Monday, August 31, 2009

Social Care

Since they opened up the Health Insurance market here, which they called liberalising the market, this has meant that a public service has been re-designated as a profit making enterprise and the franchiches were up for grabs.

The health insurance has gone up considerably in price and has been cut back even more considerably.

Up to 2005 the basic cost per month was aprox. 30 guilders, for which you got good care, also regular dental checks by the dentist.

And then they turned public companies into private companies and opened up the market and health became a commodity and now we pay 250 Euros each per month and get less than we did previously.

Plus everyone has to pay 150 up front at the beginning of the year.

It is also very frustrating here, a new law the WMO came into force in 2007, up to then local council carried out the governments guidelines which was organised and administrated centrally from The Hague.

Now the new law which administers the provisions for the sick and handicapped is administered locally and has variations depending on location.

Each city and town has the right to specify what they will provide; in Haarlem it is easy to get a hand bike attachment for the wheelchair, but not in Amsterdam.

I applied for one in 2007, on the advice of the ergo therapist by the RCA, after several months where it seemed the outcome would be good; I finally got word that I had lost.

But had I really lost as instead of a nothing I was a going to get the Speedy, the electric scooter as soon as I handed in my scooter.

This was great news as I could not use the scooter as I could no longer walk at all b y the time I was given the scooter.

Had I been given it right away when I needed it I could have had 6 months use of it, as it was it went to the RCA with me when I became an in patient and the scooter sat in the hall and was only used once when I had a test drive in the park.

The WMO is a frustrating law, while the law states what you have a right to mobility aids, what you actually get is a different thing altogether, as it is up to the individual councils.

Sadly it is run on a cost cutting model, so they do not look for the best for you and your situation, instead they will look for something that gives the minimum and is cheap.

This is not a good way to run a support service, it results in strange rules, and for example I had some facts to back up my appeal against the hand bike decision.

I pointed out to them the health benefits of being able to effienctly move yourself around in the wheelchair with a manual hand bike attachment.

I was informed that medical reasons were not grounds for appeal, that they looked at it purely on administrative reasons and I had none so my appeal was dismissed.

At the RCA I also noticed that week after week people were being given the same type of wheelchair, seems one size fitted all.

Obviously they had bought in bulk and were giving them to everyone who needed a wheelchair, even
Though they were big, clumsy and heavy.

Spoke to two people, she unhappy in a chair too heavy for her to move independently in; he with heart problems and asthma had to push her, he had to sit every few meters, which is not possible everywhere in Amsterdam.

Or there would be huge delays getting replacement bits for a wheelchair, met one man at the RCA, who needed new wheel guards so he did not get splattered every time it rained, he had been waiting for a year.

He had many appointments with an advisor from Welzorg and each time the wheel guard was not ok, it would generally not be the right size, eventually a year later he was the proud recipient of a set of cheap plastic wheel guards that kept him dry.

In Amsterdam it is difficult to get about in a wheelchair, the accessibility law means all premises open to the public like shops and cafes and restaurants are accessible.

Here you can still see new premises that have big thresholds and so no way you can get inside without a lot of effort and assistance.

The City Council should refuse shops and other business their operating licence until their premises are accessible to all.

The City Council bought new trams; they spent millions, just before the new law on accessibility came in here in Europe.

The trams do not facilitate smooth access, instead the conductor has to bring out a two small metal ramps and try to get it set up so the prospective wheelchair passenger can roll on.

Sadly the tram stops do not provide enough room for this manoeuvre and tram conductors were endangering their health trying to lift people sideways onto the ramp.

That means that trams are not accessible and if you do manage to get in there is a small space which you share with bicycles and prams.

The Government has done similar with he trains, buying trains that are inaccessible without the assistance of the train conductor.

You have to phone and book in advance inclusive of your return journey and station you will arrive and leave from.

The trains should be accessible now but somehow they have managed to wriggle out of conforming to the law, until they can buy new rolling stock, think aprox. in 2020.

I have noticed that there are alot of incompetent people out there masquerading as people who care and they are frittering away money that was earmarked for mobility aids and adapted housing.

Shame that the people that are good and do put your interests first are not those involved in advising the Council as to what you need.

They are using their skills to help and support people who are vulnerable because of sickness and progressive diseases.

They are the jewels you meet as you progress through the labyrinth that is Social Care.


steve said...

Austin buses are accessible. The bus stops are another matter. Many are in the middle of a block with no curb cut or paved waiting area. You can get there, but they may have to drop you in the middle of the street!

Light-rail service is supposed to start soon. The trains and stations look good, but the tracks and crossings are a mess.

In San Francisco, we used the public transit system all the time without any problems. Stops that weren't accessible were clearly marked. Station elevators were kept in good working order. The weak link turned out to be the operators themselves. Our friend Florence was locked in a street car in her chair for over 15 minutes while the driver took a break. She asked to be let out, and he refused.

Herrad said...

Hi Steve,

Here there are underground stations where the lifts can be almost permenently out of order.
Someone I met at the RCA was trapped out in the suburbs because her stations lifts were always out of order.
I hear London buses and buses in Norfolk are very accessible.
Think we need to win the lottery soon and move to San Francisco
Thanks for coming by and commenting.

Anonymous said...

Hello Herrad! Seems like a wordly trend with the cost of healthcare going up and the quality plummeting. Hope you have a nice Monday. I'm just sitting by the computer catching up on blogs...kind of bored! It's sunny and 15 degrees, very pleasant day! Had a run-in with creepy neighbour yesterday...he showed up on the property unannounced to take some wood that he was SUPPOSED to wait to take until after I left! So a few phone calls, threats to call the police and yelling later, he ran away like the weasel that he is. My landlord was so pissed at him that he couldn't speak, lol. So he's gone for the rest of the month, so my landlady just informed me, I can live here in peace for a while. What an a-hole huh? He refuses to accept that he's not in control of the situation!!! DRAMA!!!!

Kimberly said...

Seems the Health Care Systems is screwed up no matter which Country you live in. Here, in California, I got my power wheelchair, but the insurance company won't help with the 15,000 dollar cost to have a wheelchair lift put on our van. (They say the ramp is a "quality of life" issue and they are not required to assiste with quality of life issues. So, I only ise the power wheelchair to wheel around the house (keeping in mind it was NOT built to be a handicapped home so most of the doors even a regular wheel chair wont fit through (like BOTH bathrooms). The only time I go out with the power chair is when hubby is home to manage everything. I often wonder what the point of acquiring the wheelchair was.

Herrad said...

Hi Rain,
You are right it is a world trend, its called making everything a commodity.
If they could take oxygen they would!
Your creepy neighbour sounds a right pain as well as an a-hole.
People like that are a waste of space.
Thanks for coming by.
Hope you have a good evening.

Hi Kimberly,
Your insurance company's dec ision sounds really screwed up, the ramp is vital for you.
Is there anyway they can relook and classify it differently?
Can you appeal their decision?
Shame you can't get the ramp.
Hope you have a good day today.

Lucy said...

I can sympathize so much with all of you. Here in the US my son had the same problems. He got his meds free from the veterans hospital but accessibility to almost anywhere was either impossible or needed much assistance. While in Vets Hospital a man brought Alan his meal tray and I don't remember what kind of meat was on it but I happened in for my usual visit and Alan was barely able to feed himself by that time and could not cut up meat. I was cutting up his meat and asked him if he asked to have it cut up for him and he said , yes I did mom, and he said the man that put it in front of him said no that my son would have to manage cause he was just pretending to be as bad as he was. You have no idea how much I wanted to hunt that man down and somehow hurt him and taken away his dignity.

Herrad said...

Hi Lucy,
What a horrible story about your son, how can someone working in a hospital do that.
I can imagine you were very cross indeed, for him treating your boy like that.
The bastard.

robert said...

Good morning Herrad,
about the situation here in Athens, where not too long ago the Olypic Games were held and one would like to assume, all to be to the best: Tram is nearly always accessable, but always way too full to enter with a buggy, let alone with a wheelchair.
Buses - no way! First of all one has to step about 40cm of height, in order to enter, and they are as well too packed.
Taking a 'walk', both with a buggy and your child and/or with a wheelchair nearly impossible, as cars or broken pavement, trees, holes in the ground etc. make it impossible.
And still we stay, paying about 250 a month for insurance, apart from all the 'extra money', as couraption is still very high and mostly in the health sector.
A 'long breath' to get through all of this and a nice new start into the week.

Herrad said...

Hi Robert,
Thanks for telling me about the situation in Greece.
So we are all more or less in the same boat then.
A lon breath is indeed needed.
Hope you had a good start to the week too.

Have Myelin? said...

Health care is a problem world-wide, I think. No one seems to have the ideal solution.

I am in the middle of a battle between Medicare and Medicaid. Two different health care systems here, and I need to be on Medicaid. It's nuts.

I feel for you, and I'm sorry.

Herrad said...

Hi Sherry,
Thanks for coming by and commenting.
It seems to be pretty shitty for the poor world wide.
Hope you can sort out your health care.