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  #101  
Old 26.08.2016, 15:28
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Re: Routine physical examination

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After the excess!

Reminds me of my doctor - "don't worry, the insurance covers it".
It all counts as "covered by insurance", even the excess. If it weren't covered, the excess would never be exhausted
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  #102  
Old 26.08.2016, 15:28
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Re: Routine physical examination

'Actually, no. Despite his "poor lifestyle", it would appear that your friend is in continued good health -- the tests don't lie (the odd false negative excepted, of course ). In all likelihood, he can continue to live as he does and continue to have few or no ill effects. He's just one of those lucky ones.'


Yes and no- talk about dangerous advice. There have been several programmes and articles lately about excessive and routine alcohol misuse in the UK, and the massive rise in permanent and often irreversible liver damage.

And Type 2 Diabetes is also on a massive rise- no regular testing telling you that 'so far' you've escaped- will prevent it happening.
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  #103  
Old 26.08.2016, 15:43
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Re: Routine physical examination

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Not obvious to me or anyone else in that thread, especially given the way Sbrinz flounced out of it. He had ample opportunity to correct any "misapprehension".
"signed by both" is quite clear imo.
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  #104  
Old 26.08.2016, 15:48
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Re: Routine physical examination

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"signed by both" is quite clear imo.
He was talking about the original contract -- the one that the special unilateral amendment legally supersedes.
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  #105  
Old 26.08.2016, 16:04
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Re: Routine physical examination

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He was talking about the original contract -- the one that the special unilateral amendment legally supersedes.
Well, yes, but I find it unthinkable that he would mention that the old one was signed by both and not realize that the same must apply to the follow-up, especially after others mentioned it.

Anyway, it's water under bridge.
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  #106  
Old 26.08.2016, 16:27
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Re: Routine physical examination

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Mr Waugh,

How many people do you know in Switzerland, apart from those on the most desperate level of social security (if any), who do not have health insurance from private organisations such as SWICA, Sympany, Visana, Sanitas, Helsana, Assura, Supra, etc.? It's mandatory!
I think Jag isn't talking about the insurer but rather, the product. Allgemein (mandatory), Halbprivat and Privat, respectively.

According to the BfS
- private non-mandatory insurances (Halbprivat and Privat) pay for 9% of the total costs
- social insurances (Allgemein (mandataroy) plus what's paid by AHV, IV, Militärversicherung) make up 41.2%
- the government pays 18.3% (financed by taxes)
- private households directly pay 30.5% (Franchise and the 10% on the first 7.3k(?) insured costs, non-insured stuff like teeth, meds bought directly, etc)
- other (legacys for instance) pay 1%

See the 2nd PDF on this page, page 15.
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Old 26.08.2016, 16:36
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Re: Routine physical examination

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Mr Waugh,

How many people do you know in Switzerland, apart from those on the most desperate level of social security (if any), who do not have health insurance from private organisations such as SWICA, Sympany, Visana, Sanitas, Helsana, Assura, Supra, etc.? It's mandatory!
My question was in response to your "Virtually everybody here has private healthcare" claim.

As the healthcare insurance companies are private, in one sense absolutely everyone has private healthcare.

What I was asking about is what the split is between Mandatory, half private, and full private.

@Urs

Yes, I saw those numbers, but I'm not sure if we can interpolate them back to x% mandatory, y%half, and z%full. I'm a bit surprised that this isn't straightforward to find.
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  #108  
Old 26.08.2016, 16:39
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Re: Routine physical examination

Yes, Urs, ich weiss. The point is that, rather surprisingly to those with Anglo-Saxon backgrounds, everybody here insures themselves privately. You'd have to understand the Anglo-Saxon mindset to "get" this. Forget about quibbling over the name of part of the policy; fact is, everyone is insured privately.
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  #109  
Old 26.08.2016, 16:47
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Re: Routine physical examination

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Yes, Urs, ich weiss. The point is that, rather surprisingly to those with Anglo-Saxon backgrounds, everybody here insures themselves privately. You'd have to understand the Anglo-Saxon mindset to "get" this. Forget about quibbling over the name of part of the policy; fact is, everyone is insured privately.
So in the middle of an extended discussion where the claim that people who are privately insured (clear intent to indicate Half or Full private policy holders as far as I can tell) demand needless tests, you now want to use the UK usage of the term to apply to the case in Switzerland, and not allow a relatively simple question about what is the case here in Switzerland?

Ok, as you wish.
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  #110  
Old 26.08.2016, 16:56
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Re: Routine physical examination

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Participatory medicine -- now there's a can of worms. Government opposition to it is one of the primary reasons for the ban on advertising prescription pharmaceuticals to the general public in the majority of countries. One notable exception to the ban is the US, where, as everybody knows, medical costs are (now?) sky-high.

Genome sequencing is very much the hot topic of the moment. The possibilities (actually, probabilities, now) are very exciting. CRISPR will undoubtedly continue to excite huge amounts of angst in the usual hand-wringers but could herald one of the greatest advances in human medicine of the last millennium -- no exaggeration.
Participatory medicine is so much more than dtc pharma ads. It's patients working with physicians to achieve better treatments and health, especially in the case of difficult chronic health issues, auto immune diseases, cancer and rare diseases. And they help physicians understand what it's like to be a patient. Even rock star docs enter the system sometime and are suprised by their treatment. It has a lot to do with data - having access to your own data, and networking with others, for example.

With regard to breast cancer, there are grass roots organizations to fund research on metastatic cancer, inform on clinical trials and change research priorities. In both the US and UK, current epidemiolgical tracking does not identify people who metastisize after an early stage diagnosis. The push to change this comes from patients.

Ok, I'll stop here, oh except to say that i know several people who, after doing their own research, including a couple with genetic testing declined statins - the antithesis of dtc advertising.


Sequencing has some interesting issues. The value of the information, ownership and power to use it in a discrimatory way. And the fact that it's not just the DNA but all the other bits to turn it on and off. Interesting times.
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  #111  
Old 26.08.2016, 17:24
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Re: Routine physical examination

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Once registered with a GP, at least here in Neuchâtel as BM says- you get letters reminding you to go for mamograms routinely and it is heavily subsidised.
You don't even have to be registered with a doctor of any sort. You get the invitation to go once you turn 50 and every 2 years thereafter. I assume they get the info as to who is eligible from the communes.

Not all cantons offer this service.


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She, like my OH, cannot fathom why a child with a cold or minor sprain, stomach upset, etc, should be routinely seen by a peadiatrician and that it is a waste of money and professional resources.
I've never really understood that either. From what I can tell most paediatricians who have practices are basically GPs for children and specialist paediatricians for more important things are based in hospitals.

Last edited by Belgianmum; 26.08.2016 at 17:36.
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  #112  
Old 26.08.2016, 19:30
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Re: Routine physical examination

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I haven't even registered with a doctor here yet, because I'm scared of the costs involved.


[...]

And is it true that insurance companies can limit the doctors you can go to?
For the medical costs in general, see this thread: Medical Certificate?, especially posts 9 and lower

You have several insurance models which could or could not limit your doctor choice:
- Basic (no limits)
- GP/Hausarzt (you have to go to your GP first for every health issue, he then will recommend a specialist or other doc if need be)
- HMO (you have to stay within the same group of doctors)
- Telmed (you have to call a number/service before going to the doctor)

Basic is the most expensive of these options, the others can result in cheaper premiums.
Ask your insurance company about the time limits/notice periods in relation to signing up with a different insurance model.

Never put your health at risk due to costs. If your income is insufficient, you can apply to the canton (SVA) for a subsidy.
See this post from this thread Praemienverbilligung? [health insurance subsidy/discount]

Last edited by glowjupiter; 26.08.2016 at 19:55.
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  #113  
Old 26.08.2016, 20:51
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Re: Routine physical examination

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it does actually make sense to do a regular check. for example, for breast cancer.
No, actually. Here's Gerd Gigerenzer, one of the world's best statisticians, arguing in the British Medical Journal that it is pointless.

http://www.bmj.com/content/348/bmj.g2636
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  #114  
Old 27.08.2016, 00:06
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Re: Routine physical examination

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No, actually. Here's Gerd Gigerenzer, one of the world's best statisticians, arguing in the British Medical Journal that it is pointless.

http://www.bmj.com/content/348/bmj.g2636
He's actually a psychologist. And he's correct - we've been sold a bill of goods on early detection. Early detection and awareness are ideas that have lined pockets of pink ribbon organizations with very little impact on actual survival.


screening has its (limited) benefits. I believe he is specifically talking about the benefits of early detection.

Last edited by edot; 27.08.2016 at 05:47.
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  #115  
Old 27.08.2016, 08:50
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Re: Routine physical examination

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It all counts as "covered by insurance", even the excess. If it weren't covered, the excess would never be exhausted
You used the phrase "covered by insurance" to imply that there's no worry about the cost, which is clearly not the case if you have an excess.

An excess is another way of saying "the first x amount is not covered by the insurance".

HTH
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  #116  
Old 27.08.2016, 09:50
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Re: Routine physical examination

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For the medical costs in general, see this thread: Medical Certificate?, especially posts 9 and lower

You have several insurance models which could or could not limit your doctor choice:
- Basic (no limits)
- GP/Hausarzt (you have to go to your GP first for every health issue, he then will recommend a specialist or other doc if need be)
- HMO (you have to stay within the same group of doctors)
- Telmed (you have to call a number/service before going to the doctor)

Basic is the most expensive of these options, the others can result in cheaper premiums.
Ask your insurance company about the time limits/notice periods in relation to signing up with a different insurance model.

Never put your health at risk due to costs. If your income is insufficient, you can apply to the canton (SVA) for a subsidy.
See this post from this thread http://www.englishforum.ch/family-ma...-discount.html
For the benefit of anyone who may be looking to choose an insurance model in future the different models are as follows.

Standard model ( not called basic)
GP/family doctor
HMO
Telmed.
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  #117  
Old 27.08.2016, 11:34
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Re: Routine physical examination

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You used the phrase "covered by insurance" to imply that there's no worry about the cost, which is clearly not the case if you have an excess.

An excess is another way of saying "the first x amount is not covered by the insurance".

HTH
Depends on how you look at it. If it weren't covered by insurance it would not count against the excess at all. What is generally covered is being deducted from the excess until that is exhausted, after which they pay more of the bill. If insurance doesn't cover a specific treatment at all, it will not be deducted from the excess in the first place.
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  #118  
Old 27.08.2016, 12:06
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Re: Routine physical examination

In Switzerland- as everyone is 'privately' insured indeed- the terminology is understood by all- doctors and patients. The first thing my surgeon asked me when we made the date for my knee replacement was 'vous êtes assurée en privé?' (are you insured as a private patient) meaning: do you have supplementary insurance that will pay for your operation in a private hospital and have a private room?

My reply was of course NO, as we arrived here over 60 and with pre-exisiting conditions of various kind (my knee included- totally knack*re* after a car accident 46 years ago). I was lucky that regs he mean that private hospitals have to take on a % of 'plebs' without the 'private' option- so I had my operation in a very nice private hospital, with my own room, marble floors and statues and great care. My 10% was about 1000CHF.

Everyone in Switzerland is aware of the difference between basic cover and 'private/supplementary'.
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  #119  
Old 27.08.2016, 12:35
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Re: Routine physical examination

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He's actually a psychologist. And he's correct - we've been sold a bill of goods on early detection. Early detection and awareness are ideas that have lined pockets of pink ribbon organizations with very little impact on actual survival.


screening has its (limited) benefits. I believe he is specifically talking about the benefits of early detection.
I want to explain this a little better. Two issues with early detection - the first is that sometimes detection is too early and it's more a false positive and people undergo unnecessary surgery and treatment for something that never becomes cancer. That would be stage 0. Not all stage 0 cases, but enough.

The second - Don't get me wrong- I am happy I was treated before there was any evidence my cancer spread. But I will never ever be able to say I am cancer free or cured - only no evidence of disease. It's possible that I have decreased my odds of metastasis. I just don't know. Because of the lack of good epidemiological data, we don't know enough about who metastasizes from early stages.

So rather than early detection fluff, we should be encouraging better epidemiology. But that's not sexy.
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  #120  
Old 27.08.2016, 13:07
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Re: Routine physical examination

Prostate cancer in older men is a good example. One of our friends in the UK, aged 79, was detected by his yearly private care examination. It was a tiny little tumour. Had he been an NHS patient, he would probably have been told to leave well alone as it was likely to be not aggressive, and that the operation would probably cause more problems than it would solve.

But as he was with Bupa- he decided to have full prostectomy as it was covered- and his surgeon didn't really explain the possible consequences (private health care is about making money- telling someone it is best to wait and see, or leave well alone- does NOT pay) - so he went ahead. it has been a nightmare, left him incontinent, and he truly regrets having it done- as he has now been told he would probably have lived many years without any problems at all. An anecdote yes- just one of many examples.
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