doctors bills/medical aid

[Dave A]

How about the "diagnose by numbers / my name is Earl (crossing of the list)" exercise I'm currently experiencing

When it comes to dealing with anything that is less than clearly obvious, I prefer my doctors to be 50 years and older

[Christob]

Well let me open myself here for a lot of criticism here and try and give some clarity on the private healthcare industry in South Africa.
Medical aids are not for profit organizations but the companies managing them (administrators) are not. So they do make money out of the system.

Lets compare the SA system with the UK where healthcare is free. Waiting time to see a GP 3 weeks - here you make an appointment and see the doc the next day. Waiting time to see a specialist is 3 months and lets for instance say that your Gran needs a hip replacement then you wait 18 months - and no I am not talking rubbish this is the average waiting times in the UK. So lets compare access to healthcare with the UK!?!?!?!?

In America a Ceasar for the wife to deliver a baby will cost you $17000 US, Compare that to more or less the same cost in rands here and so you will understand the difference.

Private healthcare in South Africa is relatively cheap and reliable and no doctor can guarantee that he will fix the problem it is impossible!!! Nowhere in the world...

My suggestion is to stay on medical aid or a hospital plan - when you need it and its not there its too late...!!!

[Graeme]

What you guys have gone through sounds like a series of nightmares! I belong to Key Health and have had none of these problems - they have paid for two operations for my wife recently and they paid in full for hospital (Entabeni), surgeon, anaethetist, drugs etc without the slightest hassle, they pay for expensive medicine for cronic condidions in full, no hassle with dentistry if within pretty generous prescribed limits - the only time I have had to pay for myself is for recent visits to our GP for which they allow so much per annum. I think you chaps should look around and find yourselves decent medical schemes; there are plenty of them - ask to see their schedule of benefits before joining. The only negotiating I had to do was with the Anaethetist, who readily agreed to charge medical aid rates - but the time to do that is a day or two before the operation, not whilst waiting to go in to the theatre! Most medical schemes have a hospitals pre-admission routine; i.e. you warn them beforehand, even if this is on admission (if an emergency) - you ignore that rule at your peril.

[Alta Murray]

I have been through some tough medical bill calls lately, and I have always meant to read this thread:

Yes, I agree with Dave that if we start with our own savings we can end up ahead of the game, but it is such a huge risk Dave that I can feel my knees knocking. The same goes with normal insurance.

A bed in ICU on a ventilator costs you R 12 000.00 per day. That is not including the blood tests, dr's fees, medicine,x-rays etc. And after having been a frequenst visitor in the ICU with both my parents, I can tell you that age is not a defining factor, it can happen to any one of us any day. I got a bit nervous when the hospital bill got to R700 000.00 and there was still no improvement with my father, it puts you under tremendous pressure as you are faced with a loved one's suffering and the financial implications.

I had to pay off a lot of bills, and starting with my mother, who died after 6 weeks in the ICU, I couldn't believe the cost left over after the medical aid had paid their bit. I was upfront with all the service providers -- I would honour the debts and arranged for payment plans -- everyone one was so helpful, I got discounts and as I type I am still paying off on an a stent at the local private hospital in 12 manageable amounts.

Trick is you have to know your rights, I would have been left with a private fund minus 1/2 a mill, if I did not know what rights I were entitled to. The best thing I have ever done was to appoint a lawyer for my father, it was a cost and a life safer. She only ever advised me on what to do, and made one call to the hospital. Her fee compared to what she saved us, was a mere pittance. Check your rights on the Internet!

I have also found the advocate at the Health Department very helpful, he helped me so much, but I will still rather go to a private hospital. The State ICU's are top notch but the general wards are too scary for me.

Do have a medical aid, but compare the different options, I am on Discovery and I am very happy.

To take a doctor to court, oh please don't even bother, that is why my son hates the medical students and we are told there has always been bad blood between the two faculties. I had a ceaserian where the dr botched up bad, I could actually feel him cutting and opening the incision on one side, and he had his mistress, who didn't work at the hospital, with him, so the poor man was in a hurry. I felt every single thing on my left hand side, and I was the second patient this had happened to. The pos. outcome was that I was out of the hospital in a jiffy, recovery time speedy I was asked by the hospital if I would like to sue the dr, as they were going to take steps against him, but I wasn't interested at all.

But i also know a lot of dr's who are fantastic, and have stood by me as I dealt with my parents, so it isn't all bad. Check the rates out before you go see a specialist, many dr's opt for medical aid tarrifs, and there is no differentiation between the level of expertise you will receive.

[Alta Murray]

Oh, and if you are not happy with the first treatment, go for a second opinion. Medicine is not an exact science! I go to a GP who has a more holistic view of medicine, so even after being traumitized after both my parents, he told me to take some healthy exercise and stop feeling sorry for myself, he didn't put me on medicine, and his answer to flu and colds -- Viral Choice which works a charm.

Got sick in Scotland and was very impressed with their treatment, and it was for free!

[Sieg]

I agree with Dave about the "older than 50" bit. And, check out the doctor's car: if he / she drives a fancy one, stay away or you will end up paying for the next service.

[Dave A]

Hopefully I'm cutting this out right:

A bed in ICU on a ventilator costs you R 12 000.00 per day. That is not including the blood tests, dr's fees, medicine,x-rays etc.
...
I had to pay off a lot of bills, and starting with my mother, who died after 6 weeks in the ICU, I couldn't believe the cost left over after the medical aid had paid their bit.

... I would have been left with a private fund minus 1/2 a mill, if I did not know what rights I were entitled to.

At the risk of being really morbid, it is damn expensive to die slowly nowadays. When it comes to terminal illnesses, would it be going too far to say the medical expenses are taking first bite out of the estate - and to some extent they have a hand in just how big that bite is?

[murdock]

a friend has just been paid out R250 000.00 in damages for a mistake made by a doctor...it took a couple of years but they settled.

[Alta Murray]

In some instances yes, Dave, the patient is terminal, hooked up to life support and then all the other law issues kick in, so you can't just remove the patient from the life support. I quote from a medical convention (non-verbatim) we need to get back to basics and determine just why life support was invented, it was for operating theatres, and to support a patient when the disease takes longer to heal than the human's natural defences can stand, and where someone has been in an accident.

My experience has shown me that doctors are not prepared to get involved in the legal issues when making a decision when to remove life support, they seem to regard that as a grey area as their only function is to heal and to save a life.

My question is at what cost? What would the long term outlook be for that patient, and what would the quality of life be? And what would the cost be afterwards to take care of the disabled patient? My question has always been this -- What is the use to save a life, only to *not* have the funds to take care of the patient afterwards?

It might seem that we will never have to deal with these issues, as we are still fairly young, but we all have parents, and if it comes down to the crunch, it becomes your responsibility. You have to stand there and make decisions about another human life.

My mother is a case in point -- she had heart, lung and kidney failure yet was hooked up to life support for 6 weeks, and when the medical aid was exhausted, they switched off the life support?

My father was a different scenario, in that the doctor constantly drew graphs for me, so I could understand the predictable outcomes, and he was also willing to sit down and take the costs into account, and discuss that with me. So I knew that my dad was going to be faced with diminishing quality of life. There will be no further medical intervention with him, but his care costs between R 10 000.00 - R 15 000.00 per month.

We are fortunate that we have the ability to take care of him, but what about all the adult children who can not, or are not willing to? It breaks my heart that.

Also my dad invested wisely in his life time, so that there is a fund available, but not in my wildest dreams, nor in his, would we have thought the cost so immense. Why? Because we didn't check, and we thought that it would never happen to us. Not this.

Sit down with your parents, discuss the financial issues with them, take into account that R 500 000.00 per annum for hospital care is *not* enough, get them on a good medical aid, and budget for after care.

They did it for us, after all.

[Alta Murray]

Thanks for the tip Murdock, you make me so lis to go after that butt munch and at least get something for the pain I suffered, and use the money to pay for my dad Your friend was very fortunate, and I am happy for him.