The NPR ran a wonderful piece yesterday on the state of Germany's health-care. After listening to it, I was tempted to buy the first available ticket to Berlin and move there permanently. For anyone who has doubts about the viability of the universal health care system for this country, has to listen to this piece. Let me summarize the characteristics of Germany's health-care system.
Contrary to the prevalent misconception that the government runs the health-care system in Germany, the government only regulates the non-profits and profits that are the main providers of health benefits. The citizens pay 8% of their gross income and everyone gets equal coverage: no deductables, no pre-existing conditions, and absolutely no waiting lists for MRI or other specialized exams. Thus, the German health care system is run on the principle of solidarity: the more you make, the more you pay, but everyone gets the same coverage, and no one is left behind. The coverage is compulsory. Those making more than $72,000 can opt out of the system and buy private insurance from insurance for-profit companies, and they get to choose from a list of top doctors.
But as the interviews in this NPR piece show, patients are satisfied with their coverage, and are absolutely behind the idea that everyone needs to be covered.
In case you have an elder to take care of, you are paid to take care of them at home if you do not want to send them to the lonely exile that is the nursing home. In case you get sick at night and need a doctor, you get to call him/her at any time of the night and they pay a visit to your home.
The ability of the system to sustain itself is mostly due to the lower health care costs when compared to the US. And how do they do it? The government heavily regulates the non-profits that run the system and put pressure on them not to increase the prices. They are banned from jacking up the premiums on their clients in case they get sick or as they get older. The doctors' salaries are 1/3 of the US doctors' salaries. The average salary is $120,000. This is a very reasonable income, especially if you live in a country where you don't go bankrupt every time you pay visit to a specialist or have a surgery; and where you can take public transportation and not pay 1/3 of your earnings for the gas.
But for us to have a system that even resembles this one, we have to embrace the concept of solidarity. And America, as it is today, is so far away from this moment.
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3 comments:
I agree completely with the spirit of this post. Problem is, as you are probably aware, there are deep-seated cultural and structural obstactles that would prevent the US from ever adopting such a system.
"Thus, the German health care system is run on the principle of solidarity: the more you make, the more you pay, but everyone gets the same coverage, and no one is left behind. The coverage is compulsory."
Its unfortunate and stupid characteristic of American life, but huge percentage of people in this country think that health care is a consumer product like any other, even though you can die from a lack of it. I try to avoid the essentialist "people will never change" form of argumentation, but the moral logic of neoliberal capitalism seems to be permaneantly etched into the American brain.
"...and where you can take public transportation and not pay 1/3 of your earnings for the gas."
Another reason why the American model of capitalism is falling behind Europe. The Euro model is ultimatley more sustainable.
Well, nice article. But some things are missing. For example, that there are more and more doctors from Eastern Europe and Asia, not talking about nurses and other medical staff. But once they will run of immigrants and than there will be similar problems as in Canada. I am not going to defend USA health care, I believe it's really not working very well, however, as a Toronto life insurance broker I believe private sector should play a part, because lacking money in the system are often realised too late.
Take care
Lorne
Thanks for an excellent point, Lorne. You are right, I failed to mention that. But in answering your argument, I don't think that the Europeans will ever "run out immigrants" since the EU keeps expanding and will soon be forced to liberalize its labor policies. Look at what happened to Ireland once Poland joined the EU: more than 200,000 Poles went to work in Ireland, boosting the economy, sending their money home, but also returning home. So, I think the EU will realize that many of these immigrants don't just want to stay in their countries, but that they actually benefit their economies.
Also, I think that Germany's health care system does include private sector. The non-profit organizations seem to be doing pretty well, and like I said in my post, if you earn more than $72,000 you can opt out of the public system and buy into for-profit private insurance companies. So, the German system is very innovative in that it establishes a functioning cooperation between the private, the non-profit and profit, sectors and the government.
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