31 August, 2009

New Fund Raising Event Format

A have this friend in the States who is one of those straight-out-stand-tall type of women that I so admire. She is helping the people I work with in Kenya and me figure out what sort of activities we can undertake to find sponsors and donators for our various projects.

Recently, she told me how many people she knows in the States are organizing private fund raising events. The idea is to find a nice location and then hold a brunch, lunch, or dinner where everyone gets to eat and enjoy themselves for free, and they donate a certain amount of money to a cause or organization in return.

I thought I would give it a whirl and set out to give a private charity tea party the last Sunday in September. We are going to try and raise money for the Community Breakthrough Support Mission, so they can make a down payment on some land for their new school.

One of my favourite restaurants has generously offered to let me use their restaurant (they are closed Sundays) and they are donating the coffee and tea. Friends have said they will bake cakes. In this culture of homemade Black Forest Chocolate Cherry cakes, the cakes promise to be very special indeed. My son and two friends are going to man the massive steaming espresso machine and whip up cappuccinos, espressos, latte machiatos (sp) to dream for. My daughter and a few of her friends will do the serving. I’ll either be out front circulating amongst the guests ever so calm and suave (not my forte) or be in the kitchen washing the dishes (most likely scenario).

The reason I was attracted to this private charity event, is that the amount of work you invest and the amount of risk that the whole thing will fall apart are minimal. A graphic designer friend made up an invitation. I sent it out to all of my friends and their second cousins. At the moment it looks as if there just might be a healthy-guests-to-cake ratio attending. Last week, before everyone was back from their summer vacations, it looked as though there was going to be more cake than guests… which possibly still might happen. I’ll let you know how it all works out.

28 August, 2009

Man with an Imagination

I saw the funniest thing this afternoon: a fellow riding an Harley (old model) wearing a motorcycle helmet covered in white feathers. He was obviously trying to make the thing look like the head of a bald eagle. Totally bizarre.

27 August, 2009

Dropping by for Dinner

This week is a friends-dropping-by week. A friend who lives around the corner called today and asked if she could drop by for a pasta dinner. She has been an ever present ersatz aunt for our kids, so has an open invitation. There have been endless pasta dinners and lively discussion over the years. Would be impossible to count how many.

Feeling rather sentimental this evening, since I just realised my son is going to turn 19 in a few weeks time... gosh, time does fly.

For those of you who have no patience for sentimentality (usually I am one of those people), you can go over the our Short Short Stories blog and read the story I wrote about a surprise that didn't quite go right.

24 August, 2009

A Friend Drops By

A friend living on the northern tip of Denmark was travelling today on a train through Germany. She decided spontaneously to get off the train in Luebeck and make a pit stop visit. We met for lunch. Had a lovely chat. She then got on the next train heading north. I went back to my office with a smile on my face and a warm feeling in my heart. A sunny day in more ways than one.

22 August, 2009

Saying Adieu

When I moved to Germany 27 years ago, the first people who befriended me were Bernd and Trude. They were much older (nearly 30 years older) than I was, but we had a wonderful close and lively friendship. One that was easy to nurture, yet caused other people, including their two grown sons, to wonder what the attraction was.

Bernd died a few weeks ago and so this trip down to southern Germany to visit old friends, is mixed with a bitter sweet experience of saying adieu to my old friend. Yesterday and today, Trude and I talked about old times. She told me about his last illness and we visited the chapel where his memorial service took place and the cemmentary where he is buried. It sounds as if this would be a sad things to do, but actually it was more touching and endearing and, yes, at times, tearful, but mainly a quiet prayer to send him on his way.

20 August, 2009

What has social medicine ever done for me?

I moved to Germany about 27 years ago from Canada to work as an engineer in a large international engineering company (think Seamens spelt different). Moving to Germany meant that I received immediate social medical insurance. Having spent nearly 20 of those 27 years working in the medical equipment field, in quality control and service, I’ve had the opportunity to view various medical systems all over the globe from the sidelines, as it were. Some systems work relatively well, others not at all.

Much of what I read these days in the US newspapers makes it seem as if adopting a universal health system is going to lower standards medical services. It is as if Mr. Obama is trying to flog off something inferior. It doesn’t have to be so. Having friends and family scattered all over, we’ve shared many stories about in ins-and-outs of our countries medical systems. What these discussions made me realise is that, even though many Germans complain about their social medical system (national favourite pastime), and there are many things that could be improved, and many indications that services will get worse, overall, we have it good.

I can say this because the system here tries to keep some things that traditionally were good (e.g. having the same family doctor for 20 years), as well as implement some things that are new (e.g. alternative medicines). All the while, they offer everything from preventative medicine to emergency care for everyone living in Germany.

The title of this post “What has social medicine ever done for me?” comes from a conversation I had recently with an acquaintance, who was complaining about having to pay for a selective preventative procedure at her gynaecologist. As a response to her, and hopefully of interest to you, here is a list of a handful of situations that highlight what the social medical system has done for me or my family over the years:

  • We have had the same family doctor since we moved into our present apartment for the last 15 years. If, as has occasionally been the case, one of us is too ill to come to her office, she makes house calls.
  • At all births, even in hospitals, a midwife as well as a doctor is present. Midwives are there to assist you through the labour and birth in a way that doctors can not.
  • During my second pregnancy, I experienced early labour pains as of six months. I had to say at home in bed the last trimester. The medical insurance paid my salary after the initial six weeks of being on sick leave.
  • After my children were born and after we went home, my medical insurance paid a midwife to come for a daily visit for ten days. They also paid for a friend to clean my house daily for two weeks since I had to (unfortunately) have caesareans both times.
  • They paid for both my children’s orthodontist costs when they needed braces and my son's dental surgery.
  • They paid for taxi costs when I had to come into physio therapy after some surgery.
  • When my daughter became lacto-intolerant as a young child, they paid for homeopathic therapy.
  • I’m not sure who pays for what (i.e. employer, medical insurance, and social services), but for 6 weeks before estimate date of birth, during your stay in hospital, and 3 months after your baby is born, you get 100% of your salary, (You also get partial payment for up to 1 ½ years and job security for up to 3 years maternity leave, but that has nothing to do with the medical insurance).
  • For the last 12 years, I have been a part of a preventive breast cancer program receiving mammogram and ultrasound examinations for free since my mother had breast cancer.
  • The insurance company pays for part of my glasses and hearing aids costs. There are glasses and hearing aids available at the prices they pay me, but they look somewhat gorky, so I choose to buy more modish expensive ones.
  • They pay for annual and semi-anual check ups to the gynaecologist, ERN, cardiologist, internal medicine, dermatologist, and dentist.

Well, I was hoping to come up with ten examples and I came up with eleven, so I guess I’ll stop while I am ahead.

19 August, 2009

German Medical System 101

Ronni asked her non-US readers to write about how our universal (social/national) medical insurance systems work. One aspect that I find interesting about the debate in the US is how little differentiation is made between the existing universal medical insurance systems. Instead, the discussions seem to be stuck with the “Yea or Nay for Health Care Reform”. So much of what I am reading these days has to with the analysis of the poor behaviour of the nayists. Their tactics and arguments rob me of words. I do hope that Ronni’s idea of each of us writing posts the next two days has a positive effect in some way or manner to the debate.

In Seth Godin’s recent blog post, “Willfully Ignorant vs. Aggressively Sceptical”, he presents a short astute argument to those people who openly oppose health reform. He writes, “If you want to challenge the conventional wisdom of health care reform, please do! It'll make the final outcome better. But if you choose to do that, it's essential that you know more about it than everyone else, not less.”

Even if the differences in the various systems are not highlighted or discussed, it would be advisable for people on both sides of the argument to take a look of these systems and try to decide which components they like best. There are a slew of articles available out there that point out the differences. Admittedly, many of them are not written from the patient’s point-of-view, which is why I thought I’d write about how the German social medical insurance system works from a user’s perspective.

It is actually a very easy system to understand; it is a two-tier system where you can decide yourself if you want to be state insured or privately insured. Most people opt for the state system.

The principal reason some people go private is out of costs reasons. If you earn a relatively high income, it can be
less expensive to be privately insured. All people, whether privately insured or state insured, go to the same doctors’ offices and hospitals. You chose whom you want to go to and where you want to be treated. You can choose general practitioners or specialists according to your will.

There is a selection of state run insurance agencies to choose from. Each agency has to compete against each other in services offered and costs. They all offer the following:

Children (under age 18)

Children and students are insured under one of their parent’s insurance policies at
no extra cost. This insures that 100% of your children’s health costs (medical and dental) are covered for all short term or long term diagnostics or therapies. All prescription drugs are paid by the insurance company. You go to a pharmacy with a prescription slip and they hand you over the drugs; the pharmacies deal directly with the insurance companies for recompenses. With certain chronic illnesses (e.g. neurotmesis, asthma, allergies), recognised alternative medicine therapies (e.g. homeopathy, acupuncture) are also paid for.

If your child is sick, each parent is able to take up to 10 days of “child sick leave” per child per year. The insurance company compensates 75% of your salary for these sick days you’ve taken because of your child’s illness. If your salary is below a certain income, 100% is compensated.

All billing formalities are carried out directly between doctors’ offices, hospitals, and insurance agencies: you go to the hospital or doctor’s office, they swipe your insurance card through the computer, you receive medical advice and then you go home to get better. Basta!

Adults (> 18 years and employed)

Insurance pays 100% medical and dental costs. Up until recently, this really was 100%, but in the last few years some of the selective (e.g. dental crowns) and cosmetic (e.g. plastic surgery) procedures are only partially covered. If there is any indication that such a procedure (e.g. breast reduction) is not solely cosmetic (e.g. back aches), the insurance company will pay for 100% of the costs.

Most people have a general practitioner they go to. This doctor,
  • cures you of most of your ills,
  • writes you your prescriptions,
  • writes you off on sick leave,
  • and makes recommendations for you to various specialists for both preventive procedures (e.g. mammograms), as well as acute diagnostic or therapeutic procedures (e.g. at a cardiologists).
Any procedure that is needed to be done immediately, you usually can get an appointment at a specialist or hospital right away. For preventive procedures, you might have to wait a 2-3 weeks for an appointment at a specialist.

Your state insurance company compensates you your income if you are ill for longer than a six-week duration. Under six weeks, your employer continues to pay your salary.

The insurance costs are a fixed percentage of your monthly salary. At the moment, the costs are somewhere between 12-13% of your salary. Your employer matches and pays the same amount (i.e. 12-13% of your salary) to your state insurance company. Thus, there is no necessity for company health insurance policies. (Therefore, it doesn’t matter if you are a large corporation or a small business, you pay the according to the number of employees and their income.) The monthly payment is automatically transferred from your pay check.

Students (> 18 years and not yet graduated from university)

Insurance pays 100% medical and dental costs. Your insurance rates are approx. 100 USD per month.

Adults (> 18 years and unemployed)

Insurance pays 100% medical and dental costs. Your insurance rates are paid by the unemployment agency or social services.

Adults (retired)

Insurance pays 100% medical and dental costs. Your insurance rates are paid by the state pension plan.

What I am hoping to convey in this post is that when talking about Health Care Reform, we don’t talk about the quantity of care, this is what doctors provide, but about the services offered and prices paid. And, these things do vary. The medical system in Germany has evolved over the decades. It is always changing, and so will the US system once it gets set up.

My personal belief is that any medical system that doesn’t offer full coverage for all people at competitive prices is a system that is ill. By all accounts, full medical and dental coverage in the States is almost unpayable for the average family. Why not just say, “Yea to Health Reform”, it would be the beginning of a long journey for all and not the collapse of a system for the few.

17 August, 2009

Food for Thought

If found that the facts contained in this video race by too quickly to read at the speed the video is presented. Nevertheless it is worth pressing the pause button while watching the video and taking time to digest the information.

What do you think, fade or revolution?

11 August, 2009

Magical Night Journey

One of the many joyful experiences I had during this last trip Montreal happened during the last hours of the journey. When the plane hit Europe (Ireland) and all the way down to Munich we had a spectacular clear view of all the cities and highways illuminated in oranges, reds, and yellows.

It is impossible for me to describe the magical beauty of this aerial landscape. The hour or so I watched, I thought we were seeing veins of burning lava, a treasure chest of jewels, and brewing colony of insects all in one. We flew in a perpetual dawn that never became sunrise...

Why Social Media

If you have ever asked "What is all this crazy hype about social media?", here is someone who makes no apologies, is in your face, and yes, is blatantly up front about saying "enough with the stupid question" and urges you just to get going.

I found it surprising the 2/3 of the global internet population uses social networks. It seems as if a large part of my own social circle belongs to the 1/3 that doesn't. Why is that?

10 August, 2009

The Big Picture

The Big Picture is a fantastic site. Every few days, The Boston Globe presents a series of photos, fantastic photos, that concern a current topic of interest.

Whether the photos are about water,


Or, about Greenland,


they are not to be missed. Sometimes the topics are about war and violence and I can not look at the images because they just hurt too much, but mostly they are just spectacular.

08 August, 2009

Contemplation and Definition of success

I first heard of Alain de Botton when reading his book, The Consolations of Philosophy. Since then, I’ve very much enjoyed reading his work and hearing interviews he’s given. So, you can imagine my delight discovering he held a Ted Talk.

Do take a look while he contemplates how our culture defines success and how we might look inside of our minds and hearts to find a more appropriate definition.

06 August, 2009

Back from our Trip

Can't talk, let alone write... feeling the jet lag. On the red-eye flight from Munich to Hamburg, the pilot said something like, "Thank you everyone for arriving on time this early morning. Most of you probably were up even earlier than those of us in the crew. So, why don't you all just rest your heads and try to sleep. I won't bother you with any annoying announcements until shortly before we land." And he didn't.