The German Model is Worth Pursuing

Satchel

2,500+ Posts
It's much better than the for profit system we operate under, imo:

A little background on Germany’s health care system: Everyone has health insurance, and the premiums paid are placed into a pool and distributed among the 200 nonprofit insurers from which Germans can choose. Parents don’t pay for their children’s health insurance, probably as an encouragement to increase the country’s lagging birthrate.

As a group, the insurers negotiate prices with medical professionals. Those too poor to afford insurance have it subsidized. The nation’s health care spending is about 10 percent of its gross domestic product. By comparison, the United States’ spending is 16.2 percent and rising. In 2007 and 2008, 86.7 million people were without insurance at some point, according to research by health care advocate Families USA.

My health care experience in Germany ended 10 years ago when I returned to the United States, so I wrote to my cousin Veronika, a nurse at a surgical unit with 30 beds in Bavaria. Not only does she work in the system, but she also pays taxes that go toward providing her health insurance.

She shared her thoughts on the system — good, bad, otherwise — and I’ll share them with you (for the record, I translated the letter from German to English).

Her monthly income, before taxes, is 2,000 euros, or $2,900. From this, she pays 8.2 percent in a health payroll tax, up to about $1,300 a year. There are people in the U.S. who pay this per month.

“Personally, I find this totally OK,” she said. “It’s not necessarily cheap, but it’s also not overly expensive. Anyway, everyone has to pay into it.”
The Link
 
Well played, Shiner.

There are several systems that would be vastly superior to the inefficient mess we've got (which is somehow getting even messier and more inefficient). Our system needs a massive, complete overhaul.

I'm also completely against Obamacare, which kept the whole wasteful sham intact and passed the bill to the taxpayers. Great "solution," isn't it? Since private dollars can't afford our runaway costs, let's just send the bill instead to the taxpayers. They'll never, ever run out of money (right, Greece?).
 
ObamaCare is nothing more than a giant insurance industry and union hand-out. It's an insurance program that does almost nothing to ensure efficient health care for Americans.

We either need to go to a single payer system or somehow get the government the hell out of health care. The German model merges both and the U.K. system is largely the same way.

The Canadian system is somewhat more restrictive about private health care but again, they only spend 10% of their GDP on health care.

Obama didn't have any real health policy experience. The problem was that all his advisers didn't have any real health care experience. Hind-sight will reflect that Obama's big problem was the people he chose to help carry through his policies. Poor decisions across the board.
 
Satch,

Far more disturbing than either country's health care system is the fact that you lived in Bavaria and left. Not only is Bavaria one of the most beautiful places in the world, it is beer heaven. In the last few months, I've been to Garmisch, Mittenwald, Fussen, and Munich, and I can honestly tell you that I'd happily be a homeless, uninsured bum in any of those cities.
 
Deez, I didn't live in there although I've spent time on the German mainland. The article details the writer's experience.
 
Maybe the German system works because it only handles 81 million people. 300 million(legal) residents. is quite a step up. I'm not saying it couldn't work, but often when these comparisons are made the population numbers are way out of whack.
 
Can we just get over this whole absurd notion that health care should never, ever be rationed? If I were adrift in the Pacific with only a small canteen of fresh water, I would ration it. When I retire and start withdrawing $ from my tax-sheltered accounts, I'm going to ration it.

We have a choice here. We can take the stance that healthcare is just sooooo important, that we're going to give everyone everything. We're going to do yearly blood panels and stress tests on everyone. Anytime you get a headache, come on down for your MRI. Scope the knees of everyone with arthritis. We're going to do absolutely everything to extend the life of every 95-year old -- give them heart transplants, dialysis, put them in the ICU for 3 months on vasopressors and antibiotics. We're going to treat every malignancy, no matter how grim the prognosis, with millions of dollars of chemotherapy, even if such treatments statistically extend life by only a few weeks.

-----OR-----

We can start with the notion that we've got a finite amount of money. So let's spend as little as possible on administration and oversight. Let's put as much of the money as we can toward things that WORK. Things that have value. For example, an otherwise healthy middle-aged guy with community-acquired pneumonia (a disease that used to kill lots of otherwise healthy people). We know that we could pay for a $60 or $80 prescription, and that person will live. Sounds good. Let's pay for that.

Let's use tax dollars to pay for other drugs that have a track record of extending and improving the quality of life. Let's pay for that knee arthroscopy in situations where studies show there's a real benefit to be had. Let's try to figure out what circumstances have shown routine stress tests to save people's lives, and let's only pay to stress those patients.

If you're uncomfortable with the idea of healthcare being rationed, click your heels together and say, "The USA is going bankrupt. The USA is going bankrupt. The USA is going bankrupt." Then read this post again.

Repeat as needed.
 
I talked to a woman whose husband died two weeks after he was hit by an auto while stepping off the sidewalk. He lived two weeks, but never regained consciousness. Hospital bill $700,000. Keeping him alive with no quality of life created a massive transfer of wealth. What else are you going to do?
 
If we "reform" torts much futher they will pretty much cease to exist, which is great until a doctor screws up, your life is ruined and you live on SSI in public housing the rest of your life.
 
Seriously, I was thinking you lived in Germany and used their system. I read your link. Note that there is also a button for quotations. .
 
Generally I agree with you 89.
We will never be able to afford covering EVERYTHING. We might be able to offer a form of universal healthcare but heavily restricted. Then like the German model, the rich will have more options. Overall though necessary procedures would be covered, unnecessary would be available but for cash and not through insurance.

1/4 of all the money paid by medicare each annually is for the last year of a patient's life. It sounds unsympathetic but this is the target area with the most impact.
 
I think the money spent to extend lives a year or two is misplaced.
I know it sounds crude, but there has to be some way to decide, yes we could spend $500,000 to keep you alive for another 3 years or we could spend $1000 for the next 6-months to make you comfortable. I remember a news show was in a hospital doing a story on this and the doctor went in to see a patient who was terminal, his care was costing $10,000-20,000 per day. The doctor asked him, "Do you want to be resuscitated?" To which he replied that he would like to be brought back. I don't know how you go about removing that decision from him, but it is a major drain on the system. Some sort of balance has to be found.

On a related note:
I recently got my total compensation analysis from the company I work for, and I only pay a small portion of my health insurance costs out of my own pocket (approx $300/month). The company has provided us with tremendous health care insurance but it cost the company $17,000 to provide my family of 4 health insurance. That just seems a bit crazy to me.
 
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I'd follow the german model!
 
So satchel, when you lived in Germany how was your experience with the healthcare system? Would love to hear your first hand experience.
 
Son of a son has indeed identified a German model worthy of pursuit. As far as health care coverage, if Obamacare has freaked out a significant portion of the electorate, a Western European style system won't get a serious look until sometime after 2020. Depending on what the Supreme Court says, it may require enormous popular backing and a Constitutional Amenment, or at least a remaking of the court.
 

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