October 16, 2008

Healthcare Abroad: Germany

Wayne Glowac

http://www.tennessean.com/apps/pbcs.dll/article?AID=/200809240210/BUSINE...

Many feel that the answer to our healthcare problems is government control, unfortunately, that may simply trade current challenges for new ones. Like this article about Germany’s healthcare. It’s proof that every system has its flaws, and expecting perfection is useless. But for the U.S., decision makers might want to at least take a look internationally for ideas.

Germany’s government insures and provides healthcare for nearly 90 percent of its population. Citizens give up a significant portion of income taxes (13 to 14 percent), but in-turn receive comprehensive care, even after they stop contributing at the retirement age of 65. Those that make enough money can opt out and purchase private insurance.

One of the major differences is that patients act like true consumers; they “shop” for their care. If a wait is too long, a doctor’s demeanor is unpleasant, or an exam was not thorough enough, a patient can simply switch doctors. There’s little worry about insurance because most doctors are covered by the nearly 400 plans available, and premiums are set based on a patient’s ability to pay.

Doctors themselves face actual competition, which is why there is a higher number of specialists in Germany than elsewhere. Patients are not required to have a referral to see a specialist, and often see more than one of what we would consider primary care physicians.

It all sounds great, but as evidenced by the protest, it has its flaws. Citizens have to pay a large chunk of their regular income, and those who can opt out based on earnings can pay for better care. This separates somewhat of an “elite” class of patients who can afford better coverage. And, to keep costs down, the government has not been able to give physicians and employees competitive raises, causing many to leave the country.

Obviously this is a simplification of a large and complex system, but still offers some points for comparison when looking at making changes to our system here at home.

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