What do you pay for?

[murf]

I am interested to learn about the expense of dialysis in other countries. In Australia, I pay for absolutely nothing. Perhaps transport costs could be added as an expense as there is no recompense for travel to the centers (tho' taxi vouchers are often given out). So, what do you have to pay for? What contributions does your government make? My limited understanding is that in some Asian countries, you are up for the lot. TIA.

[Hubbs]

well here in the states our S.S. and in my case my health First Health plan pays it. little over 2,000 a month
but i had to co pay for the 3 day Hospital stay at the beginning witch was 500 out of my poket. i paid that with my tax returns. whew! the bill was for 10,000.  BTW. hospital beds are NOT for sleeping.

[Phil]

I'm in Italy....I pay nothing. All my various medicines (Aranesp, renagel, Norvasc) are all free as well. All doctor appointments & medical exams are also free of charge.

It's a great deal, and can't even start to understand how tough it must be for people in the US.

[romanyscarlett]

I live in England so my hospital stays, surgeries, consultant appointments, dialysis etc is all "free".

I've put free inside inverted commas because whilst I'm not getting medical bills each week, the NHS is paid for by tax contributions. Not that I'm complaining in any way though - I'd rather pay taxes and not have to worry about finding the cash to have treatment. The NHS gets a lot of criticism from people who only focus on the bad press but I have always been impressed with the level of care I have received.

I used to have to pay for any medication I needed at a price of around £7 for each prescription but now I have a fistula all medicines are free.

[Poppylicious]

I'd rather pay taxes and not have to worry about finding the cash to have treatment.

Absolutely! The NHS does have its faults but the fact that we can even go and see our GP free of charge makes me feel blessed to be English. It would be interesting to know how much money is spent on Blokey's care/treatment, but I'd hate to receive an actual bill for (some of) it.

[carson]

I live in Canada, and I don't pay for anything..

[glitter]

here in the US we paid for all prescriptions until my husbands medicare kicked in after three months, but only because we didn't buy prescription coverage. then meds were 2.00 dollars to 5.50, and our non profit dialysis center accepted his insurance as full payment, until medicare kicked in, then it was accepted as payment in full. His Dr. appts. per month ran about 100 dollars in co-pays- and when he died, all outstamding bills at the hospital and eveywhere else were wiped clean. The hospital bills were for the accident that he was in before dialysis. He had a 10,000 helicopter ride that day- which is Blue Cross/Blue Shield covered in full.

PLUS the price if insurance which was about 450.00 per month

if we would have been without funds- he would have gotten medicaid right away- and they would have covered most everything for free-including what we had to pay the first three months- here you must spend everything you have before you quailfy for that. or/ wait the three months until medicare kicks in

[del]

I'm in Canada as well and every thing is paid for.  You do have to pay for the medications you take.  I have good insurance though. 

[sullidog]

I have primary from my employer and secondary from medicare. Once I meet my ductable I don't pay a thing and my dialysis is free to me ever since I've been on it (primary pays 100 percent of it.
Troy

[Stoday]

It would be interesting to know how much money is spent on Blokey's care/treatment, but I'd hate to receive an actual bill for (some of) it.

If he has hemodialysis, average UK costs were published in NICE Technology Appraisal Guidance — No. 48 dated September 2002 as follows:

The estimated total cost to the
NHS per year in the base case of the model was £19,300
for home haemodialysis compared with £21,000 and
£22,000 for haemodialysis in a satellite unit and
hospital, respectively. This was based on costs for access
surgery, equipment, system set-up, buildings, staff,
consumables for three sessions per week and costs of
dialysis complications

[RightSide]

For dialysis or consults with specialists, typically a private insurer in my state will pay 80%.

Medicare is my primary insurer, so they pay the first 80%.
Then Blue Cross is my secondary insurer, and they pay 80% of what is left (which equals 16%).
The remaining 4%, I'm responsible for.

And that can add up, because:
Three times a week, I get dialyzed.
Once a week, a neph comes to talk with us during dialysis.
Once a month, the dietitian comes to talk over our latest blood work numbers.

So I get a bill in the mail periodically, which maybe equals a couple thousand dollars each year.

Beyond that, I just have modest co-payments on my prescription drugs.  Typically $20 per refill.

[RenalSurvivorDotCA]

I'm in Canada as well and every thing is paid for.  You do have to pay for the medications you take.  I have good insurance though.

Really? All my meds are covered by the province under the dialysis program. I was surprised because I was on bp meds before my kidney failure and  after I started hemo, they said bp meds fall under hemo program.

As for other dialysis expenses, I pay nothing. Damn good thing. Unit Manager told me dialysis costs them $80k/ year per patient.

[murf]

I should have added that I do pay for medication but as a pensioner I only pay $6 a prescription. it seems to me that apart from USA most countries look after dialysis patients. Many thanks for the information and I find it very interesting.

[del]

All the supplies for hubbies dialysis machine are paid for as well as venifor(iron) and vitamin pills.  Prescription meds we have to pay for (like sensipar) . With my insurance we pay about $7 for each refill. 

[Riki]

I'm in Canada too. I have to pay for my medications, but I'm covered through my mom's insurance, so I only have to pay 20%.  Besides transportation, that's all I pay for.

When I was in the States, I paid $400US per treatment, and that didn't include any medications.  I had anything I needed  at home before I left.  I have learned, however, to never leave home without bandaids, even if traveling in Canada.

[RenalSurvivorDotCA]

I'm in Canada too. I have to pay for my medications, but I'm covered through my mom's insurance, so I only have to pay 20%.  Besides transportation, that's all I pay for.

When I was in the States, I paid $400US per treatment, and that didn't include any medications.  I had anything I needed  at home before I left.  I have learned, however, to never leave home without bandaids, even if traveling in Canada.

LOL.  Riki, I know what you mean about the bandaids. When I went to Vegas, I brought a huge handful of SureSeals and TipStops. They were like "Ohhh, where did you get those? They are expensive! Did you have to pay for them?"  Their jaws dropped when I told them my unit gave them to me. "GAVE them to you??For free???"  LOL

I even still have a box of Tegaderms and all kinds of hand cleaners/wipes from when I had my permcath. I have an emerg access kit in my car and one at work, too. Compliments of my dialysis unit.

[Bajanne]

In the territory in which I am presently resident, dialysis started out being completely free.  However, it then changed slightly and if you had medical insurance, the insurance had to pay.  I had medical insurance at that time, so my insurance paid.  Then my contract as a teacher was not renewed (because I had to take time off each week to go to dialysis) and I lost my medical insurance.  I asked them at the unit what would happen and they said "Well, we can't let you die" and dialysis continued as normal.
Now we keep hearing that there will be many changes to the financial running of the hospital and dialysis patitents will have to pay something. We are waiting to see what that will be.  For now, everything is free - dialysis, epogen, meds that you get during the treatment, Sureseals, etc.
In my country, Barbados, if I was resident there everything would be free.  We have National Health Service there.  If you choose public medicine, everything is free.  And if you have a chronic disease like asthma, cancer, diabetes, hypertension, etc., medication is free even if you went to a private doctor,  so long as the drug is on the Drug Formulary.  Medication is free from birth to 16 years old and from 65 on.
However when I visit Barbados, I have to pay for dialysis, since they count me as a visitor since I have no nephrologist there.  Bummer!

[-Lady Noir-]

I'm in Italy....I pay nothing. All my various medicines (Aranesp, renagel, Norvasc) are all free as well. All doctor appointments & medical exams are also free of charge.

It's a great deal, and can't even start to understand how tough it must be for people in the US.

It's exactly the same here in New Zealand! Bar the medications, but they are cheap as..

[Riki]

I even still have a box of Tegaderms and all kinds of hand cleaners/wipes from when I had my permcath. I have an emerg access kit in my car and one at work, too. Compliments of my dialysis unit.

wanna send me that box of tegaderms?  I stilll use them when I put emla cream on my arm.  I had a box from when I was on PD, but I went through them

[noahvale]

***

[Riki]

uh... think you should take your politics to another section.. but yeah, we pay higher taxes, but we don't have insurance companies looking at everything, trying to find a reason to drop coverage when we get sick. 

[carson]

And we aren't governed by the pharmaceutical companies and insurance companies either. When my nurses go to the US for conferences, the "companies" don't even want to talk to them because the can't sell their crap to us. My doc told me that their bottom line is the mighty dollar, not the patient

[RenalSurvivorDotCA]

Whenever the topic of healthcare and coverage comes up and someone craps on me like "Yeah, well, you pay through the nose in taxes..."
 I always say: "I'm still willing to bet that my "high"taxes are still less than your taxes + your insurance premiums + your medical costs not covered by your plan."

I pay zero and I'm very thankful for that. Yes, I pay taxes but so does everybody else.

[Riki]

my best friend hates going to the doctor, because she really can't afford to do it.  a few years ago, she slipped on some ice on steps going into the subway in NYC. She tore something in her knee, and it really should be operated on, but instead, she lives on Motrin because she can't afford the surgery.

[Stoday]

uh... think you should take your politics to another section.. but yeah, we pay higher taxes, but we don't have insurance companies looking at everything, trying to find a reason to drop coverage when we get sick.

Clearly noahvale has a political ax to grind, quoting a newspaper article that's seven years out of date. You would expect things to have improved in the last seven years.

Nevertheless, his post is relevant insofar as what you pay for in the UK is less than you'd get in the US (or other major countries in Europe for that matter). Like the woman in the newspaper article, my local dialysis clinic was full. I too finished up in hospital for 8 days after emergency admission and then got HD twice a week. I too got an immediate transformation of my condition. I understand most patients don't see much improvement for some time, presumably because they've started dialysis before their kidneys are completely wrecked.
 
This is worse than rationing, which implies an ouvert and visible shortfall of services. It's invisible, pernicious and thus attracts no attention to rectify the shortfall.