Notes on Germany's health care system
1. World's first national health care system
2. Health care is guaranteed to anybody residing in the country, legal or not.
3. Benefits include doctors, dentists, chiropractors, physical therapists, psychiatrists, hospitals, opticians, prescription drugs, nursing homes, health club memberships, physician-recommended vacations trips to the spa, and numerous others.
4. Ample supply of hospitals and doctors, so there's no queue for treatment. Waiting time for elective/non-emergency surgery and emergency care is less than in the U.S.
5. Patients can choose any doctor or hospital, and insurance must pay the bill.
6. There are over 200 insurance plans that you can choose from. These different plans compete for your business despite fixed prices for services and treatments.
7. Insurance plans are known as "sickness funds". They are private entities.
8. Health care providers are private businesspeople working in private clinics.
9. German hospitals are normally charity-run non-profits, but there is an increasing number of for-profit hospitals as well.
10. The private insurance companies negotiate prices with the private clinics and hospitals, and these negotiations are almost entirely government-independent. There is much less government regulation than in the U.S.
2. Health care is guaranteed to anybody residing in the country, legal or not.
3. Benefits include doctors, dentists, chiropractors, physical therapists, psychiatrists, hospitals, opticians, prescription drugs, nursing homes, health club memberships, physician-recommended vacations trips to the spa, and numerous others.
4. Ample supply of hospitals and doctors, so there's no queue for treatment. Waiting time for elective/non-emergency surgery and emergency care is less than in the U.S.
5. Patients can choose any doctor or hospital, and insurance must pay the bill.
6. There are over 200 insurance plans that you can choose from. These different plans compete for your business despite fixed prices for services and treatments.
7. Insurance plans are known as "sickness funds". They are private entities.
8. Health care providers are private businesspeople working in private clinics.
9. German hospitals are normally charity-run non-profits, but there is an increasing number of for-profit hospitals as well.
10. The private insurance companies negotiate prices with the private clinics and hospitals, and these negotiations are almost entirely government-independent. There is much less government regulation than in the U.S.
11. Germany's system is understandably very expensive. In an effort to control costs, Germany strictly controls payments to physicians. They use a "digital health card" (die elektronischen Gesundheitskarte), which, like in the French system, eliminates a lot of overhead by eliminating administrative costs that go into billing, clerical work, maintaining medical records, etc. The U.S. hasn't even totally switched over to electronic medical records, let alone a card that you use for all things medical.
12. Patients are only responsible for co-payments for covered services and treatments.
13. Because Germany's system covers non-surgical procedures, alternative therapies are always given as options in addition to heavy drugs and surgeries.
12. Patients are only responsible for co-payments for covered services and treatments.
13. Because Germany's system covers non-surgical procedures, alternative therapies are always given as options in addition to heavy drugs and surgeries.
14. Premium is a fee that usually equates to around 15% of your paycheck (similar to income tax int he U.S.), split between you and your employer. This is about the same amount taken from U.S. paychecks for medicare and medicaid, but then we pay an additional percentage for our healthcare.
15. Physicians complain about poor compensation. But government and sickness funds are constantly trying to reduce costs. Health care reform is constantly being proposed, but the basic system has remained untouched.
16. Germans are required to pay into health care.
17. Price negotiations are differ regionally, prices are then fixed for every physician and hospital in a specific region.
15. Physicians complain about poor compensation. But government and sickness funds are constantly trying to reduce costs. Health care reform is constantly being proposed, but the basic system has remained untouched.
16. Germans are required to pay into health care.
17. Price negotiations are differ regionally, prices are then fixed for every physician and hospital in a specific region.
18. Sickness funds are nonprofit (no shareholders!). There is thus no incentive to deny coverage. All plans are required to pay any claim submitted. This is also good for cost control because they don't have to pay for the claim-review system for which we pay so dearly in the U.S.
19. If you lose your job, the government jumps in to cover your premium. You thus are covered through the same plan while you look for a new job, regardless of the time during which you are unemployed.
20. It's very easy to switch insurance plans.
21. Competition between plans is tough. A basic care package is required, and the premium is the same no matter which plan you have (percentage of pay), so plans compete by offering perks like quick claim payment, exotic therapies, and free neonatal nursing care.
22. Insurance plan competition is driven by executives' desire to insure more people and thus make more money (think U.S. care insurance)
23. Richest families are excused from mandated insurance coverage. They may choose to buy private coverage from for-profit companies.7% of population takes this route. These alternatives plans may cover fancier facilities or care provided by famous physicians.
24. Co-payments are tiny (around $13 per quarter year)
25. Germany malpractice insurance is very cheap, but litigation is very rare.
26. Other than co-pay, no money changes hands at the point of care.
27. In 2002, a round of health care reforms installed caps in certain regions on patient expenditures per year or the number of patient visits reimbursed per year.
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