Hospitals, ER and medical aids

[Isetech]

I have spoken to a few people with regards to this issue we experienced yesterday and again to day, it seems it is a very common problem. I get the feeling its money making scam that operates at the hospitals. Please feel free to set the record straight.

We went to the hospital ER ( a private hospital, because we have medical aid and top up cover and top cover for the top up and top up for the doctors who charge 500 % more than the standard medical aid rate etc etc)

We are told the patient is a priority 1 case, and a "scan" is required, the standard co payment required is R3800, however because it is a Sunday and the patient is not yet booked into the hospital, we are required to pay Sunday rates up front, which is double plus plus plus plus, its not covered by the medical or the tops or the other top ups etc etc.

My question was, why not book the patient in first them do the scan, I am told that it doesnt work like that.

We pay upfront then once they get the scan results they will then decide if the patient is admitted or not.

My question was if the patient is a priority 1 patient, 5 days of hectic headaches, vomiting and high blood pressure 160/110 to a point that there are concerns that they might have a stoke, yet not sick enough to admit to the hospital.

Eventually after 5 hours of drips and medication the patient is told they can leave because we decided not to pay for a scan.

I requested the release forms so that I can fill out all the details of this terrible experience and informed the person that the ER will be held responsible for anything that happens to the patient once we leave. Because the hospital is not linked to the ER in anyway, the hospital cant be held liable.

They decide maybe that is not such a smart move, so I am told that if they do a lumber punch on the patient then they can admit the patient.

Just when you thought it is that simple, I am told they cannot admit the patient because Discovery medical aid is closed on Sundays, REALLY, a mullti million rand medical aid doesn't have a 24 hours call centre to deal with admissions on a Sunday, REALLY ?

5 hours later the patient is taken to the ward, because the private hospital doesnt have any beds available and is still not officially admitted.

This morning at 9 am the patient is still not officially admitted yet, so the scan people are calling for a R3800 upfront payment again so they can collect the patient.

Personally I think the hospital should sell some of the leather couches at the entrance and invest in a few more beds for patients.

After the doctors visit later in the morning, it turns out the patient is sick enough to be admitted, does require scans and physio and a visit to the neuro and a visit to the doctor who did back op.

[Isetech]

What makes me laugh at the way the hospital operates, if you use the main entrance it looks like a 5 star hotel with all the fancy leather seats and couches and glass fire places.

Yet if you sick and have to go to the ER, you have to use the side entrance like rich people do with tradies, you have to sit on a plastic chair (no leather seats in the ER ) in passage like you do at public hospitals wait in long que for your turn.

As a priority one patient you get to sit in a wheelchair with a drip, because they dont have enough beds in the ER to manage the volume of patients and wait for a bed to open.

There was another patient who didnt have the cash to pay the double rate plus plus for a "scan" so he was left to sort himself out and leave when he felt well enough to leave, he was there from the time we got there and was still there when we left.

[Blurock]

I have spoken to a few people with regards to this issue we experienced yesterday and again to day, it seems it is a very common problem. I get the feeling its money making scam that operates at the hospitals. Please feel free to set the record straight.

We all know that medical aid is a money making scheme. You pay through your neck only to find that the things that matter are not covered. The excuses for not paying certain medical procedures are sometimes laughable. Private hospitals belong to investors and doctors who want to earn more, not look after patients. Discovery is a joke as you can only communicate with a robot - no humans work there! The whole medical aid thing is like a mafia and their options and rates so confusing that no-one can make head or tail from it.

The idea of a national health care is therefore a good idea, but unfortunately it will be a major disaster to leave it to our dysfunctional, kleptocratic government. So maybe the alternative is to stay healthy and save up for that unforeseen medical event. But for most people living hand-to-mouth that is also not an option.

So in other words, we are screwed, whichever way you look at it.

[GCE]

Private medical should be illegal or hospitals and doctors rates should be regulated by the law of the country.

Don't agree with that statement - What should happen is more competition . There appears to be an increase in small hospital licenses being given out which whenever there is competition there will be a downward drive on prices.
Over regulate and prices go tend to go up as it becomes more difficult for others to enter the arena

I can only imagine if they ( government ) came to you and said you are overcharging, you need to reduce your hourly rate otherwise we are not renewing your contractors license - I bet there would be an outburst

[Isetech]

So what do we learn from our bad experience this week...

1/ A privately owned ER attached to a privately owned hospital makes claims against the ER completely isolated from the hospital.

2/ You cannot be admitted to a private hospital via a private ER on a Sunday afternoon, because the private medical aid is closed.

3/ You will not be admitted to a private hospital on a Sunday, if you just have a headache, no matter how severe the headache. A scan will be required, which the medical aid doesnt cover if you are not admitted to the private hospital, but you cant get admitted to the hospital until you get the test results. For the record a scan on a Sunday afternoon will cost you more than it will cot you to fill you tank of petrol about 5 times, we all know how expensive that can be. My advice, contact your medical aid and check, you dont want to lying on a bed in an ER trying to sort out silly things like this

4/ If you are experiencing really bad headaches and want to be admitted to the hospital, tell them you want a lumber punch. In our case medical aid allows the ER staff to process the documentation required.

5/ You think why would you want a lumber for a headache, well it turns out that 7 days later, after not being sick enough to admit, longs hours of fighting with everyone, a scan was done, a neuro was required who identified inflammation around the brain, which motivated a lumber punch, which identified spinal leaking, which is the cause of massive headaches, vomiting and high blood pressure.

Fact: If you suffer from migraine headaches, as you get old they should ease, if they dont best you be going for a number of tests, but I would strongly advise that you understand the procedure, you rights in the ER and what your medical aid covers and when.

If they find you have leaking spinal fluid, it will be detected during the lumber punch, they will call and anaesthetist to verify the low pressure, they will then remove blood and inject it into you spine, it will travel through your spine and when a leak is detected, the blood will create a clot and seal the hole. It might need to be done 2 or 3 times to seal the leak. This could put an end to those nasty headaches.

You will have to flat for a minimum of 24 hrs while the blood finds it way through your body.

I wish I knew all this 2 weeks ago.

[Isetech]

It is absolutely disgusting that patients are treated like this, as for anaesthetists negotiating with patients at the entrance to theatres over rates, someone should video the experience and share it so it will go viral for everyone to see this disgusting behaviour.