Different types of hospitals?

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Hi!, I live in Australia so I haven't seen any of the recent episodes of ER and I won't till February. Anyway I thought I'd just ask this question in advanced so I'll be clear on what they are talking about in the show. What is a county hospital???. Also what to they mean when they mention HMO??? (I have to admit I heard this from Chicago Hope). In Australia we have two types of hospitals. Public(for everyone regardless of health insurance status) and private(for people who have private health insurance). Thanks :)

-- Anna (annave8@hotmail.com), November 26, 2000


A county hospital is a Public Hospital. They take everyone regardless of health insurance plans. I think most of them are "teaching" hospitals as well (students work cheap)

HMO stands for Health Maintenance Organization. It's a type of Medical Insurance. The Doctors and Hospitals are members of the "organization" and I think that they all agree to fixed costs for the services they provide. When individuals purchase this type of insurance they are allowed to choose which Organization Member Doctor they wish to assign as their "primary care physician" for men (& kids) it's ususally a family practice doctor or general medicine, a woman can make it an OB/GYN or the Family Practice Dr. Once that is established, you must see the Primary Care Dr. for everything (except emergencies) and he has to refer you to any specialist you need and all then costs have to be justified and pre-approved by the HMO. The advantage to this type of plan is that the patient only has to pay a "co-payment" for all their medical attention - usually $15 for an office visit, $5 for a prescription $150 for a hospital stay and $50 for a visit to the ER provided you follow all their rules and jump through all of their sometimes ridiculous hoops - otherwise they don't pay a dime.

This is a "lay-person" explanation. I'm sure that there are professionals on this site that can give a more accurate description. I have an HMO but I still am not an expert on how it all works. Sometimes the hoops they make you jump through seem pretty repetitive and un-necessary but all in all - it's a pretty good deal. :-)

-- linda (l.brown@mindspring.com), November 26, 2000.

There are also city hospitals, which are public and often in the poorest part of a city (as is "County" in ER). Teaching hospitals can be either public or private. Around the Harvard Medical School in Boston, for example, are several affiliated private teaching hospitals, including two of the top eight hospitals in the US.

Most hospitals are general hospitals, which treat patients with all types of conditions. There are also specialized hospitals such as children's hospitals and hospitals that specialize in cancer, diabetes, or another disease.

-- Driad (driad@mailcity.com), November 27, 2000.

There are also HMOs that are their own organizations. Instead of being made up of doctors in private practice who agree to the fixed fee rates, the HMO has it's own doctors, labs, pharmacy and so on. The patient pays little or nothing out of pocket, but the premiums are high. These are the ones too that can reject hospital visits (they have their own ERs) and medical treatments (they have a standard of care) and medicines (they have their own pharmacies and drug protocols). I belong to one of the larger ones- Kaiser Permanente. Sometimes I hear things about the HMO refusal and I get a bit antsy wondering if Kaiser would do that to me......

-- Minnie (tcminnie@aol.com), November 28, 2000.

Yo Anna! I also live in Australia - by any chance do live in the Sydney or Paramatta areas? I have also been wondering what a 'county'is. My friend thought it was 'country'!!

-- er_aussie (er_aussie@hotmail.com), November 29, 2000.

Regarding one of the above comments (which was a terrific explanation considering how complicated HMOs are!) - I belong to Kaiser Permanente, and am not required to have a primary care physician, and if I do choose one, do not have to see them for all visits. They allow me to change my primary care physician whenever I want, so it actually seems to have very little significance who I choose! Actually, I rarely see the same doctor twice; it generally depends on who's available.

-- Maureen S. (shepcaff@ix.netcom.com), November 30, 2000.

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