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Let's roll with this knowledge, and dream of what can be.
Those of us who live in America know next to nothing about how other countries' health care systems operate. Not because we're stupid or ignorant, I'd like to think, but because we are not allowed opportunities through our mainstream media to learn about other countries, so myths created easily perpetuate. Many of us turn to alternative sources of media or the internet (or both), but still, there's generally so much policy jargon to sift through. THIS is partly why Michael Moore's documentary Sicko left so many in the American public stunned regarding the various types of health access and services that citizens of other nations receive.
NPR did a piece today on Germany's health care system, a system which by the way has existed for over 125 years. For some jaw-dropping action, read the whole article, it's not that long. What really struck out for me was a fundamental difference in the set of values we hold above all else, in both countries. What we tolerate or praise here would not be tolerated there. What we struggle with here in regards to access to healthcare, bankruptcy from medical bills, huge deductibles, time to see docs, are a non-issue there. Obviously there are problems in every system. Here's a glimpse, though, of some of the virtues of the German system we're not exposed to in most of our media sources. Some quotable quotes:
Germany on access to doctors at times of need:
On one particular night, Juergen was the doctor on call for the region. Any German who needs after-hours care can call a central number and get connected to a doctor.
On access to humane and intuitive support services after an operation, as told by a woman who had thyroid surgery:
"Then I came home to my little daughter, who I couldn't really lift up because of my neck having been cut open," Sabina says. "So I asked my doctor, 'What can I do?' And she said, 'Well, your health insurance will pay for someone to come help you in the house.'"
They also pay for support services and money to families who want to keep their elderly parents at home and out of nursing homes. Again, a fundamentally different set of values.
On coverage for everyone:
The health care system... is not funded by government taxes. But it is compulsory. All German workers pay about 8 percent of their gross income to a nonprofit insurance company called a sickness fund.
On SOLIDARITY:
Basing premiums on a percentage-of-salary means that the less people make, the less they have to pay. The more money they make, the more they pay. This principle is at the heart of the system. Germans call it "solidarity." The idea is that everybody's in it together, and nobody should be without health insurance.
This one really got me. I dream of the day (it is possible!) when Americans routinely use the word solidarity.
On the cost to employers:
The big difference is that U.S. employers pay far more, on average, than German employers do - 18 percent of each employee's gross income versus around 8 percent in Germany.
On humanity (FUCK DEDUCTIBLES!)
Moreover, German health insurance has more generous benefits than U.S. policies cover. There are never any deductibles, for instance, before coverage kicks in. And all Germans get the same coverage.
After mentioning they would NEVER move to America STRICTLY because of health care costs for their chronic problems, a couple also notes the embarassing statistic about bankruptcy due to medical costs in America. On DIGNITY:
"It's also the No. 1 reason in the United States that people personally go bankrupt," Sabina translates, "which would never happen here ... never!"
On family coverage:
Nicole pays a premium of $270 a month for insurance that covers her children, too. Nicole pays a single $15 copayment once every three months to see her primary-care doctor - and another $15 a quarter to see each specialist, as often as she wants. She pays no copayments for her children's care --and her insurance even covers her daughter's orthodontia bill.
If you're self-employed you have to buy insurance from a private for-profit company (not the non-profit sickness funds). This is also an option if you make more than a certain amount a year. Interestingly...
But most people don't opt out. Chris says that's because there's a fundamental difference in the way Germans view health care and the government's role - which, in Germany, means refereeing the system and making sure it's fair and affordable.
The German govt regulates the insurance companies, or in better terms, holds them accountable to a basic set of guidelines:
So Chris' insurer can't raise his rates if he gets sick or jack up his premiums too much as he gets older. The government also requires insurers to keep costs down so things don't get too expensive.
And again, on SOLIDARITY:
Germans really hate any hint of unfairness in health care. The fundamental idea is that everybody must be covered and, preferably, everybody should get equal treatment. So the fact that 10 percent or so can buy some perks is an irritant - something Germans complain about but manage to put up with.
I noted that the article didn't mention anything about the uninsured in Germany (those who are not employed or are not self-employed, or who are self-employed but cannot afford the monthly premium). And then I realized that NPR had done a piece on the uninsured in Germany. 0.2 of the population there is uninsured, there are only 8 free clinics in the country, and that's changing for the better as a new law was passed that would allow for the uninsured to be covered. Picking up my jaw again from the floor.
ALSO check out the interactive international health care comparison chart at the NPR site -- you can do head to head comparisons of US vs Germany, Britain vs Germany, Switzerland vs Japan, and other such permutations. It's pretty interesting.
Thoughts on all of this? Let's roll with this knowledge, this new perspective, and dream of what can be. Cmon, pick your jaw up already!
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