Germany’s Health Care System: It’s Not The American Way

[and-justice-for-all]

by Uwe E. Reinhardt

From an American perspective, Germany’s health care system represents
a nettlesome challenge. Americans now spend 14 percent of their gross
domestic product (GDP) on health care, while Germany spends less than
10 percent. Yet, for all that heavier spending, the U.S. health care system
has never managed to provide all Americans with secure, portable health
insurance. Evidently, for many low-income Americans without health insurance,
the system now rations health care by income and ability to pay.

By contrast, Germans of all ages have long enjoyed fully portable health
insurance that provides what is effectively first-dollar coverage for a very
comprehensive package of benefits. Furthermore, unlike U.S. patients, who
increasingly find their choice of doctor and hospital limited through the
technique of managed competition, German patients still enjoy completely
free choice of provider at the time illness strikes. In cross-national opinion
surveys conducted by the Louis Harris organization in conjunction with the
Harvard School of Public Health, both German patients and physicians
express relatively greater satisfaction with their health care system than
their American counterparts express with their system.1

The relatively low level of health spending in Germany is all the more
remarkable, because Germany’s population is so much older than America’s:
15.5 percent of the German population is age sixty--five or older,
compared with 12.2 percent of Americans.2 In fact, the United States will
attain Germany’s current age structure only in the year 2020.
In their paper on the German health care system published in this
volume, Klaus-Dirk Henke, Margaret Murray, and Claudia Ade describe
Germany’s current attempt to control the cost of its health system through
top-down global budgeting.

One would think that this analysis would be of great interest to U.S. policymakers, who also are deeply concerned over rising health costs. Indeed, about a year ago, as our debate on health system
reform went into full swing, I published a similar analysis in another journal, also in the hope of informing U.S. policy making.3

More: http://content.healthaffairs.org/cgi/reprint/13/4/22.pdf

[CTyankee]

1. Excellent. Thank you for this. It is helpful, esp. the part about our and Germany's older population

nt

[and-justice-for-all]

2. Your welcome..nt

[and-justice-for-all]

3. Kick

[malaise]

4. I love your health care posts

:yourock:

[and-justice-for-all]

5. I am trying to keep them alive a little longer...

I moved one to my journal because I could not stand to see it sink so fast, I also cross posted it to the Health forum.

[Vinca]

6. The problem, though, is more than "low-income" Americans

being unable to afford to buy insurance. It's also SICK Americans who are cherry picked out once they become ill. Big insurance bails when most needed. All the people who sit on the sidelines with their precious employer-provided policies and rally against public health care need to know that if they become ill they are locked into their career choices for the rest of their working life. A change of jobs is out of the question because another insurance policy will not be easily available and, if you happen to get one, a relapse of that same illness won't be covered. Unless you are fabulously wealthy and can personally foot the bill for a major illness, you're screwed in America.