German efficiency costs 10 euros

Goal: reduce unnecessary medical consultations and lower health care costs.

Method: make every patient pay €10 the first time he visits the doctor every quarter.

Result: chaos.

I’m not dying or anything. In fact, based on how often I have called in sick in nearly eight years at my full-time job – that would be twice – I am pretty damn healthy, touch wood.

But over the past six months I have had to see not one but two specialists for completely unrelated and – let me stress this, Mom – non-life-threatening conditions.

Last fall, one of the specialists referred me to a third specialist, and because this new guy is really booked out, I couldn’t get an appointment to see him until next month.

So this is where German efficiency kicks in. I’ll try to keep it simple.

Unless you’re insured under a private scheme and therefore get your ass kissed by everyone the royal treatment, you have to pay €10 the first time you visit your doctor in any quarter. You receive a little receipt with a stamp on it from the doctor to show on arrival at any further medical treatment during that quarter.

Too bad if one appointment is at the end of March, the follow-up the beginning of April. Ten bucks each time.

If you need to see a specialist, your family doctor will write you a referral. So last autumn I took a referral to see one of the specialists, who did some tests, the results of which made him write out another referral to the third specialist.

I phoned the third specialist, but because I couldn’t get an appointment until February, and thus in the new quarter, I had to go back to my doctor to get a new referral. Apparently they die, like mayflies. So I went back to my doctor today to get a new referral. They gave me one, but then they asked me for €10.

Damn. Even though I’d already paid €10 at another specialist’s office this month, and so covered myself for this quarter, I’d left the receipt at home.

No problem, they said. We’ll issue you a bill for €10, and if you come in any time over the next two weeks with the proof you’ve paid the €10, it will be waived. Otherwise you’ll have to pay us €10.

Not wanting to forget the matter, I pedaled home and came back with the receipt within the hour.


Sorry, they tell me. We know this says you paid your €10, and we believe you actually did, but because you also need to give us a referral from the doctor to whom you gave the €10, we can’t accept it.

But he’s an ambislambic bardgimologist specializing in midgemriolic gambiderpodery, I tell them, and has nothing to do with this other problem.

Sorry, we need a referral.

So I take the receipt and, since they’re within a few blocks of one other, pedal over to my family doctor and tell the nurses there the whole story. They issue me a referral.

As I was riding back to the specialist I thought, good thing I’m healthy and can take my bike all over the place to do this shit. What if I were really sick, or old, in a wheelchair, or God forbid forced to jump through hoops behind the wheel of a car? I’d probably just drop 10 bucks whenever anyone asked for it just to avoid the hassle.

The receptionist at the specialist’s office looked at the referral, ripped up the bill, and said it’s all taken care of.

Though I know she was just following procedure, I felt like saying thank you and have a nice fucking day.

© 2008 lettershometoyou

9 Responses to “German efficiency costs 10 euros”

  1. January 18, 2008 at 12:39 am

    And this is exactly why the Canadian system is better….

  2. January 18, 2008 at 1:07 am

    I have to say that generally I envy you the German health care system. If you only waited a month for a specialist your lucky. Here the wait is roughly three months, I waited 18 months for a hip replacement and got to spend a whole 7 days in hospital. My friend in Germany got to spend 6 weeks in a rehab hospital. But your right about bureaucracy in Germany and their penchant for having every i dotted and t crossed…ciao

    hi rosetta – actually the first specialist took more than four months, the second about two and the third one about four – so it’s not that quick.

  3. January 18, 2008 at 6:32 am

    Holy cow… that sounds like a real mess… at least you ARE healthy.

    The elderly in the US get rooked because they are sick and unable to go from office to office to convince bureaucracy they are right–they just give up and take the path of least resistance. I wonder how many in Germany will end up doing the same thing.

  4. January 18, 2008 at 8:06 am

    call michael moore…..

    …you know, I still have to see that film!

  5. January 18, 2008 at 4:37 pm

    Things have definitely changed since I grew up in Germany some decades ago. Back then there were no fees, or co-pays, or long waits. But beaurocracy … yes, probably, because we are good at that, we like our rules and regulations, you know. Overall though German healthcare is sure still preferable to the British NHS or the American system?

    On a different note, just because the receptionist’s behavior reminded me of this, here is another little story of rule-sticklers: Before Christmas we flew on NW from Connecticut to Amsterdam and this is what happened at check-in at the airport. My husband and I had one bag each, his weighed 47 lbs, mine 55 lbs – I was 5 lbs over the limit. The check-in girl pointed this out and wanted to charge me for excess baggage. “My husband and I fly together so we can pool our luggage, he is 3 lbs under, so can you waive the 2 lbs?” I asked. “No, you cannot do that, you have to pay for 5 lbs or remove something.” “But I know that airlines allow passengers traveling together to pool their luggage.” “Not on NW.” “Actually, this is an IATA regulation.” “Not here.” “Ok. Then how about this: As a single passenger I am allowed to take two pieces of luggage at 50 lbs each on a transatlantic flight. So I am allowed a total of 100 lbs. I only have one bag which is 55 lbs, so I am not over my overall limit.” “You are over the limit for one bag. Pay or take something out.” Oh. My. God. This went on for a little while, because, you know, I used to be a check-in agent, and I knew the rules, but I also always remembered the term “service” in “customer service.” So in the end I took something out of my bag, she labeled it and asked me to bring it to the drop-off point. I walked away from her desk, put what I had taken out back in, and dropped off the bag.

    You know the expression “If you pay peanuts you get monkeys.” And these monkeys are not trained to use their brains to make judgment calls. Couple that with a beaurocratic culture and voila!

  6. January 19, 2008 at 10:21 am

    Hello Kerstin – and welcome!
    That’s a great story. I did the same thing pretty well going through Heathrow last year. They have this ridiculous one-piece-of-hand-luggage policy. So as I passed the minion in charge of telling everyone this before the security line-up, he made me stuff the contents of a smaller hand luggage bag into the bigger one. Once through security I simply broke them back down into two bags and nobody said anything further. You have to wonder why they bother.

  7. January 19, 2008 at 4:04 pm

    Well, at least all that cycling is healthy!

    I use a combination of private and public health care in Spain – neither one would be good enough on their own.

  8. January 19, 2008 at 4:21 pm

    As an expat in Hong Kong I used BUPA, a British firm. They were really good – they offered a minimal coverage with no fancy extras at a reasonable price and they paid you back promptly.

    I have a cycling post coming up one of these days…

  9. January 22, 2008 at 12:47 pm

    I wish you had made up this story. They really fucked up the medical system in Germany with this 10 Euro fee. Have you tried getting an appointment at an eye doctor? Most aren’t even taking new patients – and if you do get something it’s a year in the future. Better to make an appointment now, just in case.

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