fork over to the health care God each week for keeping me on its list, and c) cannot switch dentists after the procedure is approved unless I want to submit the procedure for the approval of the health care Gods and wait again to have thsi simple action completed.

But hey, I’m one of the lucky individuals that is insured. When I was making less money and my previous employer didn’t cover me, we hovered above the cut off for getting state health insurance by about $100 a month. That means we were $100 a month TOO WEALTHY to get a state handout, but many hundreds of dollars per month too poor to either afford health insurance or pay for the procedure out of pocket.

That mans that we couldn’t get that simple dental procedure for A YEAR because I had to find another job, get health insurance, get a dentist, get it approved, etc. And that REALLY sucked.

And the position of conservatives on this crap? If you’re not insured at the time – it’s your own damn fault and it sucks to be you. This is why the US is paying MORE for health care costs than it should – for all the people with chronic illnesses (like diabetes) that cannot afford preventative care.

And because health insurance is so expensive, access to simple health coverage – that shouldn’t be that expensive, anyway – is denied to many American citizens (about 45 million out of 200 million).

hi chaps. Can’t you hear the lamenting of the Italian guy who had some little insatisfaction or delay with the Italian Healthcare?
-Oh, we are in Italy you know, this is neither socialdemocrat Scandinavia-Finland or Usa, we are in Italy we got beaurocracy-.

Come down southway when you are sick, men. Take money anfd girls with you. We’ll take care.
Strudel from Italy

The trip from Meilahti to Lohja takes 40-60 minutes. You waited for your operation for something like 6 hours if I remember correcly. I doubt they would have started the operation immediately even if Meilahti hospital was the correct one for the guy.

True, but 10 minutes after arriving at Jorvi they checked to see how bad my appendicitis was (blood test, piss test). They determined that I would be okay if I waited six hours for surgery. To my knowledge, this buddy of mine didn’t get checked, just booted out and sent elsewhere.

Lemme just say that I’m not supporting the U.S. style of healthcare here either. Finland’s healthcare and U.S.’s healthcare are equally fucked up, just fucked up in two different ways.

The one thing they have in common is that both governments are strapped for cash and when cash is low, services suffer. If both governments focused on only the core, essential services (like healthcare), we’d see much better services.

Phil

Hitting the pork again?

Or was that the 225 Million dollar bridge to nowhere alaska?

Or the 7 Trillion dollar free drug program for old folks nobody even asked for? ( I was told NOT to enrole in the new Gov drug program. My private Insurance is much better)

Its all Pork.

I think Phil should look a little deeper into this issues, kind of take an approach of a journalist.

Public healthcare doesn’t mean municipalities could not agree on fees for outside patients. Even today we have these healthcare districts, for example people from Espoo can get treatment in Helsinki.

Public and private services could and actually are used at the same time. If treatment can’t be offered fast and close enough in a public hospital, it should be offered in the closest private hospital. This would make it necessary for municipalities to agree on compensations for patients.

You guys have PRIVATE hospitals? In the land of free Health Care?

Ok, I am game, Why?

16: so that the wealthy people don’t have to wait in line.

I’ll note that under the law, a patient requiring immediate medical care cannot be referred to another hospital because he or she is not resident in the municipality running the hospital. They can transfer patients, but only if it doesn’t pose a danger to them.

So, somebody screwed up in the friend’s case. I hope he filed an official complaint.

@18: Both in Finland and US the issue of taking care of the critical patients regardless of the residency/insurance comes from the Hippocratic Oath (http://en.wikipedia.org/wiki/Hippocratic_Oath). And common sense, too.

As somebody already pointed out “choosing a hospital” depends on your insurance (if you’re not among the *15%* of the unlucky portion of population). Even if you have an insurance it might only cover the “Lohja” hospital. Or the treatment in the “Helsinki” hospital might cost you Shitloads, if the hospital is an “out-of-network provider”. And even if you are a critical patient and you have to go to an “out-of-network provider” it still costs you the same Shitloads.

There are good socialized healthcare systems, and bad ones. This is not a problem of the socialized healthcare system but the Finnish kind of it. If we had a better system, you could go into any hospital like Phil said. But it could still be socialized. Or do you think that our system is the ONLY way…

winter:
You guys have PRIVATE hospitals? In the land of free Health Care?
Ok, I am game, Why?

For the same reason that there are hospitals where you pay $10,000, $100,000 and $100,000,000 in the USA. So that the filthy rich wouldn’t have to tolerate the presence of the common folk. The difference is that everyone gets treated, not just the ones that can pay $10,000.

Regarding this reported idiocy: yeah, it’s absolutely retarded, and yet another reason why we need to get rid of this jungle of municipalities – what the fuck are we paying them for if they can’t even arrange a simple thing like this among themselves?

I think we are going out of thread. The issue here is not comparing Finnish to American system, as I suppose each has its pros and cons, the issue is that I got a confirmation of a suspect I always had about Finnish health care system: I hate it.
I have heard of the “localized” hospitals. That you got (even seriously sick) and you don’t get treatment because you’re from another city is sicker than the sickness itself… What if an Helsinkian gets sick in Rovaniemi? Do they send him/her all the way down there…

Another thing I hate is that before seeing a doctor here in Finland, you have to pass through the permission of the nurse, which no matter what you have, will dismiss you with a “take something hot and rest”, even if you have a broken arm (really happened).

I have to say that health system in Finland sucks, and is a pity because all the rest is so great, from the social point of view (sometimes, even too much, since this is a socialist nation)…
Health care in Italy is one of the few things which are better handled than in Finland, to answer to was talking about the italian system.

17 and 21

Ok, so the rich don’t like lines. Again I am gullable. Why do you have friggin lines?

Or do you send the rich to the back of the line, just so they will go private?

winter: One theory could be that we don’t collect enough taxes to cover a proper healthcare system. Too many people to take care of, not enough recources. Get it?

And yes, the system isn’t perfect.

Phil, let’s face the facts:

1. The murder rate in Baltimore is that of Helsinki about 1600 percent, your point of origin. And you keep telling us how bad things are here…

2. You have NEVER, EVER run a business nor owned one and you still think, you are such an expert TELLING US Finns, how we should run our businesses. You are Nokia employee, nothing else.

3. You did receive excellent treatment by our “crappy” health care system and you still keep on telling us how privatized health care is better even when there is about 20 percent of Americans without any kind of health insurance WHATSOEVER.

So are you just stupid or blinded by ideology?

Winter, amazingly enough you don’t know how the American health care system works, or … well, actually that’s not surprising, I guess. You’re a brainwashed American, after all (not that all Americans would be but how come just the most ignorant ones seem to have an Internet connection?). The US spends about two times more money on “socialized” health care than Finland, and of course not “only for the poor”. And that’s without taking into account the tax cuts everybody with an insurance gets.

On the other hand, many Finns don’t seem to understand how the Finnish system works either. There’s nothing mysterious about it. You’ll get treated at whatever hospital you happen to end up – even if you’re a foreigner, by the way – unless the staff determines that it’s safe to get you to your “own” hospital. Get bitten by a snake in your friends summer cottage next Juhannus and get what I mean.

tim you are in denial. There are very big problems with our public health care because of lack of resources. Politicians seem to be too afraid for now to drive the whole thing down for now, but I wouldn’t count on it.

m, there is not a country in Europe – not to mention the US – whose health-care system wouldn’t be in some sort of a crisis. People are getting older and the treatments more expensive. Fortunately the Finnish system is not among the worst – not among the very best either, though.

I would rather fall ill in Finland, Sweden, the UK, Germany, France or any other country with a universal health system rather than in one where the first concern is the patient’s credit rating.

Some things aren’t meant to be run as a business, and I think health service is one of those. The Americans spend way more on health care overall, yet there are millions of Americans who don’t even have access to it, which seems nonsensical. The reason for the high prices are that health is run as a business not a service; patients become “customers” of that business. They are subject to be charged as much as the business can get from the customer in order to maximise profits just as in any other business. Seems a strange way to run a health system.

That said, most European health systems are facing problems as people live longer and more expensive (but also more medically superior) treatments arrive on the scene from medical advances. However, I don’t think that running health as a business is the answer.

Funny fact of the day, Phil! U.S spends 16% of all the tax money to healthcare, while Finland uses 7,5%. So you take worst from both worlds and still have to pay yourself sick if you don’t have a good insurance.

I don’t remember Phil touting how spectacularly fabulous the U.S. healthcare system is.

Phil, since you’re allowed to vote in council elections, have you considered contacting your representative and addressing this issue? Just writing about it on a blog doesn’t quite cut it. It is, as a matter of fact, a little too Finnish.

Well we agree on this ” Too many people to take care of, not enough recources. Get it?”

We just don’t agree on how to ration Health Care out.

Your view is, everyone gets in a line and hope they get care, unless resources run out.

My view, is, the payers get in line first, then all the rest until resources run out.

Did I get it?

winter:
My view, is, the payers get in line first, then all the rest until resources run out.

In the case of the US, this would mean that the Chinese (over 1 bn) get treated first, then Americans (~300M) if there are still enough resources. Did I get it?

My friend from US had same problem last year here in Helsinki. We took her to hospital and after 5 hours of waiting, doctor told us that everything is fine and he advise her to take Burana:))))))))

She was so bad that she was hardly walking. Next morning she took plane back to US and right from airport she was transported to the hospital for a surgery. Her doctor in US was shocked that less than 12 hours ago she had doctor examination and he didn’t notice appendix.

By the way, she had travel insurance and paid about 1300€ for doctor examination in Helsinki.

If you can breath – you’ll never get any service here.

“If you can breath – you’ll never get any service here.

Yes, there are only incompetent doctors here as all the good ones migrate to the US.

Winter – Well, if you want decent care and you don’t want to wait up to a year for an appointment, you go with private care. A reasonable number of employers have some sort of private health clinic/care arrangements. At least in the US medicare didn’t extract a rather hefty percentage of your paycheck for a service you’d never have an opportunity to use.

I have to admit I was rather surprised that the pre-natal nurse informed me she’d be on holiday for July and that I wouldn’t have my regular appt until mid-August. I’m wondering if I get 6 weeks off from being pregnant, too. Basically all she does is take my blood pressure and my weight anyway. I’m not sure why I bother.

Well, if you want decent care and you don’t want to wait up to a year for an appointment, you go with private care.

Total horseshit as usual. If you’re sick you’ll get usually treated the same day you call the health center. If you can’t wait you can go also to a hospital and wait up to a few hours, usually less.

Why all these lies? Just asking.

“If you’re sick you’ll get usually treated the same day you call the health center.” Same in the USA, just go to an emergency room. At least they can’t send you to another city because you live over there.

And did I hear your doctors are going to the USA? What gives, are they tired of socialized Medicine? Or just want to get rich?

No, you did not hear that. You just didn’t understand the sarcasm.

And did I hear your doctors are going to the USA? What gives, are they tired of socialized Medicine? Or just want to get rich?

The person who wrote that was probably being sarcastic. We do have private clinics although I suppose doctors are paid more in the US. I don’t think the difference in pay is so dramatic that many finnish doctors are migrating to the US. Statistics anyone?

#36: Why all these lies? Just asking.

How do you know they’re all lies? The system is far from perfect. Having to wait for one full year before getting treatment is a bit of an exaggeration, though – Phil got his appendicitis in six hours.

Spendler…same day? I’ve had the creeping green snot flu that has been going around for over a week now. Calling public…no appointments. My husband even tried calling my pre-natal nurse….she was away for the week Calling the private….same day appointment. . I’m not going to go to an ER for the flu. It also seems the common knowledge at work that if you are sick and want an appointment anytime soon, you go with the private clinics.

And mh, depending on the specialty and where they practise, doctors in the US can do rather well for themselves…a GP can make upwards of $250k. Doctors emmigrating from Finland would be required to take a medical board exam so some agency US would likely have stats on Finnish doctors taking that exam.

hfb:
And mh, depending on the specialty and where they practise, doctors in the US can do rather well for themselves…a GP can make upwards of $250k.

Well, last year the annual tuition at Harvard Medical School was $35,800. If I paid that (+ living expenses) with a loan for six years, I’d expect to make top dollar after that. We’re talking about a $250-400k student loan, depending on whether you want to take up golf in your student days.

Of course, Finnish doctors who get their degree at the expense of the Finnish taxpayer and emigrate to the US are getting the best of both worlds.

And yes, it is common knowledge that you might have to wait for a couple of days for an appointment in the public sector, whereas you can most often get one the same day at a private clinic. That is, unless you want to see an obscure specialist. But I wonder why you’d want to see a doctor for a viral infection, as the only thing you’ll get anyway is that dreaded sick leave.

In case you’re interested, my snot hasn’t turned green yet. I was at work today and am going tomorrow like a good Yank. Hell, where’s my H-1B visa?

Yeah, I was being sarcastic.

1. The murder rate in Baltimore is that of Helsinki about 1600 percent, your point of origin. And you keep telling us how bad things are here…

What does that have to do with anything?

2. You have NEVER, EVER run a business nor owned one and you still think, you are such an expert TELLING US Finns, how we should run our businesses. You are Nokia employee, nothing else.

And I don’t claim to be an expert.

3. You did receive excellent treatment by our “crappy” health care system and you still keep on telling us how privatized health care is better even when there is about 20 percent of Americans without any kind of health insurance WHATSOEVER.

Like I said, I’m not supporting the American system either. And I’d hope you’d agree that the Finnish healthcare system isn’t perfect, the post above is a prime example of one of its many flaws.

Tbey’ll do it anywhere if you just tell them too. My sister broke my finger with one of those tailball toys while on summer vacation. I also live in Espoo, and we were in Salo, and breaking your finger is next to nothing compared to appendecitis. At first they whined about at the local healthcare station, that you should go to Espoo. All it took was a bit higher tone of voice and a really upset face and 15 minutes I was back to the summer cottage with x-rays and a cast on my hand. Probably saved a huge goddamn buck for the village of Espoo.

So, Finnish mentality is just like that, if you don’t say anything they’ll give you the runaround anytime since it’s in the procedure. I doubt Tony Halme would kindly go to his local hospital if he was in Rovaniemi with his hand holding his other hand after he shot it off. That shit just doesn’t go.

Oh, and after reading all of the comments. Private hospitals are maybe for yes, rich people. But also, people who want to pay for service not to stand in line. I know a lot of people that don’t “trust” the public services and that they rather go to a private reception even though their income level is lower mid-class. Not to even mention all the companies that have healthcare, use private businesses. Simply because of the fact that it costs less money to get your employee home and healthy asap instead of sending them to public reception where they have to wait a week to be checked for flu. Saves money, tic tac, hello economists.

“I don’t think the difference in pay is so dramatic that many finnish doctors are migrating to the US. Statistics anyone?”

Not on me, but the numbers -especially among specialists- is really, really high. And the closer to the US, the worse it gets; Canadian universities are considering not letting in doctors from other countries unless they agree to do at least six years there before migrating southward, and requiring contract signings for Canadian doctors.

Considering the sheer number of European doctors we have here -my main doctor and my kids’ doctor are European (Norwegian and French)- I would say it’s pretty damned high. No I don’t have any numbers offhand, but I do note all my doctors are from Europe.

@post 44,
it’s always a good idea to take the hard line with these people.
The assumption is you’re an idiot and know less about a condition you’ve had for years than the doctor who met you two minutes ago and has you confused with another patient.

The universal health care system needs a teardown and rebuild.

It should be like this; Hospitals are private institutions. The goverment provides all citizens with an insurance that covers whatever is agreed it should cover. Base services in other words.

This allows hospitals to deal with their own bussiness on their own, make their own pays and whatnot like any private enterprise and the people get their base service and we are not reduced to the joke that is american health care for everyone but the rich.

This is the best combo of public and private interests and very small buerocracy wise.

Americans want universal health care.
http://www.cnn.com/2006/HEALTH/06/07/universal.coverage.ap/index.html

Once again, it won’t take you a week to get an appointment even if you just have flu. You call the health center the first thing in the morning and usually they manage to find an appointment the very same day. At least every time my family has been sick it has worked like that here in Turku. If you don’t have the change to call in the morning, you’ll go to “päivystys” which is not exactly an ER but a place where you can go even in the middle of the night – if you just can convince the nurse that you can’t wait till the next day. I’ve been there with a flu, no problems, I just told them I needed a paper proving I’m really sick. Then there is furthermore the University Hospital’s emergency room where you go if you think you’re dying. Well, at least I would head there.

This morning I drove a friend of mine to the University Hospital to get an eye operation for his other eye – the other one was operated earlier. I asked him about the standard of care there. According to him everybody had been really nice. What about infamous queues then? He told me that both operation was scheduled “as soon as he wanted them”. I don’t know exactly what he meant by that – but I can ask because I’m going to drive him home later today

Anyway, it’s amazing that I’ve been able to raise two kids and can’t think of any complaints. On the other hand, I have to knock on wood. No, just a minute, about twelve years ago my older son broke his arm. With your kid in such pain you don’t take any risks. I have to admit that we took him straight to a private clinic.

With some experience of doctoring in the capital area I can confirm that the situations there often are absurd. With a justified pride I can state that im most of our rural areas the system works astonishingly well. We have never asked any embarrassing questions about a place of residence from a critically ill patient before treatment. All those questions are asked afterwards.

It should be like this; Hospitals are private institutions. The goverment provides all citizens with an insurance …

In fact that’s exactly how it should not be. The reason why the Finnish system is so eficient – and it really is – has mostly to do with the near monopoly the public sector has in health care. When about 70% of all expenditures are paid by tax money the payer naturally can pretty much decide what to do, how much pay for the staff, for example. In the US I seem to remember only 40% is public money and thus the big companies, greedy doctors and so on have the biggest say. The pateint naturally is not benefitting from a system like that.

To quote an acquintance:
We have a decent health care system, but it’s suffering from underfunding and understaffing because the government on all levels has basically told the medical professionals, especially nurses and other such staff, to work like slaves on completely indaequate pay in shitty conditions without complaining and fuck off. Then they’re wondering and expressing “concern” that the health care system is getting under increasing strain and that it’s very hard to get people to do it.

Oh yes I can see how this can be construed as efficient when the goverment has the power to do that. No thanks. I prefer my idea which is more or less switzerlands version.

Lets summarize

1) Finns think the Health care is ok, but funding is going down not up. Not a good trend.

2) Every one talks about going private. Seems like thats the trend.

So question one. Which system (Public or private) is growing, which one is getting smaller. Or maby both are growing?

Second question. Where are the better doctors? (I bet in the private side.)

We all know question 3, where are the shorter lines?

@winter,
the answer to your second question is that the much of the time the same doctors work on both sides. There used to be a strange hybrid thing with no English word for it called ‘erikoismaksuluokka’ which meant that surgeons could use public hospital facilities at cost to do private operations. (Cost the patient a lot less than a completely private operation.) But this was unfair, apparently, to the other doctors or something, so they’ve tried to put an end to it.

1) Funding is naturally going up but not as fast it should, the population getting older and the treatments more expensive. The same problem applies to every industrialized country.

2) The richer Finns get, the more they are spending on private health care – in addition to using public sector, too. The poor Finns can’t afford private sector, although it’s heavily subsidized.

3) Pretty much the same doctors work both public and private, either at the same time (working part of the day at the hospital or something and the rest in a private clinic) or switching between the two sectors over time. Take my wife’s brother. In short: first he worked in a health center, then in a public hospital specializing, then both in the hospital and a private clinic, then back to solely i a (different) public hospital. Now he’s the chief surgeon in yet another hospital. I’m sure he could start a private career anytime and make somewhat more money, but that doesn’t seem to be his thing. And why should it be, why bother when he can afford that big house of his already? Besides he seems to appreciate different things anyway. Like helping people.

5) Private sector has usually shorter lines, but not necessarily. Then again the lines in the private sector would be long too, if they promised to treat everybody with the quite nominal fee the public sector is billing.

Thank you!

“Päivystys”, the Jour is _not_ intented for every idiot for dropping in in the middle of the night at his whim. It is intended for conditions that require immediate attention and cannot wait. If there is one kind of persons I hate it is those pampered welfare state citizens who imagine that they just are somehow entitled to see a doctor at 02.30 AM havind had symptoms of flu the previous day.

A system of health care paid by insurance (of whatever form) and provided by private hospitals looks attractive on the surface but isn’t really a good system.

Look at the economic dynamic of the system. The insurance (if comprehensive) will essentially pay for any operation that the physician at the scene deems necessary. Is it in the physician’s interest to use that tab as efficiently as possible? No, in fact, it is the opposite: it is in their best interest to find as many reasons to bill as much as they can. This is a road to disaster.

Of course, you can balance this system by introducing insurance investigators who examine bills and determine if they are legit. To do the job properly, they need to be qualified physicians, and they need to have access to all the data that the physician at the scene had. Essentially, these investigators would be doing the job all over again, except never seeing the patient.

Result: the money you save from preventing fraudulent billing is spent in maintaining a paraller physician workforce. Why not let the “investigators” be the healers, and cut the private hospital out of it altogether? These physicians would have budgetary responsibility on what they spend, and thus they only do what they need to do.

Oops. Looks like we just transformed the “market-based” healthcare system into a state-operated, “socialized” system.

—

IMAO the problem with the current Finnish system is not fundamental but is a symptom of the municipality system’s disease which the current government is trying and failing to remedy.

There are pros and cons. Personally at the moment I would gladly see a free market ultra capitalistic health care where people would _pay_ and pay dearly for what they want instead of just loudly demanding some inviolate “rights” they think they somehow must have. This is a public health care physician’s personal opinion spewed out of pure hatred.

Antti

I have you considered a 3rd system?

Its a pay as you go system for every day care. But when you reach an certain spending level (10% of your salery), you jump to a split 80% Insurance, 20% you pay, and a third level where insurance takes over 100%?

Thus no need to investigate anyone, and all small stuff comes out of ones pocket?

Its a alternative to an pay as you go system. (Which I really think is the answer)

Lets make folks responsable for their actions. If you drink hard and need care for your liver, then you pay, not me.

I think this socialized system of rewarding folks for bad behavior in the interest of helping them is “Sick”.

“Päivystys”, the Jour is _not_ intented for every idiot for dropping in in the middle of the night at his whim.

No indeed. In case sombody not familiar with the system following the discussion, please read my previous post. The bottom line is that you can get to see a doctor within 24 hours even with a flu, not within a year or so as our usually reliable correspondent told – even if you’re belong to the class of “every idiot”. Whatever that means.

Catilina:
Personally at the moment I would gladly see a free market ultra capitalistic health care where people would _pay_ and pay dearly for what they want instead of just loudly demanding some inviolate “rights” they think they somehow must have.

This should, of course, be coupled with a free market ultra capitalistic education system where students would _pay_ and pay dearly for their medical degrees, instead of being pampered welfare state citizens demanding an inviolate “right” of going to medical school.

Suits me fine. In ten years’ time I have paid my medical education back in taxes already. Why on earth should anybody have to see a doctor with symptoms of flu in any case?

Btw the doctor you meet at midnight has most likely been there already 20 hours and has 16 hours left. He is thought to be at hand in case he is needed. He is _not_ there to see welfare state citizens demanding their “rights” with symptoms of flu when he should be sleeping for the next working day.

Catalina, if you were really a doctor or even a nurse you would know that people don’t visit a doctor or a nurse because of a flu unless they a) need a certificate proving they are ill or b) are afraid. You would also know that visiting a doctor is rarely free (although it doesn’t cost “dearly”). Few people are rich enough to pay something like 15 euros just for the privilige to get to whine.

Fortunately for you, whining here is free, though.

Fortunately for the rest of us, you really have nothing to do with taking care of people.

Actually people show up for various reasons. Getting a certificate for a sick leave at midnight isn’t exactly a life threatening situation. Nor is insomnia presented at early night. You would be surprised to see _why and on what grounds_ people actually seek a doctor at jouring hours. Then it happens that those people that really are seriously ill must be attended in extra time.
Obviouslu _you_ have never done this work yourself. This is regular and never ending complaint in restricted medical discussion boards, and my whining is _very_ moderate in tune.
When have _you_ spend over 400 hours at your work place a month and all you got in reward were taxes?

Re Catilina’s lament,
the one time my wife needed to get to the jour at Malmi at night, just after Vappu, she got excellent treatment and was moved to the front of the queue, ahead of the drunks and the brawlers. The staff do try to distinguish between time-wasters and self-inflicted problems and ‘real’ patients. They have my sympathy. But the trouble is, some real problems may get dismissed as time-wasting too.

@62: A “pay as you go” system would just evolve – fairly quickly – into an insurance-based system, because people who have some sense in them and are not millionnaires will realize the benefit of a medical insurance in a “pay as you go” system.

I don’t understand where you get the idea that in an insurance-based system (even if the insurance only covers the “big” bills) there is no need for the insurance companies to invest in fraud detection and investigation.

Yes, we _are_ pretty good at that. The first glance when shaking is aimed to the question: “is now something seriously wrong?”.

Guess what? Those drunkards and brawlers an sufferers of mild discomfort get a correct and mostly polite treatment too, and they are _demanding_ it. They see it as their “right” to get to a psychiatric ward immediately when a regular shelter isn’t comfortable enough, their knee sores have needed checking just _now_ after all these months and so on and so on.

Antti

Sure – insurance must have controls, or they will be taken advantage of. Thats the same for a free Medical program, its just a matter of how long a line one wants to stand in.

Make insurance kick in at a very high number, and make folks actually responsable for their own actions (Can I say the responsabiliity word here amoung the left wing?).

Again.. why do I have to pay for a drunk and his new liver, or even his loud demands to get his stomach pumped in the ER?

Why do I have to pay for free dental work, when that person will not even brush his/her teeth?

Yeah, winter: Why the fuck I will not rob you in the traffic lights? It is my duty anyway and survival of the fittest, right? Any means necessary…

tim3

traffic light? you have those? Town I am in has a single blinking light, which makes it hard for you to rob me. (No one stops anyway)

Right now my neighbors are getting ready for hunting season. you might want to duck and cover as they are not very good shots even when Bamby and Donald are in their cross hairs.

Winter,

I could talk about social responsibility, “no-one is left behind” and all that but I doubt you’d understand the concept, so I won’t even try. Or I could assume that you are Christian (I don’t know if you are) and refer to the parable of the lost sheep and the parable of the lost son, but, as I said, I don’t know if you are Christian.

Instead, I’ll note that unless you are super-rich enough to actually afford the cost of any medical care you might need, your insurance payments would also pay for the alcoholic’s liver, in an insurance-based system with similar coverage to the public health care system.

As for me being left-wing, many of my leftist friends disagree

And even the super rich who for some reason don’t have an insurance pay in the end as higher taxes, because the health-insurance costs are tax-detuctible. It seems that the American system is designed the big companies, not patients, in mind. They’ve gotten almost free hands to rip off tax payers money, very few “checks and balances” in the system. No wonder the expenses are huge but the results modest. Or am I missing something? I mean, there must be a reason why certain low-paid employees don’t get an insurance, so the companies have to benefit somehow from not paying the fees.

Antti

Where is personal Responsability is the Social net you want? None, zero, so the Drunk keeps drinking and you are helping him out.

All in the name of Christ? Next you will be offering free needles for drug users to help them get a free fix. Wait… you are already doing that to?

Winter,

If you want to continue the debate, post some *good* arguments in my blog (I’ve reposted one of my comments here as a story there, and the comment section is open). As of right now I am no longer following this story’s comments.

Catilina – You have my sympathy as this is why I previously stated I wouldn’t go to the ER even after getting refused for appointments by both the public doctor and my pre-natal nurse who was away for the week. They say being preggers with the flu is dangerous…I guess they didn’t think so.

My mom was an MD and I used to work in the ER some summers to make money. There’s nothing like working at a young age in a primary trauma center in a large city to make you lose all hope in humanity, especially on a full moon. My mother used to wish for socialized medicine and I, too, thought it was a worthy ideal, but now I’m not so sure.

A few facts can never hurt, can they:

Finland’s maternal mortality rate is among the lowest in the world and about three times smaller than in the US.
Finlands’s infant mortality rate is likewise among the lowest in the world and about two times smaller than in the US.
http://unstats.un.org/unsd/demographic/products/indwm/ww2005/tab3b.htm

Within the EU15 the Finns are more satisfied with the health-care system than in any other country, perhaps because it’s not “socialized” contrary to what you think. But then again, no, it can’t be because the Finns have less private insurances than almost no other citizens.
http://www.irdes.fr/ecosante/OCDE/74.html
But what would they know, right?

I recently found your blog from Google and browse many of your other posts.All great. Please continue this great work. Cheers, Thank you.