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I have HMO coverage like millions of others, and we could tell you about waiting lists.  6 weeks just to get an appt with my GP -- consultations limited to 15 minutes.  almost 2 months to get access to an MRI scan after a disabling injury.

I can still barely believe this. And I thought we have to wait long!...

In Hungary, there are very few treatments you need an appointment for - you go to the hospital/medical services facility, and wait until it's your turn. This usually takes 30 minutes to an hour, but can take hours - that's what we see as too much. At some places, an appointment can be made which lets you in without having to sit there waiting. For the few services where we need to make an appointment, it's not emergency issue (say, an allergy test), but still the date is usually within the week.

...and of course, the neoliberal fanatics would like to privatise healthcare here, too... (Some of you may have read my diary about this.)

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Fri Oct 14th, 2005 at 09:31:29 AM EST
[ Parent ]
Now my incredulity is growing. I was unfamiliar with those acronyms - GP is General Practicioner, i.e. family doctor? Now I can't imagine having waiting lists there!... 6 weeks??? My disease is long over by then - or if I need medication for a chronic disease, it'll run out...

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Fri Oct 14th, 2005 at 10:01:01 AM EST
[ Parent ]
That is why you are encouraged to get a 3-month prescription from your doctor each time. They'll probably fill out several shorter prescriptions at once, dated appropriately.

A society committed to the notion that government is always bad will have bad government. And it doesn't have to be that way. — Paul Krugman
by Migeru (migeru at eurotrib dot com) on Fri Oct 14th, 2005 at 10:14:53 AM EST
[ Parent ]
I still don't get it! If, say, you have a skin problem, you have to let it fester and grow for six weeks, until the skin doctor will meet you? (Or worse, twice six weeks, the first with the GP who'll send you to the skin doctor?)

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Fri Oct 14th, 2005 at 10:18:54 AM EST
[ Parent ]
When I was at the University of California we had a pretty good (but pricey) mandatory insurance program. You could get an appointment at the Campus health centre within a couple of days, they would give you a referral and you could generally get an appointment with a specialist withina week or two.

However, my understanding is that the situation is much, much worse with an HMO (Health Management Organization). In many ways, although being a graduate student puts you squarely under poverty level incomewise, the standard of living is acceptable as long as you don't own a car or pay for cable TV.

A society committed to the notion that government is always bad will have bad government. And it doesn't have to be that way. — Paul Krugman

by Migeru (migeru at eurotrib dot com) on Fri Oct 14th, 2005 at 10:38:17 AM EST
[ Parent ]
You see, it works, DoDo, it works!

Afew Snark Technology ™
by afew (afew(a in a circle)eurotrib_dot_com) on Fri Oct 14th, 2005 at 11:04:16 AM EST
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I am skeptical of the value rendered by the med mafia in the first place -- they kill a lot of people every year by sheer incompetence, fatigue, overwork and excessive paper shuffling combined.  120,000 per annum as I recall die in the US from medical mishap or carelessness.  much is made of the shiny state-of-art technocratic icing on the US medical pie but I am firmly in the camp of those who say this is nifty but contributes little to general public health.  I will try to dig up some urls from old discussions in other venues about health care priorities.  iirc more than half our national health care budget is spent on valiant efforts to extend the final year of life, often against the patient's wish or without their conscious participation;  something wrong there.

anyway, I don't generally "go to the vet" unless I am convinced the injury or illness is serious.  have probably visited the doc only 3 or 4 times in 15 years.  it is not a system I trust; and as the pharmacorps suborn more and more docs, turning them into drug salesmen, I trust it less and less.  my experiences with it on the rare occasions when I venture into the waiting room have done little to alter my feelings -- though my GP is a good fellow and I think uncorrupted, his is the last generation of medical personnel who went through the system before near-total corporate infiltration and control of research and hospital management.  I don't trust any of the next generation.

in an emergency the system works fairly well.  but somehow that sums up the essence of corporate culture:  throw money and resources at emergencies in the present moment for quick results -- heroically if need be -- big flashy quick TV-genic results that people will pay big bucks for -- but skimp as much as possible on maintenance and long term investment and the kind of patient low-key effort that helps to prevent the emergencies.  more later...

The difference between theory and practise in practise ...

by DeAnander (de_at_daclarke_dot_org) on Fri Oct 14th, 2005 at 03:36:53 PM EST
[ Parent ]
Staying away from doctors is my goal as well.  They're completely overburdened and don't really have time to figure out your case or history.  If your insurance is good, they'll sometimes order all sorts of tests that turn out to be unnecessary.  And they're simply deluged by propaganda from the drug companies -- drug fads are a huge problem.  

Are you blue? have cramps? back pain? joint pain? neural pain? depressed, nervous, a bit shy? -- change your brain chemistry!  Take these epilepsy pills!  We don't know how or why they work but they sometimes do!!  

Paxil for depression and Neurontin for epilepsy are two of the most prescribed drugs.  I had a friend who was put on them and it turned out she just needed her gall bladder removed.  Another friend on them and it turned out she had a degenerative spinal disease.  I could go on and on -- and the docs present these medicines as though they're pain pills of some sort.  People don't even know they're taking pills that are designed to alter your brain chemistry or prevent siezures.  It's beyond absurd.

Ohhhh, the stories I could tell!  Don't get me started!!

Maybe we can eventually make language a complete impediment to understanding. -Hobbes

by Izzy (izzy at eurotrib dot com) on Fri Oct 14th, 2005 at 04:37:50 PM EST
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wow! (I'm presuming that is public sector service, no bribes required?)

The Polish health care system works that way for basic care, anything else it's a lottery. You might get decent treatment, or you might be told there's no doctor available for the next six months, or the hospital's quota for a particular medicine is full or the doctor doesn't actually see you - more patients than time for doctors who earn horrible official salaries means many require bribes to do more than just look in. (salary for a doctor with 25 years seniority is about 1800zl/mo  600 euros/mo not including overtime.) If you want to avoid waiting you either go to a private clinic and get the procedure done there or pay a fee to a doctor at the clinic to get the procedure done by that doctor at the public hospital - most doctors work both public and private skimping on their official hours to put in time at the private practices and private clinics where they actually make their money.  Horror stories abound. Recently the government fined a hospital for prescribing expensive chemo drugs to patients over 75. Plus the whole system is a bureaucratic nightmare after two rounds of 'reform.'

by MarekNYC on Fri Oct 14th, 2005 at 06:42:56 PM EST
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(I'm presuming that is public sector service, no bribes required?)

Half-yes and no. Family doctors, what Americans call GP, and a few others like dentists became private shortly after 1989 - but (1) with strong regulation, (2) and at least with GPs, not much changed in practice: people still would like to go to the nearest doctor, and competition is limited by doctors themselves not wanting too many patients. (I know this from own experience, I dislike my own doctor and once asked the one next door to take me.) As for bribes, they are said to be near-universal in Hungary, for the same reason as in Poland (but, heh, I myself never paid it).

Furthermore, I only spoke about getting tested and looked at - not about treatment. (I don't know about other places, but in Hungary, under communism special centres for all kinds of medical checks and instant treatment were built across the country, separate from hospitals and the even more local family doctors.)

Many hospitals are run-down (tough not as much as at some other places) - patients often don't have enough room, are even sent home, staff is overworked and correspondingly unkind, the buildings are in bad shape, and with machine breakdowns it happens that the ambulance car is sent to another hotel. As I wrote in that diary a few months back, the 'solution' to this in all politicians' head was further wrecking it with first cash-starvation then privatisation of the profitable parts, but the political mess around a don't-privatise-hospitals referendum and the all-too obvious public opinion made them stop. In fact, the 180-degree-turn policies of the current government seem to have borne some improvements (my personal observations only).

(BTW, I myself have the privilege of access to one of the top-rated hospitals in the country: it happens to belong to the state railway, and my job contract gives me full rights to its services free. I also have a second "GP", the 'works doctor', tough unfortunately too far away from home.)

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Mon Oct 17th, 2005 at 06:35:20 PM EST
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