Friday, October 23, 2009
German model could work here
From the RoundTable blog
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Nan Fariss
Fariss, of Roanoke, is a piano teacher and a retired registered nurse.
After reading an article in an international newspaper published in Berlin, "The Atlantic Times," I would like to share thoughts of health care in Germany with those concerned about health care in this country.
The article, "Alleviating fear," was written by an American living in Berlin who is a member of a large group known as American Voices Abroad. The group gets together regularly, and lately, health care has been the discussion. AVA members want to support reform in the U.S. using their knowledge of the German health care system, one they rate highly.
People argue against a strong government role in health care. We should recognize that the U.S. government is already paying 45 percent of all the nation's health care costs through public programs: Medicare, Medicaid, the State Children's Health Insurance Program, Veterans Health Administration, Department of Defense, workers' compensation and public health.
One hears a lot about how unsatisfactory the British and Canadian health care systems are, but nothing about the German program that dates back to 1883 and has proved to be both flexible and robust.
During the last two decades, Germans have tweaked their system, on average, every three years to address problems and keep costs under control. Members of the AVA group wrote: "Having experienced the health care system here in Germany, we feel we can contribute by sharing some information about a system that achieves near universal coverage and high-quality health care at a significantly lower cost than the American system. When Germans get sick, they just worry about being sick. When Americans get sick, they worry about their finances, the repercussions for their families and their lives."
Health care is mandatory in Germany. There are more than 200 nonprofit companies called sickness funds, which comprise the public option. Germans can select from these sickness funds, each of which provides their members with a comprehensive benefit package. These funds may not refuse individuals on the basis of a pre-existing condition or drop them if they become ill. Payments are based on gross income with an income cap of $62,781. Benefits include basic dental care. There are no deductibles and only minimal co-payments. There is no waiting time in case of acute illnesses and emergencies. High-tech diagnostic procedures and treatments are readily available.
The U.S. spends 15.3 percent of its gross national product on health care; by comparison, Germany (with high-quality universal coverage) spends only 10.7 percent. Despite that, the U.S. is lower in measures of quality of care. About 25 percent of every health care dollar spent in the U.S. is used for administrative costs, compared to about 7 percent in Germany.
Comparing costs for various treatments and procedures, the costs in Germany average about a third of those in the United States. Illness and medical bills are also the leading cause of bankruptcies. In comparison, in Germany it is impossible to go bankrupt because of medical bills, and health insurance continues with no change if you lose a job. Germans simply do not have these worries.
Despite the high cost of health care in the U.S., it lags well behind most developed countries in measures of healthy lives such as life expectancy, preventable mortality, infant mortality and proportion of adults with limitations on their activities.
One of the AVA members said, "The underlying principle of the German system, that health care should be financed by individuals on the basis of their ability to pay but should be available to all who need it on roughly equal terms, has been maintained. There is a sense here that it is in everyone's practical and humanitarian interests to promote health and to care for the sick and injured in the society as a whole. We would encourage Americans to consider features of the German system on their merits rather than dismissing them with scare words like 'socialist' or presenting them as expensively bureaucratic, as we know first-hand that they are not. We Americans in Germany strongly urge lawmakers to bring American health care up to the standard enjoyed by others in the developed world."
