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mercoledì, settembre 09, 2009

A Health-Care Trap for Small Business

Es stand in der letzten Business Week. Wird ein Mitarbeiter schwer krank, steigen Krankenversicherungsbeiträge bei Unternehmen bis zu fünfzig Mitarbeitern so stark an, daß die Firma es sich häufig nicht mehr leisten kann, diese Beiträge zu zahlen.

Obama wird seine Schwierigkeiten haben, diesen Murks zu beheben. Hier nun, was ich selbst dazu beisteuern kann: In amerikanischen Städten gibt es Walk-Ins, Praxen mit Allgemeinmedizinern, wo man ohne Voranmeldung reingehen kann. Das ist nicht schlecht. Doch geschieht es auch, dass deine Krankenversicherung nur mit bestimmten Ärzten vertraglich verbunden ist. Dann heißt es, im Internet nachsehen unter Stadt und Spezialfach. Co-Opting. Du selbst hast mit der Versicherung einen Vertrag abgeschlossen, bei dem du vereinbarst, bis zu welchem Beitrag du die Rechnung selbst bezahlst, bevor die Versicherung einspringt. Sagen wir, dreißig Dollar pro Besuch.

In der Apotheke gibt es auf Rezept keine abgepackten Medikamente. Du gibst dein Rezept ab, wartest eine halbe Stunde, während die Pillen abgezählt und in eine orangene Dose geschüttet werden. Über einen Lautsprecher hörst du deinen Namen, wenn sie fertig sind und du nimmst sie entgegen. Kostet auch noch mal dreißig bis fünfzig Dollar. Gut ist nun wieder, dass du nächstes Mal nicht wieder wegen eines neuen Rezeptes zum Arzt rennen muss. Mann kann die Apotheke wegen eines Refills anrufen. Die packt dein Medikament dann ab.

Im Emergency Room. Kommst du dort an, wirst du von hinten und vorn untersucht. Meistens sind es Contractors, also Leute, die keine Angestellten des Krankenhauses sind, sondern mit ihnen Verträge abgeschlossen haben. Radiologen zum Beispiel, die Nachts den Dienst versehen. In den Tagen darauf bekommst du gesalzene Rechnungen von verschiedenen Stellen. Laboranten, Radiologen, Hämatologen, Kardiologen usw.

Versicherungsbeiträge wurden in den letzten Jahren stark erhöht. Sie waren schon happig, als ich in den U.S.A. arbeitete. Jetzt sind sie so teuer wie eine Wohnungsmiete.

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