Healthcare in Austria
The nation of Austria has a two-tier health care system in which virtually all individuals receive publicly funded care, but they also have the option to purchase supplementary private health insurance. Some individuals choose to completely pay for their care privately.
Healthcare in Austria is universal for residents of Austria as well as those from other EU countries. Students from an EU/EEA country or Switzerland with national health insurance in their home country can use the European Health Insurance Card. Self-insured students have to pay an insurance fee of EUR 52.68 per month.
Individuals become automatically insured when they are employed, receive unemployment benefits, are on pensions or work for the government. Dependents are also entitled to healthcare they are adults or finish education. Care involving private insurance plans (sometimes referred to as "comfort class" care) can include more flexible visiting hours and private rooms and doctors.
By 2008 the economic crisis caused a deep recession, and out-of-pocket payments for healthcare increased to become 28% of health expenditures. By 2010, Austria's public spending has decreased overall, but it was 15.5%, compared to 13.9% fifteen years earlier.
Austria's health care system was given 9th place by the World Health Organization (WHO) in their mid-2000s (decade) international ranking. In 2015 the cost of healthcare was 11.2% of GDP -the fifth highest in Europe.
In a sample of 13 developed countries Austria was 5th in its population weighted usage of medication in 14 classes in 2009 and fourth 2013. The drugs studied were selected on the basis that the conditions treated had high incidence, prevalence and/or mortality, caused significant long-term morbidity and incurred high levels of expenditure and significant developments in prevention or treatment had been made in the last 10 years. The study noted considerable difficulties in cross border comparison of medication use.
Despite government claims that no noteworthy waits exist (2007), medium or long waits are normal for at least some elective surgery. Hospital organizations in 2005 stated that mean hip and knee replacement wait times range from 1–12 months, but are generally 3–6 months. In Styria and Upper Austria mean hip replacement wait times were 108 days (about 3.5 months) and mean knee replacement 172 days (5.5 months), cor cataract surgery 142 days (4 months 20 days). For Upper Austria they were 10.3 weeks (72 days, 2 months 11 days) 21.3 weeks (149 days, almost 5 months) and 12 weeks (84 days, or 2 months 23 days). A survey by Statistics Austria found an average wait time of 102 days for eye lens surgery, 78 days (2.5 months) for hip joint surgery, 97 days (3 months 5–5 days) for knee joint surgery, 39 days (1 month 8- days) for coronary surgery, and 28 days (4 weeks) for cardiac surgery (Czypionka et al., 2007, pp. 1–3, 5-9, 18).
Waiting times can be shortened by arranging to visit the same hospital doctor in a private hospital or clinic. Waits are also sometimes illegally shortened in return for legal or illegal additional payments. Hospital doctors also receive additional fees to treat privately insured patients even though they are only supposed to receive better amenities/accommodations. They may therefore treat private patients sooner  (Stepan & Sommersguter-Reichmann, 2005) . Two Austrian health insurance companies advertised low wait times on their web sites. In a survey in Lower Austria, 8% of respondents said that they were offered shorter waiting times for additional private payments (Czypionka et al., 2007, pp. 6, 11). According to Statistics Austria, 2007, in Thomson & Mossialos, 2009, as cited in Health Systems in Transition (HiT) profile of Austria, 2013, social health insurance patients waited twice as long for cardiac catheterization, and 3-4 times as long for cataract and knee surgery. Compared to individuals with private supplementary insurance, those covered by statutory health insurance wait from three to four times as long for cataract operations and knee operations. For cardiac catheterization procedures, statutory insurance patients wait twice as long. Some states have created objective waiting list guidelines to counteract this (Health Systems in Transition (HiT) profile of Austria, 2013).
Austria's health care began primarily in 1956 with the "Allgemeines Sozialversicherungsgesetz" better referred to as the General Social Insurance Law or ASVG, which mandated that healthcare is a right. Individuals become eligible, and automatically registered for healthcare, upon employment. The individual get included into the insurance fund known as Krankenkasse, which results in you receiving an insurance card that covers not only the healthcare, but pensions, and unemployment as well. The level of coverage rapidly grew since 1955-1956 ratification of the General Social Insurance Law, and by 1980 it included unrestricted hospital care, and preventive check-up.
Austria's health programs are funded by the sickness insurance fund known as the Krankenkasse, which in 2013 took 11.0% of the GDP, which was above the average of the E.U average of 7.8% of GDP. Austria's healthcare system is decentralized, and operates with a system similar to United States federalism. Each of the nine provinces and the federal government of Austria have legal limitation and roles in their healthcare system. Federal Ministry of Labor and Social Affairs is the federal aspect, its role is to develop the framework for the services that are offered, and handle the sickness insurance fund known as the Krankenkasse, which funds Austria's healthcare system. The role of the Provinces is to manage and provide the care as needed. Since Austria's health program covers a vast array of social insurance including but not limited to unemployment insurance, family benefits, accident insurance, the overall bureaucracy is vast. While the Krankenkasse is the primary fund, Austria social protection network actually implemented by 22 smaller funds, 19 of which are purely for sickness and all of which by public law are self-governed in order to insure decentralization.
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