This point has been made to me before and I appreciate it. However, I dare say people in UK and Spain understand that N.I. contributions that come out of their earnings pay for their health care. They ought to …
The other thing about the hugely complex payments [it seems to some of us] is that that has to be paid for, as well. It’s not as if the ‘free at the point of use’ systems do not also involve enormous admin and finance depts but perhaps a whole layer has to be added to the FR system - and paid for - for the ‘interface’ with the patients.
I have had bits of paper which have taken time and effort [= cost] to generate and administer and have dealt with insignificant amounts, <10€.
I also once counted the number of reference numbers on one of these missives. There were something around 25 different references numbers and codes. My thought was “What kind of system needs this number of references in order to produce this piece of paper?”
I do acknowledge that this system suits the French. It’s how they do things here.
Many weeks after applying for my CdS [Manche 50] I got a note from an office in Le Mans for a mug shot. Why not at the time I made my application?
Months later I was asked to submit the same info I had submitted on my original application and which had been checked thru’ at my RdV at the Prefecture.
Hmmm … so it does. But I could paraphrase something Ted Heath once said about the UK economy - and it applies to all economies “We can’t all be tour guides and video salesmen”
Spain has a similar penchant for civil servants - even more so. The exam for entry to the Spainish C.S. is massively over-subscribed. Successful candidates will be employed and cannot be sacked - they can be transferred but not sacked. I saw a stat of number of Civil Servants in Spain to population. The proportion exceed that of Germany by a remarkable number. I’d like to see a similar stat for France.
Is it the case that FR civil servants also cannot be sacked?
I know nothing about the health service im Spain, but I do know that he UK system is broken. If a free at the point of service system has allowed all sorts of cuts to happen behind closed doors then I’m not convinced it’s a good idea!
I’ll stick to the French system, paperwork and all….
It’s not the health service that makes cuts. It’s the poiticians in power. I cannot imagine any service provider, esp one for health “allowing … cuts.” Most of the comments I hear/see from practitioners of every medical discipine are critical of this policy.
The same can be said for the Armed Forces, Police Services, Education … all complain of cuts that significantly reduce their capabilities.
The NHS isn’t admin free. When a hospital (Trust) carries out a procedure(s) they are coded by clinical coders who review the consultant notes / details / system records. These are billed to the CCG’s at set rates who pay the Trusts.
The CCG’s commission a set number of procedures each year - I’m sure if one consults their websites one can glean some detail of how they divvy up the money - reference will be made to NICE etc (clinical guidelines).
When the Trust’s don’t do the commissioned (planned) procedures they go into a loss, coz they don’t get the income they were expecting. Often that results in a ‘government bailout’. And possibly resignations?
I think the French are very keen on insurance which is a possible reason the system is constructed that way? I wouldn’t say it’s as ‘productive’ as the NHS if there’s more people ‘processing’ a transaction than the NHS?
I understand the NHS is one of the leaders in getting healthcare ‘bangs for bucks’ and the US the worst. I might have read some figure of about 10% admin costs for France - I’m sure there mist be league tables out there…
So for the political, in UK it’s the CCG’s given the budgets by the gov who determine the activity level, in France it’s the consultants driving the demand by saying this patient needs a procedure and I’ll do it?
I’m sure there are other aspects to the France processes - maybe an interesting naturalisation interview topic?!
Happy new year to everyone. Hope 2022 brings us all health and peace.
I will and explain what I know myself about Amelie refund.
First column. Montant payé is how much you paid. Doctor have different rates and different sector. Also if you go to see a spécialiste without been referef by your GP you usually get charged more or you are not fully refund expect for gynecologist.
Second column is the base for refun. Even if you pay 85 for example, Amelie will consider you paid the base in you cases it’s 77 and you get refun based in base not real fees you paid. Some doctors increase rate in column 1 so you can get better refun not sure if it’s legal. I wonder if it’s what happened for you.
Column 3 is how much percentage of the “base” you get refunded to you 70%… Usually the remaing get refunded by mutuelle.
Amelie paid fully 100% consultation at doctors spécialiste unless as I said you went by yourself without been referred by your GP, in this case you get refund of 70% and mutuelle pay or not the remaining. Also some acts are not refunded still they will appear in your account Amelie with %. From my opinion first 85€ doctor has increased it. Other operation should appear there is a delay in transmission sometime. Hope this helps a little bit it’s only shared experiences no more
Thank you for your explanation Doha, but as I said above, we fall at the first hurdle. Montant payé does NOT show how much I paid. The rest I understand.
At the moment I’m convalescing and not doing much, but when fighting fit again I will be querying this with the cardiologist.