A little while back, I mentioned that I was trying orthokeratology. Since a few asked for an update I thought I'd give one here as well as answer the comments people left on the first post. As of tomorrow, it will be three weeks since this experiment started.
From G in Berlin: Is it new, or Europe based, or perhaps my severe astigmatism and near-sightedness did not make it an option? Did you need to fall into a certain range to do it?
It's been around since the 1960's although my UK eye guy was saying that it has had recent increased popularity here in the UK due to some newer lenses on the UK market and as well it had received approval from the US FDA which increased its profile internationally in the eye world. There was a range one had to be within on both the vision and astigmatism, something like -6.00 and -1.50, but don't quote me on that.
And do the hard lenses hurt and is there any issue of oxygen starvation to the eye?
The eye guy mentioned that the older version of lenses did have some issues, but that the current ones on the market are much improved so that oxygen starvation is not an issue in his book.
When I first put them in, it was more irritation than hurt, and my eyes started to tear up, almost like I had a bit of dust or something in them. After the second night, however it wasn't so noticeable, and I figured out to go right to bed, where they were ok when I wasn't looking all around.
This morning, I had a minor moment of freaking out when I thought that I had forgotten to put them in, they are now that unnoticed.
From J: Aren't the hard lenses uncomfortable when you're sleeping?
I had done the overnight soft lenses before so maybe I'm biased based on already having that experience, but I would say no, they're not uncomfortable for sleeping. Not sure what I would say if I didn't go through that learning experience with the soft ones. if anything, it was a bigger deal for me to be able to get them in and out, it's such a different experience than soft lenses.
From Jen: Let us know how it works. I can recommend Lasik.
(cringe!) Just the very thought of that freaks me out, the idea that one must be awake for that. But everyone whom has done it has made a similar comment as yours. I realize it's a nice solution, but give me a few glasses of wine before you tell me how they did yours.
Overall, only three weeks into it and I've been pleasantly pleased. I had a few really short nights in DE last week, going to bed at 1 and getting up at 7, so I wasn't sure how that would work, if I would be under-corrected or if it wouldn't last as long or anything like that...I didn't notice any difference than when I am in the UK getting eight or more hours of sleep.
I've gotten half decent at taking the lenses in and out. It's under a minute in either direction, so that is ok. There was some 'star-bursting' or 'ghosting' as they call it, at night, in that lighting would not be sharp or crisp, this has gradually diminished to a less noticeable point.
If I had it to do over would I do it again? Yes, definitely. As long as it continues in this direction, I will continue to carry on with it.
Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts
Monday, February 22, 2010
Tuesday, February 09, 2010
Orthokeratology
I am now one week into my Orthokeratology adventure.
This adventure involves putting in hard contacts each night at bedtime and taking them out first thing in the morning. Then, the eye retains the shape from overnight, so I'm not wearing any sort of contacts or glasses during the day.
It's been a fascinating week.
First, I've never worn hard contacts, only soft, so that has been a learning experience, getting them in, taking them out, and just having them in at all.
Second, I started to wear glasses when I was around 16 and starting to drive. Over the years I've held steady with a low prescription, but I need them for generally walking around and driving, movies, classes, etc, anything that requires distance vision.
Later I switched to daily contacts and alternated with glasses, then weeklies, then in DE I changed to the 'keep them in 14 days/nights', but would swap back to glasses then for a few days.
So at this point I've amost had some type of eye correction for almost half of my life, every single day. This is the first time I've been able to walk/drive around without anything in/on my eyes and it's vaguely unnerving as I've forgotten what that's like.
In case you're curious about the details:
-I am nearsighted, albeit mildly so. I have moved slowly through glasses/contacts until my most recent prescription of -2.25.
-I have astigmatism
Costs:
-Not sure what this will run you in various countries. In the UK I got set up for 200 GBP from my eye guy for all eye photos, office visits and the initial set of contacts plus solution etc. In theory, assuming I do not manage to lose, mangle, etc. the contacts, they should last for about 10 years he suggests, before I might need reading glasses or some other change to the eye landscape requiring a new purchase.
I would normally pay around 200 GBP+/year on a new pair of glasses + disposable contacts. (Yeah, I'm not so frugal on this point.) So changing to this method should be a more frugal option in the long-run, assuming I do it for more than one year.
Pros:
My vision at the end of today (working for 8 hours in front of a pc, and then walking an hour to reach the eye office) was better than 20/20, 10 hours after taking out the hard contacts.
Cons:
The right eye (with the stronger astigmatism) is correcting a little more slowly than the left so at the end of the day it's a tiny bit weaker. This may correct out in another week or two, or it may require a different nightly contact to sort it out.
This adventure involves putting in hard contacts each night at bedtime and taking them out first thing in the morning. Then, the eye retains the shape from overnight, so I'm not wearing any sort of contacts or glasses during the day.
It's been a fascinating week.
First, I've never worn hard contacts, only soft, so that has been a learning experience, getting them in, taking them out, and just having them in at all.
Second, I started to wear glasses when I was around 16 and starting to drive. Over the years I've held steady with a low prescription, but I need them for generally walking around and driving, movies, classes, etc, anything that requires distance vision.
Later I switched to daily contacts and alternated with glasses, then weeklies, then in DE I changed to the 'keep them in 14 days/nights', but would swap back to glasses then for a few days.
So at this point I've amost had some type of eye correction for almost half of my life, every single day. This is the first time I've been able to walk/drive around without anything in/on my eyes and it's vaguely unnerving as I've forgotten what that's like.
In case you're curious about the details:
-I am nearsighted, albeit mildly so. I have moved slowly through glasses/contacts until my most recent prescription of -2.25.
-I have astigmatism
Costs:
-Not sure what this will run you in various countries. In the UK I got set up for 200 GBP from my eye guy for all eye photos, office visits and the initial set of contacts plus solution etc. In theory, assuming I do not manage to lose, mangle, etc. the contacts, they should last for about 10 years he suggests, before I might need reading glasses or some other change to the eye landscape requiring a new purchase.
I would normally pay around 200 GBP+/year on a new pair of glasses + disposable contacts. (Yeah, I'm not so frugal on this point.) So changing to this method should be a more frugal option in the long-run, assuming I do it for more than one year.
Pros:
My vision at the end of today (working for 8 hours in front of a pc, and then walking an hour to reach the eye office) was better than 20/20, 10 hours after taking out the hard contacts.
Cons:
The right eye (with the stronger astigmatism) is correcting a little more slowly than the left so at the end of the day it's a tiny bit weaker. This may correct out in another week or two, or it may require a different nightly contact to sort it out.
Monday, September 07, 2009
Riddle me this science people - platelet donation
I was dinking around online, the UK version of the bloodmobile is in my corner of Essex next week. In the US I was a regular blood donor. In Germany I donated three times through the on-site company bloodmobile visit, but found the officious brute of a bloodmobile doctor to be obnoxious on the third visit and thereby stopped. (She chewed me out that I did not have fluent German and she did not have time to talk slow German and on and on.) As it is an American company with many nationalities who do not speak German, I pointed out that they shouldn't put the posters up in English then. (The rest of the staff was very nice as they find her pompous as well, but I really didn't have the energy for such events in Germany after a while.)
So onward...I was looking online at the UK blood donation rules, having previously been a UK blood donor when I last lived here. I was specifically interested in donating platelets. I had looked into this one of my home visits to Philly after the above Germany debacle, but having lived in the UK during the Mad Cow years, I was ineligible to even be a blood donor anymore. I was interviewed by the platelet people by phone and then invited in but my travel history then disqualified me.
I was looking at the UK platelet donation site, apparently I'm already disqualified from the get go, due to being female. Really now. Off I went to google to figure this one out. I stumbled across platelet donation in Singapore which seems to shed some light on this mystery to me, although they only 'prefer' males as oppose to 'require' males like the UK. Funny the US doesn't set gender or size requirements for platelets, (although they do set male/female height/weight requirements for double red cell donation.)
I find it funny--for relatively similar cultures (OK, perhaps theoretically different in their means of providing healthcare) that one would allow females and one not. If we were comparing a country with a more conservative viewpoint of women (say, Sudan) and the UK or the US I wouldn't be so surprised. But this difference between the UK and the US surprises me.
Enlighten me please, science minded people.
So onward...I was looking online at the UK blood donation rules, having previously been a UK blood donor when I last lived here. I was specifically interested in donating platelets. I had looked into this one of my home visits to Philly after the above Germany debacle, but having lived in the UK during the Mad Cow years, I was ineligible to even be a blood donor anymore. I was interviewed by the platelet people by phone and then invited in but my travel history then disqualified me.
I was looking at the UK platelet donation site, apparently I'm already disqualified from the get go, due to being female. Really now. Off I went to google to figure this one out. I stumbled across platelet donation in Singapore which seems to shed some light on this mystery to me, although they only 'prefer' males as oppose to 'require' males like the UK. Funny the US doesn't set gender or size requirements for platelets, (although they do set male/female height/weight requirements for double red cell donation.)
I find it funny--for relatively similar cultures (OK, perhaps theoretically different in their means of providing healthcare) that one would allow females and one not. If we were comparing a country with a more conservative viewpoint of women (say, Sudan) and the UK or the US I wouldn't be so surprised. But this difference between the UK and the US surprises me.
Enlighten me please, science minded people.
Friday, May 01, 2009
To the doctor in the UK
I previously had thoughts on the German medical system. As we know, Heather in Europe grew up under-insured in America where medical care was an unnecessary luxury. These habits permeate my thinking today; old habits die hard.
Thursday afternoon, I came to the sudden realization that Monday's issue was allergies. It was only after a mixture of sunny and rainy days, and feeling great on the rainy days that I realized this--duh. This is too early for allergy problems for me. Although--I've been told that what I have will get worse with age, it's only appeared during my graduate university years and progressively worsened since living over here, so it's anybody's guess at this point.
Wanting to grab the bull by the horns (and because I conked out from my America allergy drugs for 11 hours), I figured it best to take steps toward seeing a doctor. I looked up the closest one on the NHS website and called them on Thursday. A very nice woman on the phone answered that they are taking new patients from my part of town, and that I would need to show up in person to register and provide my passport and proof of address. Oki doki.
So I took my housemate along for moral support (and because he should have previously been registered in any event and was not yet) and showed up today.
Him: Hi, we recently moved to the area and need to register.
Her: OK, do you have your NHS card?
Him: I don't have mine, and she never had one.
Me: I only arrived in February.
Her: Well you didn't take long. Did I speak with you yesterday on the phone?
Me: Yes, that was me.
(I LOVE my corner of Essex, that people recognize 'the American'!)
Her: My son is marrying an American, they're coming here in the summer.
Me: Really?!
Her: Yes, he works in Chicago, I knew this would happen. But he comes home, that's the important part. And he's happy...
OK, you both need to fill out these forms. And did you bring proof of ID?
Me: (Good Lord, I lived in Germany--I brought along at least five pounds of paper.) Yes! Here is my passport and the work permit page...here is my NI number letter with my address...is that OK? Or I have my payslip with my address....or my work contract with my address....or.....or....
Her: Yes, the NI letter should suffice.
So off we go to fill out papers. As we're filling out forms, I'm half listening with an idle ear.
-no one was asked for any insurance card or paper or payment.
-the lady was very nice to everyone who called, there were two openings today that she offered to people trying to get in.
-one older woman walked in with a cut that wasn't healing well, she was asked to come back later in the day when there was an opening so a doctor could look at it.
So we turned in the papers. I mentioned about coming in at some point with the allergies and the woman asked if I could wait until next week, until they get me set up in the computer with a number? Yes, of course. She had handed me some office introduction materials. They aim to see everyone who wants an appointment within two days of request. In the US I've had to wait over six weeks in some offices. AND you're not going to charge me for this? (Ok, ok, so I'm paying for it through taxes...)
Thursday afternoon, I came to the sudden realization that Monday's issue was allergies. It was only after a mixture of sunny and rainy days, and feeling great on the rainy days that I realized this--duh. This is too early for allergy problems for me. Although--I've been told that what I have will get worse with age, it's only appeared during my graduate university years and progressively worsened since living over here, so it's anybody's guess at this point.
Wanting to grab the bull by the horns (and because I conked out from my America allergy drugs for 11 hours), I figured it best to take steps toward seeing a doctor. I looked up the closest one on the NHS website and called them on Thursday. A very nice woman on the phone answered that they are taking new patients from my part of town, and that I would need to show up in person to register and provide my passport and proof of address. Oki doki.
So I took my housemate along for moral support (and because he should have previously been registered in any event and was not yet) and showed up today.
Him: Hi, we recently moved to the area and need to register.
Her: OK, do you have your NHS card?
Him: I don't have mine, and she never had one.
Me: I only arrived in February.
Her: Well you didn't take long. Did I speak with you yesterday on the phone?
Me: Yes, that was me.
(I LOVE my corner of Essex, that people recognize 'the American'!)
Her: My son is marrying an American, they're coming here in the summer.
Me: Really?!
Her: Yes, he works in Chicago, I knew this would happen. But he comes home, that's the important part. And he's happy...
OK, you both need to fill out these forms. And did you bring proof of ID?
Me: (Good Lord, I lived in Germany--I brought along at least five pounds of paper.) Yes! Here is my passport and the work permit page...here is my NI number letter with my address...is that OK? Or I have my payslip with my address....or my work contract with my address....or.....or....
Her: Yes, the NI letter should suffice.
So off we go to fill out papers. As we're filling out forms, I'm half listening with an idle ear.
-no one was asked for any insurance card or paper or payment.
-the lady was very nice to everyone who called, there were two openings today that she offered to people trying to get in.
-one older woman walked in with a cut that wasn't healing well, she was asked to come back later in the day when there was an opening so a doctor could look at it.
So we turned in the papers. I mentioned about coming in at some point with the allergies and the woman asked if I could wait until next week, until they get me set up in the computer with a number? Yes, of course. She had handed me some office introduction materials. They aim to see everyone who wants an appointment within two days of request. In the US I've had to wait over six weeks in some offices. AND you're not going to charge me for this? (Ok, ok, so I'm paying for it through taxes...)
Monday, January 28, 2008
the eye dr, part 3
second verse, same as the first,
a little bit louder and a whole lot worse.
So I woke up at 0655 this morning, in order to start the eye drop regime- 07.00, 07.20, get in car, pull over at 07.40 for 3rd set, arrive at 07.50, into the office at 08.00, for another set of drops at 08.10.
(I'm not quite sure how the US can have drops that dilate your eyes within 10 min and only last maybe 45 min after that, while in Germany this is a hella long drawn out process.) It's now 11 PM and my eyes still look dilated. I had brought along my coffee as I remember being there until 10 AM last year. Unfortunately this year was a repeat, even with my three times in the seven o'clock hour.
More drops: 08.30, 08.45, 09.10, 09.20, and 09.30. Finally a set of yellow drops at 09.45, and in to see the cranky pants dr at 09.50. He goes through his measurements. I ponder the use of eye technology in America. When I lived in California, for an extra few bucks my eye dr would do a digital thingy, so you could see your actual eyes on the computer screen, and even print them out. Then they would save them each year in order to run computer comparisons of changes.
What do I get here? I thing it was a glass magnifying glass plonked on my eyeball with a lot of drops and shifted around from here to eternity while he glared under his special magnifier.
Then, the official opinion. "I have measured your eyes, look here on your chart (complete with dr scrawl), and they have not changed. However, when you were wearing your contacts you could not read the smaller letters properly, so I thought you needed a stronger setting. Or maybe it's that the contacts are not good for your eyes."
"The office is on holiday the next three weeks, come back after that, and we test you wearing your glasses to see if you read the same as with the contacts"
(handshake)
They are booked up immediately after their holiday so I'm not in again until the first week of March.
On a slightly odd note, I was asked three times whether I needed a dr note, to excuse me from the office. The last time I received a dr's note, I was 14 and getting my braces off so late into school that morning. In retrospect, I should have accepted it as a nice souvenir of the whole experience.
a little bit louder and a whole lot worse.
So I woke up at 0655 this morning, in order to start the eye drop regime- 07.00, 07.20, get in car, pull over at 07.40 for 3rd set, arrive at 07.50, into the office at 08.00, for another set of drops at 08.10.
(I'm not quite sure how the US can have drops that dilate your eyes within 10 min and only last maybe 45 min after that, while in Germany this is a hella long drawn out process.) It's now 11 PM and my eyes still look dilated. I had brought along my coffee as I remember being there until 10 AM last year. Unfortunately this year was a repeat, even with my three times in the seven o'clock hour.
More drops: 08.30, 08.45, 09.10, 09.20, and 09.30. Finally a set of yellow drops at 09.45, and in to see the cranky pants dr at 09.50. He goes through his measurements. I ponder the use of eye technology in America. When I lived in California, for an extra few bucks my eye dr would do a digital thingy, so you could see your actual eyes on the computer screen, and even print them out. Then they would save them each year in order to run computer comparisons of changes.
What do I get here? I thing it was a glass magnifying glass plonked on my eyeball with a lot of drops and shifted around from here to eternity while he glared under his special magnifier.
Then, the official opinion. "I have measured your eyes, look here on your chart (complete with dr scrawl), and they have not changed. However, when you were wearing your contacts you could not read the smaller letters properly, so I thought you needed a stronger setting. Or maybe it's that the contacts are not good for your eyes."
"The office is on holiday the next three weeks, come back after that, and we test you wearing your glasses to see if you read the same as with the contacts"
(handshake)
They are booked up immediately after their holiday so I'm not in again until the first week of March.
On a slightly odd note, I was asked three times whether I needed a dr note, to excuse me from the office. The last time I received a dr's note, I was 14 and getting my braces off so late into school that morning. In retrospect, I should have accepted it as a nice souvenir of the whole experience.
Sunday, January 27, 2008
More comments on the eye dr trip
Since a few of you had things to say and the comments box is too small for me to respond...
Having been here almost five years, I am no longer shocked or frustrated by the attitude or actions of anyone in this country. (Not sure if that's a good thing though!) Three years ago I would have been appalled, and would not have told the story as it would have been too painful to re-live. Interestingly, I told the same story in the office, and here were the German colleague responses:
colleague one: (in the middle of doing something but half listening, mumbles) private insurance....doctors in Germany....more appointments....pfui....make money...
colleague two: (never lived outside of Germany, but has locally dealt with a lot of things for non-Germans so tends to see things as such, and was the one who set up this appt). This is why I don't like doctors here. They think they're gods.
colleague three: (also never lived outside of Germany, but used to my occasional rants on living here, so he no longer takes it personally, but earnestly tries to educate me when he thinks I've missed the boat) This is how you know that German doctors are serious about your eye health, when they are serious with you. Only a good doctor would take the time to say such things.
I found colleague 3's thoughts to be most thought-provoking, as it is something I never considered. I dread this appointment weeks in advance, in general because I don't like people poking around my eyes, especially cranky ones who seems to be bent on bringing a dark cloud into everyone's day. Although based on the #3 above, I imagine the guy spoke to me like he speaks to every other person visiting his office, (although I think he's perhaps an extra bit curmudgeonly in general, even by German standards).
If you're not living in Germany you may wonder why I don't just switch drs. A few simple reasons I guess.
1. There are no 'American-style' doctors within 20 minutes from where I live. I consider it a win when I get one who can speak some English words.
2. The guy seems competent in measurements. He picked up that one eye is slightly weaker this year without me mentioning it.
3. The office staff is superb. In particular when they are explaining something unfamiliar that we don't have in the US, they have no problems repeating their instructions a second time with different German words and then listening to me repeat them back. (One drop of these special drops in each eye every 20 min for one hour prior to coming here next?)
4. I don't consider this to be a life-long relationship, as I don't plan to stay in Germany forever.
Having been here almost five years, I am no longer shocked or frustrated by the attitude or actions of anyone in this country. (Not sure if that's a good thing though!) Three years ago I would have been appalled, and would not have told the story as it would have been too painful to re-live. Interestingly, I told the same story in the office, and here were the German colleague responses:
colleague one: (in the middle of doing something but half listening, mumbles) private insurance....doctors in Germany....more appointments....pfui....make money...
colleague two: (never lived outside of Germany, but has locally dealt with a lot of things for non-Germans so tends to see things as such, and was the one who set up this appt). This is why I don't like doctors here. They think they're gods.
colleague three: (also never lived outside of Germany, but used to my occasional rants on living here, so he no longer takes it personally, but earnestly tries to educate me when he thinks I've missed the boat) This is how you know that German doctors are serious about your eye health, when they are serious with you. Only a good doctor would take the time to say such things.
I found colleague 3's thoughts to be most thought-provoking, as it is something I never considered. I dread this appointment weeks in advance, in general because I don't like people poking around my eyes, especially cranky ones who seems to be bent on bringing a dark cloud into everyone's day. Although based on the #3 above, I imagine the guy spoke to me like he speaks to every other person visiting his office, (although I think he's perhaps an extra bit curmudgeonly in general, even by German standards).
If you're not living in Germany you may wonder why I don't just switch drs. A few simple reasons I guess.
1. There are no 'American-style' doctors within 20 minutes from where I live. I consider it a win when I get one who can speak some English words.
2. The guy seems competent in measurements. He picked up that one eye is slightly weaker this year without me mentioning it.
3. The office staff is superb. In particular when they are explaining something unfamiliar that we don't have in the US, they have no problems repeating their instructions a second time with different German words and then listening to me repeat them back. (One drop of these special drops in each eye every 20 min for one hour prior to coming here next?)
4. I don't consider this to be a life-long relationship, as I don't plan to stay in Germany forever.
Thursday, January 24, 2008
Heather's trip to the eye doctor - year 2
If you were Heather today, it went something like this...show up at the eye doctor's office. Tell the nice desk person who you are and what you're there for (an annual appointment--right as rain), and have them squint at a book of tiny handwritten printed names...and ask for your name again....and peer at the book, and finally say, well, no matter, that may have been you right there erased...go take a seat.
eye dr: (handshake and then reading the chart) you were last here in march last year. i told you to come every six months. it's important. the eyes are like windows, we must take care.
heather: (once a year does me fine in the US) uh, yes..
eye dr: you're wearing contacts...(back to chart, frowning)...you only wear these only 8 hours a day?
heather: actually, no, i wear these (putting box on table) for a month at a time.
eye dr: (multi-tasking by peering with some magnifying thingy into my eye) no, no, I told you last time. (break from multi-tasking for direct lecture in German) You must not wear them more than 8 hours a day.
heather: but they're made to be worn always.
eye dr: (loud sigh.) I told you once, I tell you again...(then I get the same as previously, a second time in German, then in English also for good measure--except for words unknown in English, like 'oxygen', are kept in German) You cannot get these from a place that sells glasses, only an eye dr can say...if it gets to the point where the glasses seller can say don't wear, then it's too late, your eyes are damaged for good.
These 'all the time ones' (finally looking at the box)--they are for old people or small children, people who cannot put in contacts well (somebody better inform the Ciba marketing team)...and people like that need to come to an eye dr every month (oh really).
heather: (well actually, they came from plus.de not the glasses seller, and the whole point is not to have to take them out every night) um, yes...
eye dr: (grudgingly) but if you are going to wear contacts, these are better than most. more oxygen to the eye, less dirt--but you must not more than 8 hours wear! 8!
heather: yes...clear..windows...8
eye dr: come back on Monday to dilate the pupil. then i see if my measurements just taken are correct. and don't wear contacts the day before. or until one day after that is done or else your contacts will turn yellow. and your world will be yellow, and a yellow world is not good. (handshake)
-->Well, a yellow world seemed to work a while back for Bono, as I recall...
eye dr: (handshake and then reading the chart) you were last here in march last year. i told you to come every six months. it's important. the eyes are like windows, we must take care.
heather: (once a year does me fine in the US) uh, yes..
eye dr: you're wearing contacts...(back to chart, frowning)...you only wear these only 8 hours a day?
heather: actually, no, i wear these (putting box on table) for a month at a time.
eye dr: (multi-tasking by peering with some magnifying thingy into my eye) no, no, I told you last time. (break from multi-tasking for direct lecture in German) You must not wear them more than 8 hours a day.
heather: but they're made to be worn always.
eye dr: (loud sigh.) I told you once, I tell you again...(then I get the same as previously, a second time in German, then in English also for good measure--except for words unknown in English, like 'oxygen', are kept in German) You cannot get these from a place that sells glasses, only an eye dr can say...if it gets to the point where the glasses seller can say don't wear, then it's too late, your eyes are damaged for good.
These 'all the time ones' (finally looking at the box)--they are for old people or small children, people who cannot put in contacts well (somebody better inform the Ciba marketing team)...and people like that need to come to an eye dr every month (oh really).
heather: (well actually, they came from plus.de not the glasses seller, and the whole point is not to have to take them out every night) um, yes...
eye dr: (grudgingly) but if you are going to wear contacts, these are better than most. more oxygen to the eye, less dirt--but you must not more than 8 hours wear! 8!
heather: yes...clear..windows...8
eye dr: come back on Monday to dilate the pupil. then i see if my measurements just taken are correct. and don't wear contacts the day before. or until one day after that is done or else your contacts will turn yellow. and your world will be yellow, and a yellow world is not good. (handshake)
-->Well, a yellow world seemed to work a while back for Bono, as I recall...
Sunday, September 03, 2006
Germany differences, part 1: healthcare
Many of you ask about the differences in Germany. One of the biggest ones is probably the healthcare here. Contrary to popular American belief, Germany does not have that ubiquitous universal, national insurance that we're always hearing about in the US (but the UK does).
As a US expat I had my US paycheck and insurance. I only went once to the doctor in Germany because it involved submitting expense forms for reimbursement and having gone once to the dentist in the UK, the insurance company would not convert the pounds to dollars. As pounds are worth more than dollars, by paying me only in dollars instead of the charged pounds converted to dollars, they saved some money. Since it was only 10 dollars in the end I could not be bothered to spend that amount in postage writing them letters to fight it, but let it be known that a certain dental insurance company that uses Snoopy in its advertisements does not treat expat dental reimbursements properly.
Fast forward to Germany. Upon becoming a German J employee, I had to take a German insurance. In Gemany there are two types of insurance: public or private. Around 90% of Germans have public insurance and the remaining 10% have private.
Public insurance is an option for all Germans. There are a variety of companies that offer it, many were formed to offer insurance to a certain company or employee union, so they exist with that background but now they are open to everyone. It depends on the company or the plan year, but they charge around 11-14% of your pay to insure you, depending on how last year went. These percentages are adjusted each year, and employees can switch each year as they wish.
Private insurance is only offered to employees who make a certain amount of money. Private insurance offers a higher level of coverage and more enhanced options to choose from. Private also gives you some leeway to create your own plan. You may choose a deductible from 200 to 1200 euro; the higher the deductible, the lower your monthly cost.
Each German must choose an insurance carrier, and then they tell the payroll department. If you choose not to pick a carrier, a standard public one will be chosen for you. Then, whether you are public or private, the company pays 50% of your health insurance premium, the only difference being that the company pays the public insurance directly, vs. for private insurance the company requires proof/cost of coverage and then pays you the 50% so that you pay 100% of the premium each month.
Why would someone choose one or the other?
If you have public insurance and you have a non-working spouse or dependent children, they are automatically covered for free under your premiums. If you have private insurance they are an additional cost.
It is easy to go from public to private--public plans must take everyone regardless of health status or pre-existing conditions. Private plans require a questionnaire before taking you and can require a physical exam if there are any doubts.
It is sometimes difficult to get in to see a doctor. However, doctors get more money from private insurance and often faster payments. Therefore, you will get an appointment faster with private insurance.
Public insurance works similarly to the US health networks that a doctor's office submits an expense to the insurance company and then bill you later for the part not covered. Private insurance requires you to submit the doctor's bill to insurance and receive payment and then to pay the doctor.
With private insurance you can request an appointment with any doctor that you like, whenever you want; public insurance requires following some procedures of who you see exactly.
Private insurance caters to the young and healthy who do not use it much. If you go an entire year without submitting any expenses, you have the ability to claim back some of the premium costs, including that which the company paid for you.
So, particularly in light of that last point, I chose the private option. Then a month ago I was playing volleyball and did something to my finger similar to what I had done previously to a different one. My colleagues did not like the black and blue color so insisted that I go to a doctor.
They were able to find me an Orthopedic/Sports Medicine specialist in this tiny town who could see me in one week. I get the feeling that they are not used to non-Germans, but they were nice enough. The office was actually an old converted house that used every square inch. There were two chairs next to a stairway that was the 'waiting area' for the x-ray room upstairs.
So for being there an hour and seeing the assistant and then the doctor, having my finger x-rayed in two positions, the doctor to look at it once more with the digital x-rays online, and then the assistant to bandage it--do you want to guess how much that cost? Having had something similar in the US the last time this happened to a different finger, I can tell you it ran a few hundred dollars, of which insurance would have covered a good chunk, if not for the deductible.
Oops, left out the final part. I was expecting to have to pay upon leaving, like in the US. They looked at me like I was crazy when I asked in bad German about the bill. You'll get the bill by mail when we write the bills. Are you kidding me? I was seen by a doctor with x-rays and all, and because I told you I have private insurance and I gave you a name, street address and birthdate, you trust that I will receive and pay the bill. Quite a change from the US doctor offices that have a big sign saying something like 'payment expected on day of office visit'.
So when I finally got the bill this week, I had slight trepidation. However, that was all for naught, as this is Germany and seeing the doctor is relatively cheap. The whole thing came up to 60 euros. A mere pittance to what I would have been chared for the same exact thing in the US. So now I need to pay and hold it to see if I go any more to the doctor. I have the ability to save bills for up to one year before submitting. Then I can see if I go again, or if it is better to pay out of pocket if I only go once and go for the 'non-use' refund instead.
As a US expat I had my US paycheck and insurance. I only went once to the doctor in Germany because it involved submitting expense forms for reimbursement and having gone once to the dentist in the UK, the insurance company would not convert the pounds to dollars. As pounds are worth more than dollars, by paying me only in dollars instead of the charged pounds converted to dollars, they saved some money. Since it was only 10 dollars in the end I could not be bothered to spend that amount in postage writing them letters to fight it, but let it be known that a certain dental insurance company that uses Snoopy in its advertisements does not treat expat dental reimbursements properly.
Fast forward to Germany. Upon becoming a German J employee, I had to take a German insurance. In Gemany there are two types of insurance: public or private. Around 90% of Germans have public insurance and the remaining 10% have private.
Public insurance is an option for all Germans. There are a variety of companies that offer it, many were formed to offer insurance to a certain company or employee union, so they exist with that background but now they are open to everyone. It depends on the company or the plan year, but they charge around 11-14% of your pay to insure you, depending on how last year went. These percentages are adjusted each year, and employees can switch each year as they wish.
Private insurance is only offered to employees who make a certain amount of money. Private insurance offers a higher level of coverage and more enhanced options to choose from. Private also gives you some leeway to create your own plan. You may choose a deductible from 200 to 1200 euro; the higher the deductible, the lower your monthly cost.
Each German must choose an insurance carrier, and then they tell the payroll department. If you choose not to pick a carrier, a standard public one will be chosen for you. Then, whether you are public or private, the company pays 50% of your health insurance premium, the only difference being that the company pays the public insurance directly, vs. for private insurance the company requires proof/cost of coverage and then pays you the 50% so that you pay 100% of the premium each month.
Why would someone choose one or the other?
If you have public insurance and you have a non-working spouse or dependent children, they are automatically covered for free under your premiums. If you have private insurance they are an additional cost.
It is easy to go from public to private--public plans must take everyone regardless of health status or pre-existing conditions. Private plans require a questionnaire before taking you and can require a physical exam if there are any doubts.
It is sometimes difficult to get in to see a doctor. However, doctors get more money from private insurance and often faster payments. Therefore, you will get an appointment faster with private insurance.
Public insurance works similarly to the US health networks that a doctor's office submits an expense to the insurance company and then bill you later for the part not covered. Private insurance requires you to submit the doctor's bill to insurance and receive payment and then to pay the doctor.
With private insurance you can request an appointment with any doctor that you like, whenever you want; public insurance requires following some procedures of who you see exactly.
Private insurance caters to the young and healthy who do not use it much. If you go an entire year without submitting any expenses, you have the ability to claim back some of the premium costs, including that which the company paid for you.
So, particularly in light of that last point, I chose the private option. Then a month ago I was playing volleyball and did something to my finger similar to what I had done previously to a different one. My colleagues did not like the black and blue color so insisted that I go to a doctor.
They were able to find me an Orthopedic/Sports Medicine specialist in this tiny town who could see me in one week. I get the feeling that they are not used to non-Germans, but they were nice enough. The office was actually an old converted house that used every square inch. There were two chairs next to a stairway that was the 'waiting area' for the x-ray room upstairs.
So for being there an hour and seeing the assistant and then the doctor, having my finger x-rayed in two positions, the doctor to look at it once more with the digital x-rays online, and then the assistant to bandage it--do you want to guess how much that cost? Having had something similar in the US the last time this happened to a different finger, I can tell you it ran a few hundred dollars, of which insurance would have covered a good chunk, if not for the deductible.
Oops, left out the final part. I was expecting to have to pay upon leaving, like in the US. They looked at me like I was crazy when I asked in bad German about the bill. You'll get the bill by mail when we write the bills. Are you kidding me? I was seen by a doctor with x-rays and all, and because I told you I have private insurance and I gave you a name, street address and birthdate, you trust that I will receive and pay the bill. Quite a change from the US doctor offices that have a big sign saying something like 'payment expected on day of office visit'.
So when I finally got the bill this week, I had slight trepidation. However, that was all for naught, as this is Germany and seeing the doctor is relatively cheap. The whole thing came up to 60 euros. A mere pittance to what I would have been chared for the same exact thing in the US. So now I need to pay and hold it to see if I go any more to the doctor. I have the ability to save bills for up to one year before submitting. Then I can see if I go again, or if it is better to pay out of pocket if I only go once and go for the 'non-use' refund instead.
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