Heilbrigðisskýrslur - 01.12.1938, Page 168

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Medical Fees.
According to the authorized rate of tariffs the district physicians are
allowed to charge kr. 2.00 for a simple consultation, but kr. 3.00 to
kr. 6.00 if there is any considerable examination to be carried out, all
according to further specification in the rate of tariffs. A district
physician is permitted to charge an extra kr. 1.00 for a consultation
away from his home, and 50% more at night than during the day
time. For surgical operations the fees are also fixed, kr. 2.00 to kr. 4.00
for the slightest ones, but they range from kr. 20.00 to kr. 80.00 for
more important operations and extra fixed charges for each day’s
attendance on the patient afterwards. These charges vary considerably
according to the importance of the operation and according to
whether the patient is in a hospital, in the neighbourhood of a doctor,
or far removed from him. The fees are highest for the first few days,
but are then reduced (kr. 3.00—kr. 1.00—kr. 0.50 a day). When travel-
ling the doctor is to be paid, in addition to free means of conveyance,
kr. 2.00 an hour for the first 6 hours, kr. 1.00 for the next 6 hours, and
kr. 0.50 an hour after that. This arrangement is made with regard to
such people as live farthest away from the district physician and so as
not to make the expense of fetching the doctor too great. For journeys
by night and on foot the district physician is allowed to charge 50%
in addition to the ordinary fee. As regai’ds foreigners the district phys-
icians are not bound by the rate of tariffs except for the fact that they
must not charge higher fees than “would be estimated reasonable ac-
cording to the conditions of their native country”. Doctors other than
district physicians enjoying a public salary which is no less than that
received by distxáct physicians, are in every respect bound by the rate
of tariff.
Fees charged by private practitioners are also regulated bv a tariff
by which they are allowed to charge 50% higher fees than the district
physicians, whereas specialists are again allowed 50% more than
ordinary private practitioners but only for treatment belonging to their
specialitv.
There has been a certain amount of discontent expressed by private
practitioners at having to l>e subject to an authorised tariff xxnd most
probably it is not always strictly adhered to. But this is not of such great
importance now as before since almost all the inhabitants of the towns
(and only there do we t'ind private practitioners) are covered by coxn-
pulsory sick insurance and medical aid is provided for them bv a
special agreement with the doctors under which a fixed annual sum
is paid for each person insured. Agreements have also been made
with the hospitals for a fixed payment a day for each patient insured
who goes there, medieal aid in the hospitals being included in the sum.
The Reykjavík Sick Insurance thus pavs the ordinaiw private practi-
tioners kr. 13.00 a year for each insured adult patient who chooses
them for family doc.tors, and kr. 2.50 for each child, in addition to
kr. 0.85 for each adult person. This last being used to balance in-
equality ol' income and mainly as a compensation to such doctors
as have the fewest insured persons in their charge. Specialists get