Today your faithful blogging friend has to go under the knife. Although ambulatory, I’ll be in bed for a bit probably in pain-killer induced bliss and thus unable to blog. However, I’d like to take this moment to note that although I ultimately prefer life in the United States to that in Europe, one thing that is truly superior here in Germany is health care. As a student, I pay 56 EUR a month for health insurance. Due to recent reforms, the copayment for doctor’s visits went from 0 to 10 EUR, however, only once a quarter, i.e. every three months. Once you’ve paid you can go to as many doctors as you want only having paid the once and if you don’t go at all, you never pay. Also, if you are in the hospital, as I will be, you pay a fee of 10 EUR per day. So that means that my surgery will cost me a whopping 10 euros.
Additionally, everyone here is insured. If you can’t afford it, the government pays for you. Health insurance costs are calculated according to your income and one pays around 14% of his income for it, although your employer pays 7% of that. The various health insurance companies are all state-owned although there are also several private companies.
In short, despite my many criticisms of Germany’s social system, I must admit that they by far have a superior healthcare system (although the US is of course the world leader in research and technology). Like public transport and other services, health care should not be a for-profit enterprise but rather a basic public service for all. Regardless of what anyone says, the fact that my cab ride home will cost more than my surgery leaves little room for complaint or criticism.
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Comments to this entry
mkl
March 24, 2006
8:30 am
How many people have covering, more expensive, commercial insurances, so they can use the services of private health care sector?
Is there big difference in the quality of private and governmentla health care?
Just curious...
Mi-Hwa
March 24, 2006
8:57 am
Curzon
March 24, 2006
9:32 am
I ultimately prefer life in Japan to the US, but the public health care here in Japan is abysmal. I've given up going to doctors unless I have at least two recommendations because the healthcare is so shaddy. The US embassy thankfully keeps a list of doctor's with US degrees and training, and much of the expat community goes to them.
YH and I both once lived in the same city in Japan, and he has the best of both worlds in this regard -- Japanese health care is crap and he prefers life in Canada!
Curzon
March 24, 2006
9:33 am
Consul-At-Arms
March 24, 2006
9:39 am
I thought German doctors didn't do surgery. I'm surprised they didn't schedule you for a series of ten (10) acupuncture appointments or some nice herbal tea.
Sudan Watch
March 24, 2006
1:03 pm
Admiral
March 24, 2006
6:24 pm
Although...... such a system of health insurance is a big economic rip-off, overall, a massive waste, if you will. As far as preferring life elsewhere... Australia was pretty nice, but I can't trade the USA-- and its diversity. :)
Alfred Russel Wallace
March 24, 2006
8:49 pm
Plunge
March 25, 2006
12:39 am
Saying this, many times I have had my wife have full testing done in Korea and bring the results back to the US for treatment. This is how we found her thyroid cancer was testing in Korea. Came to the US to have it taken care of though.
R. Elgin
March 25, 2006
2:32 am
Healthcare in the U.S. is a joke, it is a social failure since more people can not afford to get sick. One must screen physicians no matter which country they are in too.
Kenneth
March 25, 2006
4:05 am
There are several problems here. First, you're using "cost" very narrowly: we do not know what the "cost" to society is, and how it compares to a pure free market in healthcare. The US healthcare system is a morass not because it is private, but because it is massively overregulated, "particularly where pharmaceutical drugs are concerned":http://www.stopfda.org . Your argument here seems to revolve around the premise that healthcare is very important, and not necessarily that government manages it more efficiently than private business, in which case it should be subsidized, not nationalized. Nationalization also has endogenous problems: bureaucracies, unlike private businesses, have no incentive to cut costs and step up efficiency (they have every incentive to do exactly the opposite, and the degree of sovereignity they need just to operate means they usuallly get their wishes). Artificially free healthcare, it should be noted, creates a moral hazard as people have a weaker incentive to take care of themselves when the government provides for them free of charge. Finally, there is the economic calculation problem: everything, even healthcare spending, is subject to diminishing marginal returns. On a free market, the rate of profit between healthcare and other sectors would equilibriate (adjusting for whatever externalities may arise) and a state of what economists call social welfare maximization would occur. A nationalized industry lacks this crucially important price mechanism: thus, we do not know how much we should spend optimally on healthcare. And, of course, there is the amount we'd have to spend on healthcare to ensure that shortages do not occur, which, as the "Canadian experience":http://www.fee.org/publications/the-freeman/article.asp?aid=2638 readily demonstrates, can be quite a lot.
Just food for thought from an inexperienced sixteen year old.
Kenneth
March 25, 2006
4:11 am
Mi-Hwa
March 25, 2006
7:34 am
Elizabeth
March 25, 2006
4:12 pm
Kenneth:
1) Universal health care is not free. It's just a different system of insurance.
2) There have been hundreds of notable innovations in the medical world in France and Germany and in other European countries with socialized medicine over the past decades. The reason is that they do profit from this, even if individuals do not end up paying through the nose. It's too complicated to explain here, but I suggest you look up what Europeans are really doing (they have a variety of systems) rather than arguing against communism, which is more or less what you are doing.
3) If socialized medicine is so bad, then why does the United States have the worst infant mortality figures in the entire OECD???? We're behind Guam (no offense, Guamese) for crying out loud. Behind south Korea. I think that we were below Serbia as well- definitely behind Croatia and Macedonia. It's a crying shame and positively ridiculous to assume that socialization of health care will lead to poorer care across the board, just because communism doesn't work. And if the figures are true- they came from our own government after all- it's costing us lives.
Curzon
March 25, 2006
4:37 pm
Chirol
March 25, 2006
4:40 pm
Kenneth: While the US is on the cutting edge of research, you seem to infer that that automatically excludes other countries from making progress. I suggest you consult some doctors or med students about how much research comes out of especially Germany. A friend of mine is doing cancer research now and some of the best work comes from here according to him.
It's no secret that the US system has problems which is why I and others feel that it needs not just a bandaid here and there but a radical overhaul. I stand by the fact that certain services for the public good should not be privatized. Maybe you'd also like to do away with the police and just hire private contractors since they can manage things better than the government?
I agree that the private sector is more efficient than the government but healthcare belongs to the basic services necessary for a modern society and the US system clearly leaves many people behind which in turn causes a host of other problems which can affect everyone. The Moral Hazard Theory is a common and rather outdated critique which has been used time and time again to try and shoot down things like health insurance. Having lived almost 4 years in Europe and having many friends from other European countries I can say that this isn't as much of a problem as you claim. In fact, the Germans have introduced copayments (as I noted) in order to help cut down on unnecessary doctor visits. The Italians also did this (but earlier). The moral hazard theory is easily solved.
Everyone having basic healthcare would actually be cheaper because hospitals and tax payers wouldn't be stuck with so many outstanding bills. It would also help by preventing many greater health problems before they get worse and people go to the hospital and can't pay afterwards. Prevention costs less than treatment. Like the police, health insurance is a basic protection that citizens require which should NOT be for profit because the aim isn't to make money but merely to protect.
And if you still aren't satisfied, don't forget that government health insurance doesn't preclude having private insurance. It's also possible to have that instea d of the public which is slightly better, but only gives you things like a private or 2bed room (instead of 4), better hospital food and other small things. It's essentially the same difference as coach and 1st class in a plane. Everyone gets what they need, but if you want a few extras, you pay a little more. Perhaps you'll understand when you need surgery and have to pay a fortune for it.
Mi-Hwa
March 25, 2006
4:52 pm
moorethanthis
March 25, 2006
5:41 pm
An example: in the village where I grew up, next door to my high school and a local fruit farm, there is a private clinic. People can go there if they pay the fees - if not, they can go to the NHS hospital in the city, and recieve perfectly decent medical care - that is what me and my family did for all our ailments.
Doctors will not be forced to refuse you treatment if you do not have the proper insurance, as in the States. It is a truism that every person who does not choose to pay for private treatment will be provided for. That is the meaning of a welfare state. Although it has many flaws and inconsistencies, I'd rather have have that than a two-tier system, where some are on top and others are on the botton.
Mutantfrog
March 26, 2006
4:04 pm
Glad you're recovering well from the surgery, Chirol!
Eddie
March 27, 2006
2:24 pm
Grendel
March 27, 2006
9:12 pm
I liked the idea of payments on a pro-rata basis since back then, everybody in Germany went so often to the doctors, even twice or three times for the same illness, that the financial burden killed the system I knew since childhood. Of course, in regard to Japanese and dental care, you only go when it hurts ...while precautionary treatment is imperative in this and other medical areas. Finding a balanced middle course is not easy. Since I'm going to the pediatrician with my son, I have deja-vues, you go to the doctors, no need to pay for the treatment, after that you visit the pharmacist, and everything's free (for the little guy). In some cases, like for families (for the children, to be exact) and for the poor, such support makes perfect sense. There's a correlation between poverty and a lower life expectancy, and it's not neccessary.
Chirol, I'm glad to hear that you finally found something amiable about Germany, I'm sure you'll find more if you keep your eyes and ears open. Gute Besserung!
Kenneth
April 2, 2006
6:08 pm
Because people in the US are definitely not taking care of themselves. Besides which, merely being private doesn't make it a free market solution. As I've stressed before, the US system is burdened with massive regulations. I could easily point you to Canada, where people have to wait weeks for a hip replacement. The European system works because they permit private competition.
Chirol:
_While the US is on the cutting edge of research, you seem to infer that that automatically excludes other countries from making progress. I suggest you consult some doctors or med students about how much research comes out of especially Germany. A friend of mine is doing cancer research now and some of the best work comes from here according to him._
It stifles innovation. It doesn't thwart it completely as long as there is still a private sector.
_I agree that the private sector is more efficient than the government but healthcare belongs to the basic services necessary for a modern society and the US system clearly leaves many people behind which in turn causes a host of other problems which can affect everyone. The Moral Hazard Theory is a common and rather outdated critique which has been used time and time again to try and shoot down things like health insurance. Having lived almost 4 years in Europe and having many friends from other European countries I can say that this isn't as much of a problem as you claim. In fact, the Germans have introduced copayments (as I noted) in order to help cut down on unnecessary doctor visits. The Italians also did this (but earlier). The moral hazard theory is easily solved._
How is the moral hazard dated? Given the exponentially exploding cost of government mandated corporate health insurance in the US I'm given to doubting this objection. I was reading _The Wall Street Journal_ recently and it seems that said cost increases have eaten up potential wage gains. Again, the US system is a regulatory morass, so you can't say conclusively that privatization per se is a problem. But even if you maintain that a market will under-allocate resources for healthcare, then it should be subsidized. Heavily subsidized if necessary, but still kept private, since the private sector is more efficient that the public sector, as you have already said.