Question:
Hi all
This is a post for me to understand American culture. As you are all aware I identify as a Kiwi, therefore, my understanding of American culture is limited.
I am presently caring for a patient who is American...I belive he is from Florida. Anyway, please explain a little to me about your health system, how it works in relation to family etc.
We have observed that he becomes increasly frustrated with us, ? related to his health deviation, ? cultural clash, ? he is just grumpy.
Anyway, from your experiences within your health system, did you feel involved, did you feel as if you had choice, how much of an issue is money and insurance.
carie chicks, I respect your American culture and just would like some idea so I can meet this mans needs while he is recieivng acute care within a NZ hospital.
Thank you
I do appreciate that each of us has a culture that is unique to us and that all Americans are different. I am not trying to put you all into one bucket. However, just a little understanding may enable my care of this man to be more effective for him.

Answer:

Originally
I am presently caring for a patient who is American...I belive he is from Florida. Anyway, please explain a little to me about your health system, how it works in relation to family etc.
I don't know about anyone else, but I for one am not quite sure what you are asking.

We have observed that he becomes increasly frustrated with us, ? related to his health deviation, ? cultural clash, ? he is just grumpy.
Having been a hospital guest several times both in the states and abroad, I can assure you that there were other things I would've rather been doing, so I was grumpy most of the time. I am not entirely familiar with the NZ health system, so at this point my answers are rather limited, but speaking for myself, one of the most irritating things about having to deal with health care is the @!*%#$ insurance companies!!
Doctor prescibes treatment A, health insurance company refuses to pay, so doctor prescribes treatment B, though not as effective, so hospital stay and recovery time is longer/less pleasant, but wholly agreeable to insurance company, despite the cost difference of $0.08 in actual medications. But hospital stay is now longer and thus more expensive, so of course insurance company is going to question the necessity of that stay, even though they were the ones that required it in the 1st place!!!!

Anyway, from your experiences within your health system, did you feel involved,
Only as much as I was the victim..er, patient who was being treated...
... did you feel as if you had choice,
Choice in what, treatment? No. How to make the screwing I was going to get from the insurance company less painful? No. Choice of hospitals? No. I am not sure what you are asking about, but the only choices as a patient that I was given were what breakfast cereal I wanted, and if I needed more pain medication or not. And that was OK by me, because I was the patient and in no condition to be making choices.

...how much of an issue is money and insurance.
Big issue, as healthcare has become too expensive to be within the reach of the average person on a cash basis. But on the other hand, it is almost a given that the health insurance company is going to contest just about every charge on the hospital bill, and if the patient doesn't cough up the total amount upfront (to be reimbursed later, wink, wink, nudge, nudge maybe someday if we feel like it) he will be turned over to collections and will almost certainly have to file for personal bankruptcy to keep from losing everything.
Something must be creating a problem or at least making you and others uncomfortable regarding the treatment of this American. But Ican't really think of anything that might be a source of friction that would be unique to Americans, other than the differences in how healthcare is administered as far as the gov't and insurance companies are concerned. I wouldn't think the actual hospital experience for the American patient in NZ would be that drastically different from a hospital stay in the states...
NO SUCH THING AS TOO MUCH HOT SAUCE.

Answer:

Thank you heaps that cetainely explains a few things........no issues with insurance over here (within the public system), Thanks again and it cetainely makes a few things seem more understandable,

Answer:

Big issue, as healthcare has become too expensive to be within the reach of the average person on a cash basis. But on the other hand, it is almost a given that the health insurance company is going to contest just about every charge on the hospital bill, and if the patient doesn't cough up the total amount upfront (to be reimbursed later, wink, wink, nudge, nudge maybe someday if we feel like it) he will be turned over to collections and will almost certainly have to file for personal bankruptcy to keep from losing everything.
Something must be creating a problem or at least making you and others uncomfortable regarding the treatment of this American. But Ican't really think of anything that might be a source of friction that would be unique to Americans, other than the differences in how healthcare is administered as far as the gov't and insurance companies are concerned. I wouldn't think the actual hospital experience for the American patient in NZ would be that drastically different from a hospital stay in the states...

you hit it right on the nose..
Its ridiculous these days that we pay so much for insurance and dont get half the things we need for the money we put out to them people... Why do they must make thigs so difficult... But then again you have to have insurance or you cant afford to go to the doctor without it...
Jody
Life's short lets all enjoy it and smile

Answer:

Originally
you hit it right on the nose..
Its ridiculous these days that we pay so much for insurance and dont get half the things we need for the money we put out to them people... Why do they must make thigs so difficult... But then again you have to have insurance or you cant afford to go to the doctor without it...

That is why I have always thought of insurance as legalized thievery.
You pay all sorts of money to the insurance company in hopes you will never have to use it. If you do use it, they charge you even higher rates, but if you don't use it, you don't get any of your money back. This seems to create a situation that is ripe for abuse, because it gives every incentive to use it (you are paying for it, might as well use it), and little incentive to save yourself and the insurance company money by not using it unless you REALLY needed it.
Were I king, insurance would be structured so that if a person had insurance, but never made a claim, upon cancellation of that policy, that person would get most of their money that they paid into it back. I understand the need of the insurance companies to recoup administration costs, as well as make a bit of profit, so I would allow them to keep 20% or so. The rest must be returned to the ex policy holder. Should a person have to make several claims, then their insurance would be raised until the cost of those claims has been recovered, then the premiums should be returned to their previous rate.
As it is now, you pay all this money into the system, and they still refuse to provide services.
Legalized thievery, I tell you...and people buy it hook line and sinker.
NO SUCH THING AS TOO MUCH HOT SAUCE.

Answer:

I see you think the same as I do of insurance. In the immortal words of a great Sergeant Major I once knew, "suckwad mules"!
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"Anything not worth doing is worth not doing well. Think about it." - Elias Schwartz

Answer:

Guess then this guy is lucky, he is using our public health system and everything (the best) is free. (His parents were on holiday in NZ when he was born, therefore he is a NZ citizen as well as an American)
I think I now understand a lot better re his understanding of the health process.
Thanks again for the input.

Answer:

Originally Guess then this guy is lucky, he is using our public health system and everything (the best) is free.
(His parents were on holiday in NZ when he was born, therefore he is a NZ citizen as well as an American)
I think I now understand a lot better re his understanding of the health process.
Thanks again for the input.
This guy IS lucky! He gets his healthcare free as a NZ citizen while in NZ, but as an American citizen when he comes home, he won't be billed for his NZ hospital stay! Dang, what a racket!
If he is grumpy, it must just be then because he'd rather be out on the beach sipping margaritas and watching bikinis go by than be bored out of his gourd in a hospital bed...
NO SUCH THING AS TOO MUCH HOT SAUCE.

Answer:

I received this in my email and immediately thought of this post.... This pretty much sums up the healthcare system over here..
Frequently Asked Questions About Managed Health Care
Q. What does HMO stand for?
A. This is actually a variation of the phrase, "Hey, Moe!" Its roots go back to a concept pioneered by Dr. Moe Howard (of the 3 Stooges), who discovered that patient could be made to forget about the pain in his foot if he was poked hard enought in the eyes. Modern practice replaces the physical finger poke with hi-tech equivalents such as voice mail and referral slips, but the result remains the same.
Q. Do all diagnostic procedures require pre-certification?
A. No, only those you need.
Q. I just joined a new HMO. How difficult will it be to choose the doctor I want?
A. Just slightly more difficult than choosing you parents. Your insurer will provide you woth a book listing all the doctors who were participating in the plan at the time the information was gathered. These doctors bascially fall into two categories--those who are no longer part of the plan, and those who are no longer accepting new patients. But don't worry--the remaining doctor who is still in the plan and accepting new patients has an office just a half day's drive away.
Q. What are pre-existing conditions?
A. This is a phrase used by the grammatically challenged when they want to talk about existing conditions. Unfortunately, we appear to be pre-stuck with it.
Q. Well, can I get coverage for my pre-existing conditions?
A. Certainly, as long as they don't require any treatment.
Q. What happens if I want to try alternative forms of medicine?
A. You'll need to find alternative forms of payment.
Q. My pharmacy plan only covers generic drugs, but I need the name brand. I tried to the generic, but it gave me a stomachache. What should I do?
A. Poke yourself in the eye.
Q. I have and 80/20 plan witha $200 deductible and a $2,00 yearly cap. My insurer reimbursed the doctor for my out-patient surgery, but I already paid the bill. What should I do?
A. You have two choices. Your doctor can sign the the reimbursement check over to you, or you can ask him to invest the money for you in one of those great offers that only doctors and dentists hear about, like windmill farms or frog hatcheries.
Q. What should I do if I get sick while traveling?
A. Try sitting in a different part of the bus.
Q. No, I mean what if I'm away from home and I get sick?
A. You really shouldn't do that. You'll have a hard time seeing your priM care physician. It's best to wait untile you return, and then get sick.
Q. I think I need to see a specialists, but my doctor insists he can handle my problem. Can a general practioner really perform a heart transplant right in his office?
A. Hard to say, but considering that all you're risking is the $10 co-payment, there's no harm in giving him a shot at it.
Q. What accounts for the largest portion of health care costs?
A. Doctors trying to recoup their investment losses.
Q. Will health care be any different in the next century?
A. No, but if you call right now, you might be able to get an appointment by then.--
~* TAMIA *~
Acceptance is giving up all hope of ever having a better past.

Answer:

This might help. My son Kyle and I are out with my brothers boat on the river. Kyle steps on rock, cuts open his toe. This is on sunday so off to emergency room we go.
Wait hour and half, finally get seen, in room 10 min. tops, 5min. with DR to break little tube of liquid stitches, then put on 2 butterfly's.
Get bill, that ins. didn't cover for $193+.
I would tell patient to shut the f.... up and be grateful he doesn't have to pay!
walks away mumbling $193 for a little tube of super glue!!!!!!!
Cindi
Thats just my opinion......
I could be wrong!
Dennis Miller
searchin.....for pigs on the wing! Pink Floyd

Answer:

Thank you all for the insight......pleased to say he is getting better and soon will be back on a plane to the states!!!!!!!!!!

Answer:

Wow, you only had to wait an hour and a half!! I could only wish our hospital was like that.
My daughter was bitten by a pig when she was 7, tore her top lip wide open. It was hanging down, bleeding everywhere.
Off to the ER.... 4 HOURS LATER... we finally get to see the doctor. 15 stitches to close it up and the embarassment to my daughter after having to sit in a waiting room for 4 hours with everyone staring at her lip hanging off her face. She laughs about it now, but then she felt really embarrassed with everyone looking at her lip. Poor kid.. she's a fighter though.
Anyway... bill was well over $300. Ridiculous... they should deduct for wait time IMO. 4 hours for 10 minutes and out the door.
American healthcare is insane!!!
~* TAMIA *~
Acceptance is giving up all hope of ever having a better past.