Hospital Bill, German style

[DFW]

As some of DU knows, I just had two heart procedures done at a top cardiac clinic here in Germany. I am still waiting for the bill for the first one, the one where I was in and out the same day. But I just got the bill for the second one. I had a heart ablation done (successful!!), and was kept overnight, because they wanted to keep constant observation over the puncture wound. I was expecting about $15,000 to $20,000. I got the bill for that treatment today. It was €7664, or about $8,737.

From what I understand, the same bill at a decent clinic in the USA (anyone who knows from experience please set me straight if I am way off) would have cost somewhere between two and four times as much.

Being Blue Cross, from past experience, I expect them to deny 100% of this. I will not be surprised if they do, but German health insurance available to me costs $35,000 a year, so I am still way ahead of the game. If I get zero reimbursement, I get to deduct it from my German taxes, so, in fact, it will only cost me a net of about $4500. It seems a small price to pay for a heart that should now be good for another 20 years or so. Since EVERYONE in my family gets cancer sooner or later, that will probably be more than enough.

Gas may be hugely expensive here, but staying alive is a hell of a lot cheaper.

[lapfog_1]

1. 30 years ago

I was diagnosed with WPW... and I also had the microwave ablation. 7 catheters threaded through the femoral vein and the jugular vein. kinda of an experimental surgery in 1995.

I had John Alden GT insurance. Despite the cardiologist negotiating with them prior to the surgery, they attempted to stick me with the entire bill... $36,000 ( included the overnight stay for observation ). Lawyers from the hospital got involved... big mess.

I ended up paying $4000 of the bill because a doctor learning the procedure attended the surgery and he had not been included in the original agreement.

Shortly after that... my insurance left the state ( I think I was part of the decision ). With my prior diagnosis of WPW, getting other individual insurance was financially impossible ( $1000 / month with a $10,000 deductible from Blue Cross ).

BTW, my doc gave me 20 years with the heart surgery... it has been 30... knock on wood.

[popsdenver]

2. We can only hope

that all the MAGAot Voters, who now can't pay for their outrageous medical bills or buy medical insurance are paying attention to who screwed them over. And vote for the Dems.............(but doubtful, some right wing asshole will get on Fox News, and tell them.......It is Biden's fault, or Hillary's, or Bill Clinton, or even Jimmy Carter's fault...........

[twodogsbarking]

3. I can't look. Thanks for posting. I just can't look. Have a great day.

[DFW]

9. It was peanuts compared to what you'd pay back in the USA

You can look! It won’t hurt, I promise.

[irisblue]

4. I'm glad to see you posting today& that you are well enough to do so.

All the best to you & yours DFW

[DFW]

6. Thanks for the kind words!

I really have stuff to do in Belgium, France and Spain before the end of next week and should have been on the road tomorrow, preferably today as well. But while I may be an idiot, I am not Superman, and at 74, no matter how good I may feel at the breakfast table, that doesn’t mean that two days after a heart procedure, I should be risking day trips involving 4+ hours there (Brussels and Paris by train, Madrid by air, including airport security and transportation into town and back) and four hours back.

[Evolve Dammit]

5. Best wishes DFW and thanks for the perspective. ED

[DFW]

7. No sweat! I haven't been in an American hospital overnight since 2011.

So, i don’t know what going rates for such treatment is there, or if it varies by region. My bill for a similar problem in Dallas, but with a two night stay, was $36000 and that was fifteen years ago.

[Tripper11]

8. Here's our Canadian Health story

I'm Canadian and my wife is American. About 13 years ago we moved back to Ontario, settling into Mississauga, a rather large suburb of Toronto. Being a Canadian citizen I automatically had health insurance. My wife did not, she had to wait until she got her permanent resident card and then she would be in.
Before she got her card she had a very bad stomach/body attack. She has a lot going on, lupus, lots of stomach issues etc. When her body attacks her it can be debilitating.
Anyway, she had one and we had no choice but to take her to the ER. When we checked in, because of her status we had to pay a $300 emergency room fee. After that, she was taken in and they ran a ton of tests on her, gave her all kinds of meds for pain etc. We were there for about 18 hours.
After things settled and she was better we went home. ON the way home, I was still in American health costs in my head and said to my wife that I was a little frightened about the impending bill. We reasoned that we'll figure it out, but it had to be done.
About 2 weeks later, a bill came in the mail from the hospital. Slowly I ripped it open expecting to see some crazy 5 figure bill.
Turns out, it was $1300 buck or there abouts.
I mean what she went through, the tests, the medications etc, I would wager if that had happened here in America, that would have cost at least $20/25K easily.
We were very relieved.
This is not to say that the Canadian Health care system doesn't need work. It does need a ton of work done and more money like most health care systems. But for me, at least they're trying.

[DFW]

14. Here in Germany

If you are not German with a German health insurance, or at least one they recognize, they usually hit you with the full boat. No mercy. The difference is that the costs are far less than in the USA. My German wife had no health insurance here at all between the ages of 60 and 65 (no, there is NO universal coverage here), when her German version of Medicare kicked in. For five years, I had to pay for her German version of COBRA, about €550 or €600 per month. At $9000 a year, it wasn't cheap, but considering that she got a deadly cancer at age 64, and was in the hospital for nearly a month, I'm sure that treatment would have cost, even here, way more than the five years of supplemental insurance that I had to pay.

[joanbarnes]

10. Stay Well DFW! We love your posts from across the pond.

[DFW]

37. If I have not been the cause of fatal boredom

I figure I’m ahead of the game!

Thanks!

[relogic]

11. Ain't freedom to choose your poison

in America great? We are so proudly free (enterprise). We’ve got the best healthcare and choose to ration it out starting at the big numbers: at least $10, 20, 30 thousands or more a pop.

See how beautiful our system takes care of the least of these. No, stupid not those victims of poor health people. I mean the poor, “least of these stock holders crying about lower returns on their overinflated medical system. Ya gotta break a few eggs (hearts, livers and spleens) if you want a good heath system for us beautiful people can’t you see?.

[DFW]

15. Actually, my Doctor in Dallas said I was right to get the procedure done in Germany

He said that Germany was more advanced in cardiology than the USA in general. I'm sure the USA is the most advanced in many fields, but my Dallas doc said cardiology wasn't one of them.

[relogic]

18. Yes

It’s hit and miss, a dice throw of what hospital, doctor, technology, insurance company, plan, state, (country) etc. one is fortunate or unfortunate to find themselves.

I’m no fan of a system like that. I have my own experience with cardiology, ENT and spinal/pain specialists that would make one swear off all medical treatment in any form at this point. Particularly poverty level folk are almost as medically vulnerable as when Medicare and Medicare were first introduced.

I can say the decline in services around Pennsylvania can’t be ignored these past six years.
A crap shoot, indeed.

[DFW]

20. I left Pennsylvania in 1975, so I'm in the dark about what it is like there now

Plus, I was in Philadelphia, so I could go to "student health services" at the Penn Hospital, which was right around the corner from my dorm. Pennsylvania being the diverse place that it is (the "Philadelphia in the east and Pittsburgh in the west and Alabama in the middle" cliché is not far from the mark), I can imagine that treatment is very different if you are in Pittsburgh or Latrobe.

[relogic]

22. My dear PA

ain’t what it used to be. We’ve got a load of far- right maga state reps that can’t wait until Steve Miller and ilk finish all the jobs they’re working on.

[littlemissmartypants]

12. We love you, DFW. So happy to hear that everything is going well for you! ❤️

[DFW]

21. As well as can be hoped for, anyway!! I am grateful for your comment!!

It's my wife's birthday today, and she had to be back up in northern Germany today to sign the transfer of title of her mom's house (died on December 31 of last year). There was an unannounced traffic detour so she didn't get home until 11:00 at night (it's 1 AM now). I'm always terrified when she makes those trips up there and back. It's 3 hours each way, half Autobahn, half rural streets, and the people drive like maniacs here. But she is a big girl now (74, like I am ), and she knows how to take care of herself, and where her limitations are.

Also, it is 38° C (100°F) here and we have no air conditioning. We'll celebrate properly in a few days when her friends come for a quick birthday get together on Sunday.

[littlemissmartypants]

23. Many Happy Returns to your bride and condolences for the loss of her mom. ...

When two are as close as you are even a brief separation can be stressful. I'm glad she made it home safely.

You both have so many blessings and we appreciate that you share them with us. All the best! Enjoy your celebration!!

[DFW]

24. It's amazing what can happen in fifty years!

1974


2024

[littlemissmartypants]

25. It really is! 🌞❤️

[Tree Lady]

29. Northern Germany, my husband's father

Is from Flensburg. We found out about 10 yrs ago he never became an American citizen so we could become German citizens if we wanted to. My husband said if we were younger we would but not now. His brother got all the paperwork started with a lawyer because his son was moving there, son changed mind so did he.

[KS Toronado]

13. Happy for your outcome but disappointed in the bill.........

was hoping it was going to be under $100 like some European countries I've heard of.

[DFW]

17. I'm a legal resident here, so you heard wrong

It costs more or less the same everywhere in Northern Europe. What I had costs thousands no matter where you have it done. How it is financed is what makes the difference. If you are a GERMAN citizen (or legal resident) and either working, destitute or over 65, THEN you are insured by law. If you fall through the cracks, like my wife, who is German, did from age 60 to 65, you either get their version of COBRA or hope to the Great Pumpkin that you don't get sick. At 65, her German version of Medicare kicked in, and she was covered again. By the way, at age 64, she did get a deadly (as in no one survives) for of cancer, and the insurance I was paying for covered it. She was that one in ten thousand that DID survive it. The treatment was brutal and she was in the hospital for a month, but that was ten years ago, so it was worth it.

No one here builds hospitals for free. Medical staff does not work on a volunteer basis. Manufacturers of medicine do not donate their products out of charity. It is FINANCED differently. It is PAID FOR differently. But it does cost a lot, and it does get paid for--just not always by the people being treated. As I am not a German citizen, and I work for an American employer. I am expected to pay full German taxes (AND American taxes, with minimal deductions), to the tune of about 73% total income tax, and get NOTHING for it in Germany. No health insurance, no pension, no NOTHING except just gimme yer money! Heil Honecker!

Different countries have different rules pertaining to foreigners needing care who have neither citizenship nor residence nor a job with an EU employer. Some are very "generous," but force their own taxpayers to foot the bill. Those people who got treatment while visiting Denmark or Finland and paid under $100 did so on the backs of Danish or Finnish taxpayers. It was NOT free. Germany does not force its own taxpayers to pay for the health care of those who are passing through and need treatment. They expect those people to pay up, and submit the bills to their own insurance in their own countries. They do not feel that visitors have the right to freeload on the back of German taxpayers. I can't say that I blame them, but I pay six figures in taxes to the German government per year and get NOTHING in return. I don't find that fair, either.

[Jacson6]

16. My Angiogram cost $20k 14 yrs ago.

I'm sure that that price has doubled since then.

[DFW]

19. Now THAT is a typical horror story, the likes of which I hear often

That just reinforces my impression that I got off easy!

[cachukis]

26. Living the life. Love that you are at it.

[Celerity]

27. It would be basically free here in Sweden, so there's that.

All medical and all pharma in a rolling 12 month period costs around $350-400 usd combined, max, for the entire 12 months.

[DFW]

33. Is that for legal residents, or anyone who shows up?

Sweden’s taxpayers are fine with footing the bill for themselves, but no country’s medical system can financially survive a deluge of “medical tourists,” who travel there specifically to get cost-free (to them) medical care. And nor should it. Sweden’s residents are heavily taxed, not just “the rich.” Among some of the advantages of that is that with the money that comes in, the government picks up the bill for most treatment and medicine. It may be offered at little or no charge to the patient, but it is not free. It is just financed differently. I promise you that if you want to order a construction firm to build you a hospital somewhere, and hire dozens or hundreds of doctors and nurses, no one will do it “for free.” Even in Sweden, construction workers, nurses and doctors need to eat, buy clothing and pay rent.

If the USA is EVER going to step away from our haphazard system of impoverishing many people who need serious medical care, it will have to shift the cost away from those receiving the care to the general population, i.e. higher taxes. Since that is usually a death sentence to the candidacy of anyone running for national office in the USA, it will be the skillful politician indeed who can come up with a formula to sell THAT to a majority of voters. For all that America has suffered under the Republicans, we have yet to have our Ådalen ‘31.

[Celerity]

35. Legal residents. You do not have to be a citizen, just be living here legally. You cannot (of course) come here as a

Last edited Fri Jun 26, 2026, 02:19 AM - Edit history (1)

medical tourist. I know of no country that allows that.

And of course, as you were talking about fees you paid, that is what I referred to by 'free' or basically (or almost free). Obviously the state (as in government) picks up the vast part of the tab, and our taxes we pay here helps fund that.

[DFW]

36. Medical tourism was, for a while, at least, a concern in Canada

But this was many years ago. A friend of mine was Canada’s ambassador to the USA. His posting there ended when Bill Clinton left office, so you know how long ago that was.

The max-tax rate here in Germany is 47% (42% plus “solidarity supplement” of 5%), but it kicks in at a very low level—under €100,000 per year. Plus the MWSt (MOMS to you) is 19%. As opposed to many neighboring countries, cash is still king in Germany, so lots of small stuff flies under the radar here, and keeps the popular economy (not talking about Siemens or Volkswagen) humming. Credit card fraud is rampant here, so small shops and vendors still prefer cash.

[MustLoveBeagles]

30. I'm glad you are doing well

[DFW]

34. Thanks!

I never know what’s going on “in there,” but I try not to leave too much to chance.

[surfered]

31. Glad you are ok. I slipped and fell on stairs in a hotel in Beilstein, Germany and dislocated a finger.

I drove to a hospital (kranken haus) in Cochem. Doctor Wolf examined me and ordered an X-Ray.

He then numbed the finger, set it, and ordered a second X-Ray to make sure it was done correctly.

He put on a splint, gave me some pain pills, and advised me not to drive (I drove to Italy with no problem). The bill was 125 Euro, about $150 at the time.

Also been to the ER in London. There was no charge. I offered to pay something, but was advised they didn’t have an office that collected money.

On the other hand, foreign tourists visiting the US who develop appendicitis, leave the hospital after surgery with a $30,000 bill.

[DFW]

32. That sounds typical for all three countries

Last edited Fri Jun 26, 2026, 01:33 AM - Edit history (1)

German rates for treatment are nothing like in the USA. For what you paid in in Germany, a German’s insurance would have picked up the bill, but it wouldn’t have been any different—probably like my procedure. Much dental work in Germany is not covered by standard insurance, and there is a dentistry clinic in Budapest, Hungary that advertises daily on German TV how many thousands you can save by going there to have your dental work done, even including room and board for the length of your stay (!!).

I have never had any medical treatment done in the UK, but it sounds like their NHS does not charge patients for care, which means their taxpayers pick up the bill for their complete health system. That means that British taxpayers also pick up the bill for visitors who need unexpected treatment. As long as there is no abuse, or “medical tourism,” I’m sure the NHS can absorb the cost without going bust.

The USA is notorious for being the opposite. This is no secret and Germany has many package deals of health insurance for travelers and vacationers. Some friends ours got such a package for their son when he went for a high school year abroad in California. One day, he collapsed and was taken to the ER, where, after a few days, he was finally diagnosed with a rare heart cancer. They stabilized him as best they could so he could return to Germany. The bill was $50,000. The parents’ vacationer’s insurance that they had bought for him covered the whole thing. They didn’t want to, but this is a billion dollar/euro business in Germany, and refusing a $50,000 dollar medical invoice and making national headlines in the process could have killed their whole business. They paid.

My wife used to buy those things when she traveled to the USA with our daughters while they were still German residents. She hasn’t bought them lately, but she should. There is a huge gap in what Blue Cross says they cover (much) and what they really cover (almost nothing).