Why should I have to pay the ship's medical facility ...

[CruisinGerman]

if I purchase the cruise line's travel and medical insurance?

 

The cruise line's policy is usually more expensive than any third-party policy.

 

Wouldn't it make sense for someone who pays this "extra" to purchase the cruise line's policy (on which I'm told the cruise line earns a profit of about 50%) to at least be given the benefit in the policy of not having to pay the ship's medical facility in the case of medical accident or emergency?

 

If I choose the "convenience" of purchasing the cruise line's more expensive product, then why should I have to pay hundreds of dollars out of my pocket to use the cruise line's medical facility in the case of an accident or emergency and then have to wait for reimbursement from the cruise line's policy?

 

What do all of you experts think about this idea and why hasn't anybody lobbied for it before?

 

 

Kind regards,

 

Gunther and Uta

[cruiseco]

if I purchase the cruise line's travel and medical insurance?

 

The cruise line's policy is usually more expensive than any third-party policy.

 

Wouldn't it make sense for someone who pays this "extra" to purchase the cruise line's policy (on which I'm told the cruise line earns a profit of about 50%) to at least be given the benefit in the policy of not having to pay the ship's medical facility in the case of medical accident or emergency?

 

If I choose the "convenience" of purchasing the cruise line's more expensive product, then why should I have to pay hundreds of dollars out of my pocket to use the cruise line's medical facility in the case of an accident or emergency and then have to wait for reimbursement from the cruise line's policy?

 

What do all of you experts think about this idea and why hasn't anybody lobbied for it before?

 

 

Kind regards,

 

Gunther and Uta

 

First of all, medical services aboard ship are not provided by the cruise line but by an independent contractor. The only involvement of the cruise line money-wise is having the doctor's bill added to your shipboard account. The doctors are cash-only -- they don't have the time or desire to spend their time filling out insurance claim forms and running an accounts receivable department. I'm sure that these arrangements are set up this way so that the cruise ine has no liability if the doctor screws up and kills you.

 

One problem lies with the exclusions found in the cruise line's plan just as with third-party plans.

 

Perhaps you go to the doctor for what turns out to be a heart-related problem, you're taken care of, and go home. Only later, after requesting your full medical history from your home doctor does anyone realize that this is a pre-existing condition and excluded from coverage. What does the doctor do now? He/she is at sea somewhere with no easy ability to collect directly from the patient.

 

As long as there are exclusions that cannot be verified until after the cruise is over (in many cases weeks after) the shipboard doctor is not going to put his/her own money on the line hoping that the claim will be approved.

[CruisinGerman]

The cruise line is liable for anything you do or spend aboard their ship. If the doctor is an independent contractor, that is a business arrangement between the cruise line and the doctor and as presented to the public you are going to the cruise line's medical facility, so the cruise line will not shield itself from liability just because of a particular business arrangement between them and the doctor (who is usually from India or Colombia and not even licensed to practice medicine in the United States -- but that is another story -- since the medical charges onboard are definitely the overblown United States prices and not the $5 or less that it costs to go to the doctor in Colombia).

 

Your reasoning is quite feasible if the cruise line had to file claims on behalf of all general insurance companies. My only request is that they admit their own insurance as payment for using their own medical facility -- and I think that is quite a reasonable request. The profit they make on their OWN insurance is enough to shield them against the 1 in a 100 claims that might have some quirk. And their business relationship with the insurer (selling hundreds of policies every day) would make it quite difficult for the insurer to deny a claim as opposed to denying a claim filed by an individual passenger. And I am only asking them to do this in case of medical accident or emergency -- not because I may have a headache due to a hangover and may decide to go to the doctor .......

 

 

Kind regards,

 

Gunther and Uta

 

Kind regards,

 

Gunther and Uta

[sirwired]

I'm quite sure that well over "1 in 100 claims" have "some quirk." For trip insurance claims overall, 15% are ultimately denied; I don't have precise statistics on medical claims specifically. I'm not sure why you think the insurance company would have a tough time denying a claim... they don't seem to have any problems denying claims now; why would this change just because it is the doctor having to argue instead of the policyholder?

 

The ship is not, in fact, legally liable for the actions of independent businesses to which the ship leases space. (This also includes the spa and art auctions.) If I buy something in a shopping mall, I don't sue the mall if I get ripped off (or injured) in one of the stores.

 

The relationship between the ship's doctor and the cruise line has always been readily apparent; they are not, in fact, presented as employees of the line. If some people choose to think they are because they haven't read their cruise documentation (where this is disclosed) that is their affair.

 

And I'm a little fuzzy on why you think they should accept insurance as direct payment for major medical issues but not headaches? As of right now, you'll get treated irregardless of your ability to cover the bill... they are not going to let you die on-board the ship (or even turn you away for the headache); it all goes to your on-board account. If you can't cover the bill on departure (assuming you aren't laid up), the only immediate consequence is a really uncomfortable conversation with a member of the purser's staff before you leave.

[cruiseco]

The cruise line is liable for anything you do or spend aboard their ship. If the doctor is an independent contractor, that is a business arrangement between the cruise line and the doctor and as presented to the public you are going to the cruise line's medical facility

 

Read you cruise contract. The contract clearly spells out that the cruise line is NOT responsible for the care received by the doctor who is an independent contractor. Here's from RCI:

 

"b. Relationship with Service Providers. To the extent Passengers retain the services of medical personnel or independent contractors on or off the Vessel, Passengers do so at their sole risk.Any medical personnel attending to a Passenger on or off the Vessel, if arranged by Carrier, are provided solely for the convenience of the Passenger, work directly for the Passenger, and shall not be deemed to be acting under the control or supervision of the Carrier, as Carrier is not a medical provider. Even though the Carrier shall be

entitled to charge a fee and earn a profit for arranging such services, all such persons or

entities shall be deemed independent contractors and not acting as agents or representatives of Carrier. Carrier assumes no liability whatsoever for any treatment, failure to treat, diagnosis, misdiagnosis, actual or alleged malpractice, advice, examination or other services provided by such persons or entities."

 

Whether that stands up in court, I don't know. Bit I do know RCI can afford some pretty good lawyers.

 

And I am only asking them to do this in case of medical accident or emergency

 

 

Did you ask them? What did they say?

[CruisinGerman]

There have been scores of malpractice cases against the cruise lines for treatment in their medical facilities, and they are definitely liable no matter what their unilateral contract drawn in their favor may say to try to scare you away.

 

The doctors walk around the ships in cruise line officer's uniforms. They wear cruise line name badges. The advertisements all over the ships to sell you a flu shot all have the cruise line's logo on them.

 

Your argument about the cruise line's private arrangement with the doctors doesn't pass muster, sorry.

 

Kind regards,

 

Gunther and Uta

[CruisinGerman]

(The article mentions Holland America because the newspaper is based in Seattle.)

 

 

"A recently filed lawsuit in the Federal Court in Miami alleges that the medical staff aboard the Carnival Legend, a ship that is part of the Carnival Cruise Line, committed medical malpractice. On September 6, 2006 cruise passenger, Helen Kerr, 73, was reportedly misdiagnosed and mistreated while suffering from a fluid buildup in her lungs.

According to the complaint, Ms. Kerr went to the infirmary on the ship where they pumped her full of more fluid, causing her to drown.

Holland America and other carriers have long sought to immunize themselves from liability by trying to characterize their doctors as independent contractors. However, courts are increasingly willing to hold cruise lines like Holland America negligent for treatment provided aboard ship which falls below the standard of care.

For more information on this subject, please refer to the section on Medical Malpractice and Negligent Care."

 

Kind regards,

 

Gunther and Uta

[cruiseco]

http://www.cruiselawnews.com/2011/12/articles/passenger-rights/medical-malpractice-on-the-high-seas-do-cruise-passengers-have-any-rights/

 

 

I post this because the article is written by a lawyer who specializes in maritime law. Here's a lawyer that makes a living by suing cruise lines on behalf of injured/wronged passengers posting something like this:

 

"Yes, doctors and nurses make mistakes, but a cruise ship is about the only place where a doctor can negligently kill your loved one and there is no accountability.

 

As I mentioned last year, as long as cruise lines are not liable for bad medical care, there is no financial incentive for the ships to invest in training and hiring more qualified and experienced doctors and nurses."

 

He must be pretty sure of his facts to basically say "don't even waste my time, you're not going to win."

 

Here's from his bio:

 

"Jim Walker practices maritime personal injury law. Jim has been involved in maritime litigation since 1983. Based in Miami, Florida, Jim is one of the most widely respected maritime lawyers in the U.S. He represents passengers and crew members injured or assaulted on cruise ships around the world."

[klfrodo]

I'm not really sure I understand your arguments.

 

I've read many posts on here where going to the ships doctor resulted in no charges when passengers had the cruiselines insurance. I'm sure these instances were for minor falls, scrapes, or abrasions.

I've also read many posts on here that when charges were applied to the patients account, they were suprised at how little they were charged compared to what they were expecting had they gone to a US based ER.

Regarding the lawsuit you used as an example, you don't state the outcome of the lawsuit. This particular suit could have been thrown out. Anybody can and will file a lawsuit, doesn't mean they are filing against the right entity or that it's valid.

 

I get the impression from many of your previous posts that you really don't like the US health care system. And that's OK. Some of us don't like it either. Then again, some of us like it just the way it is. There are pluses and minuses to our system, just as there are pluses and minuses to the European system. However, I'm not going to sit here and go line by line and bash your system. That would be disrespectful of you and your community. It's your health care system, and if you like it,,, I respect that.

[CruisinGerman]

I love the U.S. Health system. I maintain an international health insurance policy and, if I ever came down with cancer or something serious, I would definitely go to Sloan Kettering or someplace similar in the U.S.

 

What I don't like are the prices and charging similar prices aboard a cruise ship even though the doctor is Colombian or Indian and not even licensed in the United States.

 

Did you know that when you price an international health insurance policy, there are two pricing levels? Worldwide EXCLUDING USA and Worldwide INCLUDING USA (I speak of elective treatment, not emergencies -- those are always covered worldwide). To include the USA is at least 50% more expensive.

 

That is the part that is a darn shame. Everything in your country is 99% of the time more efficient and less costly than here in Europe. The major exception is healthcare.

 

And if you are saying that the cruise line medical facilities do indeed accept their own insurance as payment, that was the information I was seeking because I could not get a straight answer from anyone either on or off the cruise ships.

 

And the silly part of all of this is that it just happens to be a subject that interests me. I've never been sick (knock on wood), never had to even use health insurance, and never been to the ship's medical facility except once when accompanying my wife (who has also never been sick) whose only purpose in going was to gawk at the Colombian doctor working there because, according to her, he should have been a model or an athlete, and not only a physician .......

 

 

Kind regards,

 

Gunther and Uta

[klfrodo]

That is the part that is a darn shame. Everything in your country is 99% of the time more efficient and less costly than here in Europe. The major exception is healthcare.

 

 

Not defending it, just explaining it.

 

There are 2 major reasons why healthcare is more expensive in the US

 

1. Uncompensated Care.

US regulations prevent hospitals from not providing care to ER patients who don't have the ability to pay. Somebody DOES have to pay for this. Those persons who do have insurance and do have the ability to pay,,,, pay higher rates.

Many people who don't have insurance or who have a low income wait until they're very sick, then just go to the emergency room rather than just going to a doctor during the week day when symptoms first occur.

There was a story last year of an illegal immigrant who was in a car accident with severe head injuries. Several surgeries and in a coma for several months.

The bill was totaling into the hundreds of thousands if not millions. To cut their costs, the hospital ended up chartering a private jet and flying him back to his homeland and dropping him off.

 

2. Tort laws in the US

Physicians, hospitals, and healthcare workers have to protect themselves by purchasing exhorbitant amount of insurance coverage to protect themselves from lawsuits.

 

These are costs of doing business that cannot be absorbed. These costs are are reimbursed by higher pricing to the general public.

 

As I understand it, in Europe, EVERYBODY has healthcare insurance. Of course this is paid for by much higher tax rate than what we pay in the US. I also understand that the TORT laws restrict or limit compensation for findings of malpractice. These 2 steps alone significantly reduces the overall cost of healthcare.

[CantanaLobo]

The cruise line medical insurance is typically secondary. That mostly means they only pay what your primary medical won't cover. Why would they want to give free medical care to someone who has primary medical that will cover most of the expenses?

[Keith1010]

The cruise line medical insurance is typically secondary. That mostly means they only pay what your primary medical won't cover. Why would they want to give free medical care to someone who has primary medical that will cover most of the expenses?

 

This is the right answer.

 

On top of this the actual insurance underwriter must verify that all of the medical expenses are covered by the cruise lines policy since they are the one who is paying out the expenses.

 

Keith

[Balloon Man]

This is a little like arguing how many angels can stand on the head of a pin? Depends where the pin comes from. In the UK the law looks for what is reasonable. It might sound strange but UK law worries about what the man on the Clapham (that's part of London) omnibus (that's a bus) might consider to be reasonable. So if a cruise line was to take on board a doctor who was not suitably qualified the man on the bus might think this was not reasonable. Of course, this is not relevant unless the ship was in UK waters at the time, but just sayin ......

[Jade13]

I love the U.S. Health system. I maintain an international health insurance policy and, if I ever came down with cancer or something serious, I would definitely go to Sloan Kettering or someplace similar in the U.S.

 

What I don't like are the prices and charging similar prices aboard a cruise ship even though the doctor is Colombian or Indian and not even licensed in the United States.

 

Gunther and Uta

 

On our Last HAL trip the doctor was from the US.