There has been a lot of talk lately about health care, especially in the US, and whether or not the US should adopt a socialized health care system of some form. My reply is "Why the hell not?". Those who are uninsured are paying way too much for health care, especially since they normally wait until a cold has turned into the flu and that has subsequently turned into pneumonia.
Here's my disclaimer, I'M NOT A DOCTOR. I have no clue if a cold can turn into pneumonia. I think that if you leave something untreated then it has the possibility to turn into something nasty and something that is potentially deadly.
I have lived with both health care systems. I must say, that while I was on my mother's health care, I had awesome coverage. United Health Care seriously rocked my world. I could get prescriptions with just a little co-pay. I could see the doctor for just 15 bucks a visit. If I needed a surgery, done and done. No problem. Then I turned 25 and this luxury ended.
I could have gone COBRA and stayed with my mother's health insurance, however, I would also have to sell a kidney to be able to afford it. I figured that since I was still in school, I would stick to the student clinic and I would get some form of catastrophic health insurance. Now it cost me 30 bucks to see the doctor...luckily, I just had to go twice to get a certain pill refilled. The prescriptions for students were also cheaper...I could get my monthly pill for $15 a month. Not bad, considering with mom's health insurance it was something around $10-$12 a month.
The catastrophic health insurance (THANK GOD I NEVER NEEDED IT!!!) was a whole different monster. For people who solely rely on this as their health care coverage, I feel completely sorry for them. If I needed to go to the doctor, I had to pay 40% of the costs...and we all know how doctors LOVE to run all sorts of tests. Also, if I needed, say, my tonsils taken out, I would have to cover $3,000 of the charges, plus 50% of the medications that I would need afterward! Are you kidding me? Who's got an extra $3,000 hanging out just in case. The answer: those with catastrophic health insurance just for this purpose.
I would get NO preventative treatment. If I didn't have the fall back of the student health center on campus, I would have been SOL when I had this awful cough a few years ago. Seriously, those with catastrophic health insurance, or those with NO health insurance, I feel for you. It is these people that get the shitty end of the stick.
Then I moved to Germany and it is like the sky cleared, the sun was shining and the birds were chirping....and somewhere there could have been angels singing. "You mean, that once I'm married to you Markus, I am covered by your health insurance? I get to see ANY doctor I want? I can go to the dentist again?" This was wonderful. Those in the US that get health insurance through their employer or their spouse know that having health insurance is a wonderful thing.
Let me explain a bit about the German health care system (from my perspective of course). If you work, no matter part-time or full-time, you receive health coverage. It is compulsory. You have to take part. You pay a certain percentage of your wages (around 8%) towards your coverage, and your employer pays the same. So, if you don't make too much money, no worries, you pay less for health insurance. If you make piles of money, then you pay more. The rich pay a bit more to cover the costs for the poor who can't pay as much into the system. The Germans call this "solidarity". I would tend to call it equality.
However, if you make piles of money, you have a choice. You can choose to stay on with the public health insurance OR you can choose to switch over to a public health insurance.
Markus explained this to me, but it is super complicated, so I'm just going to dumb it down a bit. If he were to choose to go with a private health insurance, he would have to pay a greater percentage out of his paycheck. Even worse, I would not be covered. He'd have to pay extra for me. The positive aspects of a private health insurance is that you get to the front of the line when you get to the doctors, and you'd get a single room at the hospital. Those are just two "advantages" of private health insurance.
Oh, and just to make this really clear, THIS IS NOT A HEALTH INSURANCE RUN BY THE GERMAN GOVERNMENT! They merely keep a really, really close eye on it and be sure that the costs don't get too out of hand...ok, they basically regulate the insurance companies closely, which is by no means a bad thing.
So, what do I get out of this whole "socialized health care"? I get good health AND DENTAL care that is what I get! Ok, I might have bitched a bit about the hospital rooms, but I have the option of staying in there for about a week and the insurance WILL PAY for it! The hospital won't try to push me out of there the day after having a baby...unless you're like a friend of mine who 4 hours after giving birth to her adorable baby girl, went home. She wanted to do that. But here's the real kicker. Her insurance paid for a midwife to come by EVERY DAY for about 10 days to check in on her and the baby. A house call! A freaking house call! I don't know if you can still get one of those in the US (and no, an ambulance coming is not a house call).
Ok, but back to MY experiences. Every quarter, I must pay a 10 Euro (about $14) ONCE. Once every 3 months!!! This enables me to go to my primary care physician if I get sick, and to my OBGYN for female stuff. I don't have to pay 10 Euro for each visit, even if it is to a different doctor. Nope, just once, to one doctor (normally your primary care physician) and then you get a piece of paper saying that you've already paid your co-pay for the quarter.
Also, on the weekend, if you get sick and need to go to the doctor, you have to pay another co-pay of 10 Euro, but it is just ONCE for the entire YEAR (at least I believe it is the year...if not, it is then once a quarter as well, which ain't too shabby either!).
Oh, and another GREAT aspect about this "socialized health care" is that I get to see the dentist (which is a separate co-pay, but it is still only 10 Euro a quarter). Seriously? A dentist? And if I need a filling, I get it. If I need some other work done, then I can get it. A crown, no prob! I do have to pay a bit extra for these services, but it not near what I paid when I had to get 3 cavities filled in the US ending up costing about $1,200!!! Ok, I didn't have insurance then, but $1,200 for 3 freaking cavaties??? Give me a break!
So now you may be wondering how long the wait is to get an appointment at a doctor's office, and subsequently, how long the wait is once I'm there. The answer, roughly the same as in the US, if not faster. When my pregnancy test turned up positive, it was a Friday. I called my doctor immediately and I got in the following Tuesday. Not bad. I remember in the US, even with my mom's awesome insurance, I would have to wait a month or so for some appointments. Once I got there, sure, we had to wait. It was probably 15 minutes or so. Not too long. Sometimes the wait has been longer, but there were more people waiting then.
One thing that I must add, German doctors do not jump at every chance they get to prescribe you some new fancy drug. They try to go the less invasive route. So, if you've got a cough, you most likely won't get the fun cough syrup laced with codine...they'll tell you to drink tea (which by the way, works just as well and you don't get the trippy side effects). However, if you have such a horrid sinus infection, they will prescribe you antibiotics. I like that they err on the side of caution with prescription meds...have you seen the side-effects some of them have??? They're worse that what they claim to be helping. Your restless-leg-syndrome meds won't help you much if they kill you now will they? And is "restless-leg-syndrome" really somthing that you should be prescribed meds for? Is it really that bad?
So, all in all, I am happy so far with the German health care system. You can say what you want about how evil "socialized" health care is and that it is just another way for the government to spy on you or whatever. But wait until you actually live with it. It is not bad at all! I think that the main fear from lots of people in the us comes from the fear of the unknown. However, if the US uses the UK as guide for socialized health care, I would be against it too! Hopefully the US can adopt some form of the German health care system.
What are your thoughts?
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I was on the private health care for a while here (while I was self-employeed), and I didn't seem much of a difference in the quality of my care. I am back on the public plan now, and I still wait the same amount of time for a doctor's appointment. I got some more tests offered without extra charges on the private insurance, but often the insurance would protest the charges and make a hassle for me. The doctors would usually end up just having me reimburse them for whatever the insurance paid.
ReplyDeleteDermatology seems to have the only noticable difference between private and public here. However, I can get anything I need at the dermatologist and pay out of pocket. I had some Laser treatment done on some broken blodd vessels (pruely cosmetic), and it cost 45 Euros - can you imaine what that would cost in the US????
"If he were to choose to go with a public health insurance, he would have to pay a greater percentage out of his paycheck. Even worse, I would not be covered."
ReplyDeleteDo you mean if he went with private? :) I have public and it covers my husband (whose wages are untaxed [Stipendium]).
Yeah, sorry. I should have made that a bit more clear. If Markus wanted to go with private health insurance, he would have to pay a higher percentage, and then he'd also have to pay extra to have a spouse also privately insured.
ReplyDeleteWith the public insurance that we have right now, he pays the 8-ish% and I'm included. And since I'm self-employed, we have to kind of cheat the system. I am not allowed to make more than 350 Euro on average per month (so, 4200 Euro a year). So I would usually work a lot at the beginning of the year, and then towards the middle of the year, I would turn into "Super Hausfrau". But with the financial crisis, most of the companies that I worked for are cutting costs...and I was one of the costs that they cut...so now I'm a full time "Super Hausfrau". But with the baby coming, that is ok.
Maybe you should change it in the original post so people don't get the wrong idea that public won't cover spouses? :) I love this post and want to link to it but as you know it's such a sensitive issue! People will be looking for reasons to hate on the German public system.
ReplyDeleteI mean the idea is that it will only cover a spouse who cannot qualify for public insurance on their own, right? We must always prove my husband doesn't have taxable income over 400 so he can be covered by mine. But if he did have taxable income then he's automatically covered on his own (as long as it is over 400). So either way, spouses are always covered either by your insurance or their own.
ReplyDeleteCN: Thanks for catching that mistake! I was writing this in the heat of the moment and I guess I slipped up my words, but it has been corrected!
ReplyDeleteYes, the public health insurance covers the spouses who do not qualify for public insurance on their own. Since I'm self-employed, we had to see how we could make the loopholes work for us, and luckily we found a way. The self-employed cannot get public health insurance on their own (or at least I didn't find a way) and I would have to have bought private health insurance, which would have cost us more than what I was actually making, so in came the loophole. :)
This is most definitely a sensitive issue, and is one reason why I posted on it. To put my two cents in on the issue. I was annoyed with friends on Facebook slamming "socialized" health care since that will "put America on the road to communism". (Real quote I got from an e-mail.) But what I really think the problem is, is that people are just super scared of the unknown, and paying a bit more in taxes that will save you lots in the long run.
I don't know. We'll have to wait and see how Obama tackles this beast...but as of right now, from what I've read about his health care proposal, I'm not too keen on the idea. I'll have a post on that later though.
You have to love Facebook friends for showing you how the other half thinks. :) That's pretty much the only exposure I get to actual people on that side of the spectrum. Of my conservative friends they're usually of the intellectual, libertarian persuasion, not your run-of-the-mill American conservative!! It's definitely good to keep me on my toes.
ReplyDeleteThanks for the run down. I too will do the linky thingy to share this information.
ReplyDeleteLink away! :)
ReplyDeleteI usually love my medical care. I feel well treated by my insurer.
ReplyDeleteI've never gotten a referral from the hausartzt to the obgyn, though, so I wind up paying at least twice there and I will often have yet another co-pay because I can't take time off to get the referral. Taking the time off for standard appointments is a significant problem as it is. I would pay a €20 premium in a heartbeat to be able to go in the evening and not have problems with my boss.
My dental doesn't really cover anything, so I paid for a more thorough cleaning. Still cost less than in the States. (I also paid $300 for a scan there, which costs €30 in my doctor's office here. If I had gone to the emergency room instead of spending half the day on the phone, it would have cost $1500 - have no idea what our travel insurance would have picked up.) Medical care in the US can be extremely frightening.
Today, I am in a situation that would be exactly the same in the US. I am travelling soon to a country where I have access to hospital-only care, I have a hautartzt semi-emergency and can't get an appointment. I am considering going to the Bereitschaftsdienst in the evening, but my German husband is opposed. (Urgent care center - where are you when I need you :) )
Also, sharing a hospital room with no curtain is cruddy. Cruddy enough that I am considering taking out an extra policy. Obviously, all of this is better than having health care bankrupt me, but I do know older folks who have financial problems similar to those of folks in the States where out of pocket costs are a real burden. I also know younger people who, arriving after age 29 or having once opted out of the public system can't get into it as self-employed people. There are people without access to public healthcare in Germany.
All that said - what I have NEVER heard from anyone, even on the "how can we frighten you this week?" news shows, is a case of a public insurer denying care or deciding later not to pay for care and leaving the insured with 10s of thousands in healthcare bills. They also can't dump you when you get sick - even if getting cancer means you lose your job.
That is odd that you needed a referral to go to the obgyn! Mine is my "hausarzt", but mainly just so that I can get the "ueberweisung" saying that I've already paid the 10 Euro, so that if I need to go to another doc, I don't need to pay. I see my obgyn a lot more, so I guess this could just be a service that they offer...I don't know.
ReplyDeleteI haven't had any major dental issues (neither has my husband) so I am pretty much in the dark about the dental stuff...I just know for that one cleaning and a little bit of filling it was only 10 Euro.
The fact that you cannot be dropped for a "pre-existing condition" or because you got too sick is one thing that absolutely disgusts me with the US system...and one thing that I like here. Health care is not a privilege! In my opinion it is a basic human right!
Oh, and a good book on why the US health insurance/health care system is the way it is, is: "Dead on Arrival" by Colin Gordon. It is a very well researched and well written book. It is very political (duh!) but I would recommend it.
ReplyDeleteAnd Germany spends ca. 9% of its GDP on healthcare and the US spends ca. 15% on healthcare. Germany covers everyone for less and delivers the results you describe. My 10 years in Germany mirror what you say. So, Germany delivers more for less money. The US is either grossly inefficient or some people are making gobs of money. I wonder who is financing the scare mongering?
ReplyDeleteI haven't lived in Germany, but visited 10 years ago. It was nice but so was everywhere else I've ever lived. Here is the problem with Germany's system and the US system. The users do not pay for the services they consume. I suggest for all you socializ(s)ed system lovers, how about grocery insurance? I mean food costs so much and everyone needs to eat. Someone is making too much money off of food. THe evil food company people are hurting tons of working people by making food too expensive to buy. I mean if I wanted a steak but could only afford a burger, someone is to blame. Food is not a privilege but a basic human right!
ReplyDelete@Anonymous (#2):
ReplyDeleteWhere to begin. I don't want you to feel like I'm berating your or insulting you, but your argument lacks...how shall I put it...well, you need a better argument than the one that you gave. You said that you have never lived in Germany, but have you lived in a country that has socialized health care? And, uh, yeah, we do pay for services rendered. Isn't that the whole point of having health insurance? We pay into a big pot in case we get sick, thus having this pay (for the most part) the services that we need in order to get better.
In the US it is a bit different, since if you work somewhere, you don't have the ability to choose your insurance provider. You get Aetna, United, whichever your employer chooses. In Germany, you get to choose your insurer.
Ok, but back to your argument. Really, comparing health care to food is a bit like comparing apples to dogs...it really just doesn't work. It would be nice to have the steak if I really really wanted it, but if I have to settle for a burger, I will. If I really really need this cancer treatment, but I can't afford to pay for it, or my insurer won't approve the treatment, I die. See. It's a bit different. And food isn't too expensive to buy because of a huge band of "evil food companies". If you would like, you could live a completely vegetarian life while growing your food at home.
So, grocery insurance? Seriously? I need some actual valid points here, otherwise, I really have no idea where to begin to respond. My questions to you: Have you ever lived in a country where there was socialized health care? If so, where and what was your experience? I have found that there are great differences between socialized health care systems...What I have written about in my blog post is simply from my own personal experience. What I have actually lived through with socialized and non-socialized health care. It is still my opinion that health care is a basic human right, not a privilege.
Oh, and yes, I also feel that food is not a privilege but a basic human right as well. That we can agree on! :)
I'm sorry, but you said it disgusts you that in the US you cannot be dropped for a pre-existing condition or because you got too sick? Hopefully that was a typo? So......if this was in the US with my income i would pay $800 a month for public insurance, where i pay $240 a month now for private insurance. And the guy working at McDonalds gets the same coverage for $150 a month?? Im sure that would work soooooooo well in the US. One guy gets a min. wage job and covers his whole family who sits at home working odd jobs so they dont make too much money and all this for 1/5 of what i pay. Awesome....
ReplyDeleteNope, not a typo. That is most definitely how I feel. I am disgusted when I hear about people getting dropped by their insurance simply because they got sick. If you look at what I say, I am talking about a system similar to that in Germany for the US, hence your scenario wouldn't be the case at all.
ReplyDelete