Affordable Health Care AbroadThose who insist that...


October 13, 1992

Affordable Health Care Abroad

Those who insist that controlling health care costs would result in poorer quality care could learn a lesson from my recent experience of a stroke while on vacation in Germany.

My bill for nine days in the hospital certainly proved that medical care can be delivered much more cheaply than it is delivered here.

When the stroke occurred Sept. 9, my family took me to a nearby U.S. Army dispensary (I am an Air Force retiree). After being stabilized, I was taken to the University Hospital in Regensburg, 30 miles away. Fortunately, the stroke ("schlaganfall" or cerebral accident, as the Germans called it) was mild, and I retained all my faculties.

In those nine days, I underwent two CAT scans, two electroencephalograms (EEGs), one electrocardiogram (EKG) and other tests.

I was in a semiprivate room, alone, and received daily injections of a blood thinner and intravenous infusions of another substance to dissolve a small infarction in my vascular system.

This, according to my neurologist, is the same treatment I would have received at a Baltimore hospital. The chief of neurology, one of the most respected neurologists in Europe, visited at least daily and my attending physician, a board-certified neurologist, checked on me several times a day.

I got excellent nursing care, far better than I got in February during four days in a Baltimore hospital. When I left the hospital, I was given all my CAT and brain scans and a medical synopsis of my case to give my physician here.

My bill was the big revelation. It amounted to slightly less than $1,500, including physician and nursing services, board and room, tests and medication. Three Baltimore physicians have told me that the same bill for these services would exceed $14,000 here.

While I don't claim expertise about medical care costs, I noticed several procedural differences which make the German delivery system less costly than ours.

For example, when I had each of the CAT scans, the chief of neurology was present to view the pictures as they were generated; the actual plate was redundant, although it was studied later by the entire clinic staff. Several other tests were done and evaluated by the physicians themselves.

In Baltimore, the CAT scan and most other x-rays are done without a physician present; a radiologist, who bills independently of the hospital, "reads" the film later, usually at a cost of several hundred dollars and sends his evaluation to the attending physician. (If a physician can't evaluate a test he orders, his credentials as a physician should be suspect.) This is just one example of how vast amounts of money can be saved.

With health-care costs long gone out of sight and now entering the political arena, the U.S. could do a lot worse than to study the German system objectively, copy what is good about it and adopt a system in which the worst parts of the German system are changed.

Of course, there wouldn't be as many millionaire physicians as we have now. Certainly, my case is a prime example of how much health care can be delivered for the buck.

Charles A. Frainie


Action Vote

Although I would never vote for George Bush or Ross Perot, I am still debating with myself as to whom I should cast my insignificant ballot. It is clear to me that Bill Clinton stands the best chance to be elected, but is also the best reason not to vote for the other two.

What would happen if Mr. Bush got re-elected? Clearly, with all likelihood and probability that the Congress will be more Democratic, assertive and independent, the chance of legislation originating from the executive branch would be non-existent.

Thirty-five successful vetoes have proved that this president is opposed to legislation promoted by Congress and is unable or unwilling to compromise.

Furthermore, Mr. Perot has no history of dealing effectively with a diverse body of elected officials over a long period of time.

His inability to accept "no" guarantees gridlock or legislation without any real influence from the executive branch. All power in any one branch would be dangerous and in violation of the principle of checks and balances.

Bill Clinton has a 12-year track record as an elected governor. Whether he has been successful is debatable.

What is clear is that although his views and policies may not all be in the best interest of progressive voters, they are pretty much in line with the House and Senate leadership.

We would likely see some quick and dramatic action the first 100 days that could influence the remaining years of this century.

Myles B. Hoenig



Your story of Oct. 3, "Black legislators pressure Schaefer to change emissions contract," caused me to think.

I think it is time for the state and federal governments to change their procurement policies to encourage and reward companies to achieve racial and gender diversity of ownership when competing for government contracts.

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