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state-run health system
(state March 05)
1. Organization
Denmark has a state-run health system. Financing, planning
and management are fully subject to the authorities. The services
are financed through income tax and there exists only one
legal state-run health insurance.
If you have your domicile in Denmark and if you are paying
taxes, you will be also insured in Denmark. No separate health
insurance fees have to be paid.
There are 2 sectors:
a) Primary sector: which concerns
the areas of treatment and care as well as prevention.
b) Hospital sector: treatment of diseases, which require a
special equipment and care by a specialist as well as intensive
care.
Every insured party is entitled to hospital treatment and
care in case of maternity. Most of the health services are
free of charge for the insured party.
The state is responsible for 80% of all health expenses, the
rest are private expenditures for drugs, dental treatments
and physiotherapy (15%) and services of private insurers.
County councils and local councils have to balance and determine
the service and tax level in order to avoid an unlimited increase
of expenses.
Therefore state, regions and local authorities are negotiating
about a fixed financial framework once a year.
2. Insurance models
Danes (from the age of 16)
can choose between 2 different insurance models:
· Family doctor/GP model: no retention for medical
and hospital expenses; restricted possibilty of change of
a GP – if you choose another doctor, your community
has to be informed; if you inform your community before the
month is halfway through, the change will already come into
force in the coming month. But then you can only change your
doctor another time after 6 months at the earliest. For a
visit at a specialist, you need a referral (exception: ear,
nose and throat specialist, eye specialist); almost all Danes
are insured through this model.
· free choice of doctor model: consultations at the
specialist are possible without a notice through a GP. This
model does not bind doctors to the established rate agreement
with the health insurance concerning the treatment of first
class members. The insured party has to pay in advance and
will receive only a partly reimbursement when submitting their
invoices, which would have been paid for the patient by the
health insurance with above mentioned model. Only approx.
2% of the Danes are insured through this model.
It is possible to receive
treatment in a hospital without additional payments. The insured
party can choose between all public hospitals. The Danish
ministry of health publishes a list with waiting periods for
operations on the Internet. If it is not possible for a hospital
to keep to the waiting time, the patient can contact a private
or a foreign hospital. It is planned to shorten the fairly
long waiting periods.
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Administration
There are 3 levels –
the state, regions and communities, i.e. a national, regional
and local level.
a) State: The state defines
the aims of the national health politics. The parliament and
the ministries of the interior and health are responsible
for the legislation in terms of health. In addition, the ministry
enacts rules concerning the administration of the health service.
b) Regions: There are 14 regions with responsibility for hospitals
(guarantee of treatment free of charge) and the sector of
practice. (exceptions: hospitals of the communities of Copenhagen
and Frederiksberg; they are managed by a special administrative
corporation.
c) Communities: There are 275 communities, which are responsible
for domestic care, dental treatment and medical check-ups
for children and the youth. Moreover, they are responsible
for most of the social services (e.g. retirement homes).
Services
· Medical care through
GPs and specialists (when insured with the family doctor/GP
model)
· Partial reimbursement of certain dental treatments.
Dental treatments free of charge for insured parties under
18 years. Seriously handicapped insured parties or persons
with an exceptional need for dental treatments (because of
certain serious diseases) receive treatment free of charge
or have to pay only a reduced amount of money.
· Partial reimbursement for certain treatments of physiotherapists,
chiropractors, psychologists and chiropodists.
· Drugs with a possibility of refund (scaled refund
charge of 0 – 85%)
· Stay at the hospital; the hospital together with
the community is responsible for drawing up a plan of rehabilitation
after the release, if necessary.
· Maternity care
· Domestic care
· Measures of prevention: advice regarding contraception,
precautions during pregnancy and maternity regulations, vaccinations,
preventive home visits for persons over 75 years (twice a
year), measures of prevention for children and the youth and
dental treatments for children and young people up to the
age of 18.
Workers’
compensation
Regarding accidents, which happen during or in connection
with work, employees are insured through their employer. The
employer registers the employee, pays the fees and is responsible
for the announcement of industrial accidents at the insurance.
Continued payment of wages in
case of illness
In case of illness, the employer
has to continue paying the full wage (maximum 2758.-DKK) for
up to two weeks. From the third week the compensation of loss
of earnings makes payments to the respective community. But
you should have been already employed for 13 weeks with a
minimum working time of at least 120 hours during this time.
There are exceptions regarding e.g. certain occupational diseases,
which oblige the employer to pay up to 4 months of sickpay.
The employee has to make an immediate announcement about his
illness at his employer, otherwise he is not entitled to receive
sickpay or continued payment of wages.
Self-employed persons are entitled to receive sickpay after
a continuing illness over 3 weeks. A new establishment of
maximum amounts is carried out annually. (Vergleiche
dazu private Krankenversicherung in Deutschland)
Figures (from 2003)
Denmark has approx.
4.31 Mio. inhabitants. The life expectancy is 74.9 years for
men and 79.5 years for women. The infant mortality (per 1000
life-births) amounts to 1.8. There is one doctor for 285 inhabitants
and one dentist for 839 inhabitants. In 2002 public expenses
for
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