How Germany’s Universal Health-Care System Works

How Germany’s Universal Health-Care System Works


Seventy percent of Americans
say the U.S. health-care system is in a state of
crisis or that it has major problems. That’s why we’re hearing a
lot about Medicare for all, including some plans going as far
as banning private health insurance companies altogether. On page eight of the bill, it
says that we will no longer have private insurance as we know it. And that means that one hundred
and forty nine million Americans will no longer be able to
have their current insurance. That’s in four years. I don’t think that’s a bold idea. I think it’s a bad idea. Problem. Senator Sanders, with that damn
bill that you wrote and that Senator Warren backs, is that it
doesn’t trust the American people. I trust you to choose what
makes the most sense for you. Not my way or the highway. One country found a way to
provide universal health care coverage while maintaining a competitive insurance
market that offers citizens more choices: Germany. Here’s
how they did it. In 2017, U.S. health care spending came
to around $10,200 U.S. dollars per capita in Germany. It was a little under $6,000. Overall, Germany spent about 11.2 percent of its GDP on
health care, while the U.S. spent 17.1 percent. Germany manages to cover
100 percent of its population. In the United States, about 8.8 percent of the
population remains uninsured. That comes to about 28 million
people with even more people underinsured. Despite spending less, Germany
has better or comparable health outcomes to
the United States. Studies show that in Germany, there
were fewer deaths that could have been prevented with proper
access to care. In 2013, there were 83 avoidable
deaths out of every 100,000 people in Germany, while the
United States had 112. Life expectancy in Germany is 2.5 years higher than the United States,
and the infant mortality rate is lower in Germany, with 3.3 deaths per 1,000 live births
as opposed to 5.8 deaths in the United States. Additionally, the maternal mortality rate
in the United States is more than 2 times
higher than in Germany. So how does Germany manage to
have better health outcomes while spending nearly half as much
as the United States? Germany is a system that would
look familiar to Americans in that everybody buys health insurance from a
private company and then the doctors and the hospitals and the
labs are almost all private. That’s T.R. Reid, author of the
book “The Healing of America.” He traveled the world exploring different
health care systems and how well they worked. But it works better in
Germany for a couple reasons. One is everybody is covered. Everybody is required
to have insurance. Everybody’s in the system. The insurance companies can’t turn you
down because you had cancer last year or something, they
have to take you. They have to cover you. Everybody has access to the same
treatment and all the doctors. You can go to any doctor without
any limits set by the insurance company. In Germany, health insurance is
mandatory for all citizens and permanent residents. There are two different systems that
residents can turn to for insurance. SHI, which stands for
statutory health insurance and PHI or private health insurance. German citizens are eligible for PHI if
they make more than a roughly 60,000 U.S. dollars per year or if
they are self-employed . Citizens making under that threshold
must pay into S.H.I. S.H.I is made up of a network
of competing, not for profit private health insurance funds known
as sickness funds. In S.H.I., dependents are covered free
of charge and monthly costs are capped around 840
euro per month. Even though S.H.I sickness funds
are not government agencies, many Germans think of them as part of
a public system because of heavy regulation. Keith Tanner helps expats
navigate the German health care system and he considers SHI
sickness funds quasi -public organizations. Basically, they have to
do what they’re told. They they are told by the government
in what range they can charge. They they’re told what health procedures
they can fund and they are told by the government who they
can accept as clients so they’re really just carrying out orders. They’re basically charities. They don’t exist to make a
profit for investors like American health insurance companies. They’re there
to keep people healthy. That’s what they’re there for. They follow all sorts of
rules that American insurance companies wouldn’t dream of. This system is funded through
compulsory contributions based on a percentage of citizens’ salaries with
employers sharing the costs. There are also built
in safety nets. The government will pay into S.H.I. on behalf of the
long term unemployed. Despite being non-profit organizations,
sickness funds compete for customers by offering specific
coverage and perks. This competition has changed over the
years as the system has allowed citizens more choice. As of 2019, there are about
100 statutory health insurance companies, but there used to be many more. When Germany’s system was first
established in the late 1800s, sickness funds were linked
to a person’s profession. It used to be that people were
assigned to a specific sickness fund based on their
occupation or region. Now Germans can choose where they enroll
and they can change funds on a yearly basis. As a result, sickness funds begin
marketing themselves in order to retain customers and
attract new ones. This also led to the funds
merging so they could become more competitive. Some of the sickness funds
offer perks that might seem similar to credit card rewards. You still can get a bonus for going
to the gym and a bonus having a checkup. This is in
the public system. And if you get a certain number
of bonus points, then you get a voucher. But kind of trivial stuff like
200 euros a year or something like that. 200 euros a year. Nothing which is particularly relevant
to the person who’s paying their 840 a month. As of 2017, roughly 87 percent
of Germans receive their primary coverage through S.H.I. and 11 percent of
the population through P.H.I. The remaining population, such as
soldiers, police officers and refugees receive health insurance
through specific government programs. All individuals
insured through P.H.I. pay a risk related premium with
separate premiums for each dependent. These risk based premiums mean that
costs will increase as the insured gets older. As a
result, the government regulates P.H.I. so people don’t become overburdened
by premiums as they age. The biggest issue with private health insurance
if you opt out of a public system is affordability
in old age. If you don’t impose these financial
constraints on insurers, then the government will be lumbered about a whole
lot of old people who reach 85, 90, 95. It’s gonna be totally able to
pay for their health insurance, so it’ll all fall back
on the government. Once someone switches to P.H.I., they can not switch back to S.H.I. in the future. But Tanner says
there are ways around that. If you’re a freelancer in the private
system, you just can’t get a job paying less than the threshold. Any employee earning under about 5000
euro a month is required to have public. If they own more than
that, they can opt out. So if you are a freelancer, you
want to go back into the public system for some reason. Then you’ll get a part time job with
a friend, pays you 500 a month for a few months, and then
you react in the public system. So there are ways to do it. The
only reason you probably want to do that, though, is if you have
lots of children, because children can be covered free in the public system,
in the private system, have to pay separately for each child. Germans can also buy supplemental
private insurance while staying in S.H.I.. For example, many Germans
buy supplemental dental insurance. The public system pays like for
major dental work, about half the cost and then you get supplementary to
take it up to 80, 90 percent of the cost. Germany’s system is not perfect. With so many different insurance
companies, there’s a lot of bureaucracy that contributes
to costs. One of the financial things thinking
it’s a big system administered by more than 100 organizations is
called krankenkassen, each of those has a head office and a president
and vice president and a financial officer, a whole lot
of unnecessary bureaucracy. This may be one of the reasons that
the German system is not as cost effective as other
European countries. More than 30 percent of both
Germans and Americans felt bureaucracy was a major issue
in their country’s system. Wait times can also be an
issue for people in S.H.I. Thirty seven percent of Germans cite wait
times as one of the biggest problems within their system, while 22
percent of Americans feel the same. Generally I think people are quite
happy with the public system. It works reasonably well. The major issue in big cities
— I’m in Berlin, Munich, Düsseldorf, Hamburg. It can take quite a while
to get an appointment with a specialist. It is the case that
the doctors prefer private patients because they own up to three times
more if they see a private patient. So what can the United States
learn from the German system? Germany has managed to balance
cost controls and universal coverage while also maintaining competition. And Germans generally
like their system. In one survey, not a single German
said they had to wait more than four months for an elective surgery,
while four percent of Americans said that they had to wait that
long for the same kinds of procedures. And only 7 percent of
Germans said they experienced a barrier to care because of cost in
the past year compared to 33 percent of Americans. Those citizens really like it. They like the fact
that everybody is covered. They like the fact that
the costs are totally predictable. You know what it’s going to cost
you and how much your insurance company is going to pay you before
you walk in, unlike the United States. They think it’s normal that
the insurance company pays every claim. They can’t believe that insurance
company might deny a claim. And they think it’s normal that
they get to choose the doctor. They don’t understand America, where
the insurance company says we won’t cover a doctor Jones. You have to go
to Dr. Smith instead. So the main thing I learned in going
around the world is you have to make the commitment to provide
health care for everybody. That’s the destination. It turns out there are many
different routes to that destination. I found, you know, the Canadian
model, the French model, the British model, the German model. They all get to this goal
in different ways and different models. So I don’t care what the model is. I think it’s important that you
make the commitment to cover everybody. And this is something
the world’s richest country has never done.

100 thoughts on “How Germany’s Universal Health-Care System Works

  1. I believe a single payer system is the most obvious way to go in the U.S. All we need to decide on is which model would we should use because clearly what we got going on now has failed.

  2. Nice job showing a rebuttal to bernie's healthcare plan and not showing the idea behind it. 🙄 As to be expected from NBC

  3. "More choises" means better healthcare for the rich, without being a part of the working
    society and contribute to a universal health insurance.

  4. When you ever been sick in a german hospital with SHI with six sick people in one Room you understand the difference to PHI in a single room by your own (of course you have the oppertunety as a SHI person to pay a extra of about 3000 Euro per month to have your own room, for PHI it is for free!)

  5. German healthcare-system is also not doing well. I would definately not use it as a good example.
    We have a great lack of nurses, doctors and money to pay them properly. A collapse is only prevented by a tremendous amount of unpaid overtime hours and poor payment.
    To fix that we would need to increase our monthly insurance dues drastically.
    Though i already pay around 10% of my monthly income for insurance (my employer pays another 10%).

    – From a medical doctor at a german university hospital.

  6. When you have a PHI in Germany you get different and better food in comparison to a SHI person without extra costs in the same hospital!

  7. It’s very simple. American politicians are in bed with large Pharma, the money these lobbyists make from insurance and pharma companies has turned their moral compass. There is absolutely no way a decent moral human wouldn’t want everyone to have medical care unless it took money from their pockets. It’s greed..plain & simple.
    America keeps telling the world that they are the greatest country on earth..they’re a long way from that title

  8. I am a german and i am in the public insurance system. I pay about 7,3% of my income. If i am sick i go to the doctor. The visit is completely covered. For drugs i pay about 10 Euro. The rest is payed by the insurance. When i am to sick to work the doctor gives me an excuse and i give this to my employer. End of story. I am paying more than i „use“, but it is ok. I know that i am covered when i have a serious disease. I dont have to think about costs.

  9. I am from the Czech Republic. I had a serious accident, injured my arm severly, had 2 operations, had to take medicine, spent few weeks in a hospital. Did I pay anything extra except 4 % of my income as mandatory healthcare insurance? No. Later I got diagnosed with a serious illnes with my blood, I take medicine ever since, visit specialist often. Again, at no extra costs as if i got a flu. Now that is what I call social security.

  10. Hmm…private health insurance providers can exclude certain diseases or raise the costs in case you want certain diseases covered. And there are uninsured people in Germany. It's rare, but even this system fails people.

  11. I'm german and SHI injured, the last summer a I had serious problem with my shoulder, it take me 3 weeks to get a kind of x-ray, if you are PHI injured they ask you if you want to come today or tomorrow, they get up 3 times the money for the same work if you are PHI!

  12. The American people are stupid regarding health care. They are being ripped off and yet they still vote against their own interest. Every western country except the US has universal healthcare. In France we have a hybrid system taking the best of private and public health. Everybody is covered and dependent on your income and desire then mutual insurance is purchased. The NHS in the UK is funded by national insurance collected at income source. It's underfunded by the present goverment but it's still damn good.

  13. That's the reason why I hate this SHI system in Germany, people with certain diseases avoid the PHI because of higher rates and go into the SHI where no extra costs, also people with many children also avoid the PHI, because you have to pay extra for every child in PHI, In SHI no extra costs for children.
    The result is the PHI have the right cheap Patient and the SHI have the wrong expensive patient!

  14. smth to ad to the private insurance model in Germany-
    You can also be "born" into it or get it by proxy. When a parent goes private and they have children under 18 years they're required to privately insure those children as well. And when those children turn 18 they can decide whether they remain private or swap to public.
    Furthermore, if you're privately insured but you didn't get sick during the year (aka you didn't make any big claims to your insurance) you actually get some of your money back that you paid them for the year.

    What they didn't mention though is that you can NOT go to every doctor you like when you're publicly insured. ast least not for free. some doctors specifically only take private patients cause they 1) get more money from them (aka they can write higher bills, smth that really needs more regulation) and 2) they can do certain procedures that would be too expensive or is very uncommon for public doctor.
    being privately insured in Germany usually means you get access to the doctor and/or treatment you need much faster, you can demand which surgeon you want, get a single bed room in a hospital etc and you also have access to things public wouldn't pay for. BUT you gotta be very careful with your insurance policy and read the fine print cause certain treatments will only be covered e.g. 90% so you need to be aware that you have to chip in (e.g. physiotherapy).

    overall Germany has a good system cause when people need help they always get it.
    It only gets more complicated when things become chronic or you have smth that is very uncommon because whatever is not written in their rule book dictated by the law won't get covered and this can lead to massive issues as well. (the law just can't keep up with certain things quickly enough)

  15. The swiss system is even better than our German system. Everyone MUST pay into SHI, if you are wealthy and want private insurance, you can get that on top.

  16. the German health care system is struggling as well though and it's getting worse. too few nurses, too few doctors, too many patients and the hospitals are turning into businesses putting immense pressure on doctors to discharge patients as fast as possible. it's still a great system, but it's far from perfect and needs change soon.

  17. also the majority of new procedures, new products, new research comes from the US because they have more money to spend

  18. As you mentioned in your video the German Healthcare system was the first of its kind in the world and was only changed and modernized around the edges over the decades. The main reforms were just expanding the system by introducing new public funds for new professions until the seperation by profession was eliminated.

    The reason no political party dares to run on substantially overhauling that system is not because we Germans think it is the best possible system but because the system kinda worked for everyone for so long. Never touch a running system.

    We didnt "manage" to keep choices etc. That is just how the system developed when there was no other country to copy or learn from.

    I find it outrageous that richer people can opt out of public health insurance funds. I would rather have one income-based health insurance fund for everyone (Single-Payer like Bernie's M4A). Nationalized health care like in the UK would be great. The system we have Germany kinda works so better not touch it … But it could work better.

    You in the US have the opportunity to build a system learning from what works in other countries but also from the problems and you shouldnt half-ass it like we did in Germany.

  19. I'm from a country where it's not mandatory for us to have health insurance. So I used to pay nothing monthly for the insurance.

    And now I'm living in Germany as a student with 720 Euro/month from my student blocked account. I used to have private health insurance here and paid like 30 Euro a month. It's an acceptable amount but just a bit annoying because the cheap private insurances (which are popular among language students) are not so well recognised. After I got accepted in uni, I had to change to public one… from 30 Euro to 130 Euro a month… Well, from having to pay nothing in the home country to having to pay ~18% of my money each month… is quite a lot but I really feel that the 18% is worth paying (even though I don't go to see doctors so often) because I know that they take good care of their residents and make sure everyone deserves what they're supposed to get.

  20. It works because the US is pumping 3.6 trillion dollars into NATO so European nations don't have to defend themselves. Money that would be spent on defense is now used for "healthcare ". You're welcome. Again. For the 3rd time.

  21. Commitment to universal coverage is the first step to fixing our healthcare system. Start with a public option and more regulations on private insurance, and if we could get the majority of people behind it, make health insurance a requirement.

  22. This is just a silly way of getting around actually just having Medicare for All. It's government, not being CALLED government. How silly. Just stop. Just give us Medicare for All, already. Stop with the insurance. We don't need it, or want it. There is no reason to have "competition." There is no reason to make it complicated. There is no need for "choice" that no one would understand anyway. If you make the program properly all-inclusive, what is there to "choose" between? People think they need choice, so Germany gives them this silly false choice to keep them happy. Ok, whatever. I personally would see that as being patronized. Just… create the damn system and give it to everyone. Done and done. Stop trying to complicate and trick people with feel-good but meaningless words. BTW, Medicare for All as proposed INCLUDES DENTAL.
    Just give us Medicare for All and stop trying to game us!

  23. These 840€ St 3:43 are for the whole Social-Care-System. You pay these for a lot of Services: Almost free Healthcare; Getting paid if you're sick and can't go to work; Pension at the age of 67; 60% of your last net income for 1 Year (or even more) in case you loose your Job, after this time rent for a small flat and ~430€ per mounth; Care in high age, and a lot, lot more…
    If you earn less money, you also have to pay less for these Services.
    The German tax System is simular:
    You pay pretty high tax rates, but you get for this: Free education at kindergardens and universities; free Job schools, money for further education so you don't need to get a part-time-job while studying; Kids at school get free Tickets for public transportation; Hightest quality Maintenance and expansion of infrastucture; etc….
    And also here: if you're married, you have children, you're income is low, you're single parent or widowed, you pay much, much less taxes.

    The German way is, that everyone has to give, so everyone has a benefit from the good economy.

  24. America claims to be the biggest defender of human rights in the world. Yet, every large- and medium-size American city has tens of thousands of homeless citizens who don't have shelters, much less healthcare.

    During cold winters and hot summers, many poor people die from the extreme cold or heat.
    Why can't the U.S. government guarantee even this very basic human right to its own people?

  25. First the guy is wrong German health insurance is not all privat neither are most of the doctors. Hers how it works there are governmental health insurance companies and private ones the privat ones you can get insured with if you are self employed or earn above a certain amount per year.

  26. But by law every resident of Germany must be insured. Doctors can always treat privatly insured people but those who are insured with a governmental insurance the doctor either has to have a licence from the lassen aerztliche Vereinigung. Hospitals are where this gets complicated.

  27. The fees for the health insurance company is played by you and your employer 50/50. Regardless of type of insurance.

  28. I encountered longer waiting periods to make appointments during 20yrs. the US than during 25yrs. in Germany. Not sure what he is talking about.

  29. Guten Tag.
    I am German, and I have to say, I hate our system, and I love Bernie's idea of health care. The thing is that we have a massive Problem that isn't really talked about in the video. We have a 2 class system. My father earns over 60k per year, so I am privately ensured. That means that I always get better treatment than all of my friends, I never have to wait, and I always get the best medicine. My friends with poor or middle-class parents are not getting all of these things. That's because the doctors are paid more for private insurance.

    (Sorry for writing mistakes, I'm not a nativ speaker)

  30. First of all health care is free. It msy not be top of the class but u can get patched up and on your way or if you rather just visit a doctor and get 50% of your prescription. No country is perfect our ego is just blinding

  31. The US doesn't need to copy the UK, or Germany, or Australia, or Singapore, or anybody. What the USA does need to do is introduce universal healthcare, whether by single-payer, multi-payer, for-profit insurance companies, non-profit insurance companies, government-managed insurance funds. Just get it done.

  32. Germany……. funny thing to know; During Hitler's reign healthcare was free for the "working class", the rich had to pay a small sum . In the Netherlands we implemented this system after the war in "ziekenfond" for the working class and "particuliere verzekering" for those with an higher income. Until they implemented those "insurance systems" based on American healthcare.

  33. And we don't even have the feeling that we pay for our health insurance. Have of the monthly fee is covered by the employer and have is “taken away“ from the salary before the net is payed out. It's just totally normal.

  34. As a german male nurse i can say alot of the things here are right, but the system in germany will crash soon or will be much more expensive in the near future for everyone because every nurse has to manage round about 15-20 invalid person every day coz they changed the system in the beginning of 2000 that every kind of illness is rated in Diagnosis Related Groups (DRG). So the insurance pay the hospital set rate money and when the invalid takes longer to get healed he costs the hospital money so the hospitals try to compensate that with alot of operations every day while the nurses almost collaps…

  35. The USA is to corrupt and immoral to ever allow a universal health care system and they are to dumb to demand it. No freedom….

  36. I mean German systems has some perks too..I'm paying 100 a month as a student and almost never go the doctors..However can't even get my glasses paid by insurance. Extra 250 bucks to pay is just nice.

  37. Thank you for these series. It needs wider circulation. We need a generous patron to distribute this so more Americans realize how much better healthcare can be and what we can learn from other countries. All this bragging about choice and how good care is in the US is just that. Bragging. To mislead the public.

  38. we have the same system as Germany back home and I love it. yes non serious Check up may wait a while but I never have to worry bout paying for it. and even if I went to a private doctor for a check up,the ones not covered by national health insurance I'd still pay less than a person in US

  39. Why did you pick Germany as a comparison? The Netherlands (just to name one example) has a very similar system and does better in literally all of the measures/charts that you show, except for deaths in child birth. The latter being explained by hospitals in the Netherlands going much further than those in most other countries to try and save the new(-to-be)born’s life where in other countries the child is given up on earlier (look it up, it’s well documented)

  40. Finally a mainstream media station does a good job of covering medicare for all. Many american politicians are paid by the insurance industry to spread mis-information sadly voters belive their lies. Under medicare for all you could see any doctor and any procedure would be covered, you wouldn't have to stay in a job you didn't like to keep your insurance and if you got so sick you couldn't work you'd still have insurance. You would have alot more freedom to choose under medicare for all.

  41. Hah you’re talking about Germany’s healthcare it’s really not the optimal option take a look at Denmark Germany’s is just the bare minimum

  42. They really need to point out that I'm paying almost 50% to taxes for this "cheap" coverage. I pay for it in my taxes I would love to only be paying 32-35% in taxes

    Organization for Economic Cooperation and Development reports that we has the second highest tax rate after Belgium when comparing 35 developed countries around the world. I would hope that everyone would consider this while watching articles about our healthcare system. I don't pay as much as the Americans do for health care while at the doctor but its deducted from me over the years.

  43. In America ( where I’m from)
    The people on the top are not concerned with the average citizen. The pharmaceutical companies,the health & insurance companies have been called out by everyone for price hikes, but because they have what we need and they have the money, they also have the power. Simple as that…. and it’s not going to change anytime soon I’m afraid.

  44. Another quick point
    "United States leads the world in medical innovation.
    In addition to the best and brightest practicing medicine and state-of-art medical facilities, we have benefited from having the best and, usually, the earliest access to the latest medical technologies and innovations. In large part, this is because they were discovered, developed and produced here in America." from Huffppost

    https://www.brookings.edu/research/the-global-burden-of-medical-innovation/ Read if you want some education on these issues.

    If they had a system like us there would be so much less development for rest of the world benefits from.

  45. As a german I fully support Bernie Sanders Bill and I can tell you that there is a big debate in germany to get rid of the Private Insurance.

  46. 9:34 chart is elective surgery: is surgery that is SCHEDUALED in advance because it does not involve a medical emergency.
    Semi-elective surgery is a surgery that must be done to preserve the patient's life, but does not need to be performed immediately. were is that chart. or the one on emergency surgery.

    number or people = physicians this all plays into account

    USA 24.5 per 10,000 people
    DEU 38.9 per 10,000 people

    trying to mislead people with some level of honesty isn't honest. CNBC needs to do a better job of reporting on the whole picture – make charts

  47. Of course the US-System is "legendary" in a bad way, BUT the German one is not always as fine as you might think:
    A few examples:

    – Like any other insurance the so called "Krankenkasse" (Health insurrance) is constantly trying to tell you what kind of medication you really would have needed, and especically what you would have NOT. Losing a ill family member often means to fight for your promised payement from the insurrance.

    – Some people migrate to Germany not to live here, but to get medical treatment. Afterwards they go back to their homecountry. Almost like a "tourist", but the treatment is often paid by the German insurrance.

    – We got high-quality-hospitals. That´s right and nice. But speaking for the rural areas of Bavaria we got to less of them. Not just to less very good hospitals, but hospitals at all and the few ones which are left are croweded with patients on some days.

    German healthcare is better than the US-System, but it´s not the "land of hope and glory"

    Greetings from Bavaria

  48. Wish someone would compare each state to see which had best healthcare. The best state would obviously be the one to duplicate and improve on. Keep the federal government out. There is a lot of room for improvement but I’m not the person to remark further cuz I’m not in the industry. I can only surmise that it’s easier to manage healthcare when it’s a smaller country but again I can’t be sure. All I know is I’ve been well taken care in the past of but it comes at a price. Cheers Bill

  49. Americans cannot enjoy the benefits of free healthcare system like the UK or Germany because of America's military spending which is used to protect Europe. Americans are suffering from diseases and financial insufficiency because they are literally paying for Europe's safety. All these countries get to enjoy free healthcare and lesser working hours and spend time with their families at the expense of us Americans who are literally dying from student debts and incredibly expensive healthcare system.

  50. You missed out to mention that freelance artists (covering many different 'trades') are covered by the 'Künstlersozialkasse', which covers half of your costs. It also pays into the state's pension system, giving artists a chance to actually have a pension like employed people. More here: https://www.bbk-kulturwerk.de/con/kulturwerk/front_content.php?idart=3194&idartlang=3572&idcat=174&changelang=7

  51. Well. I used to live in 4 different European countries: Luxemburg, Belgium, France and now, for almost 6 years, in Germany. So 4 different Medicare systems and I have to admit that the german Medicare isn’t the best. For me, it’s the french system.

    In Germany you have to pay every month in the system even if you are jobless, you don’t get unemployment benefits and you don’t have money. You have to pay every month! Even if you don’t need it. And I’m talking about the SHI. I was in this case for certain time. My Mom has to pay for me because I wasn’t allowed to get unemployment benefits. If I would unsubscribe myself from a insurance and go back 3 months later I have to pay these 3 months I wasn’t subscribed in + a 5% penalty/month I wasn’t subscribed. Oh yes! This is a very fair system. 🤦🏼‍♀️

    In Germany you have to wait a long time to get an appointment with a specialist because they are not allowed to exceed a number of patients per month. Even a general practitioner. If they do so the doctor has to pay a penalty to the medical association. So I you are looking for a new general practitioner. Good luck. You will have to call them and ask them before you want to make an appointment if they take new patients. There is a neurologist in Berlin. She has to pay a penalty of about 500.000€ because she wants to help patients. And specialists in general prefer to have patients who are in the private system than in the SHI. Because they get paid as soon as possible instead of a patient who is in SHI.

    I’m chronically ill and I got surgery for 4 times in Germany and I have never seen the surgeon. I always saw the medical assistants. Everyday another one. And I was in a teaching hospital! Patients who are in the PHI get all these privileges. Due to my chronicle illness I have to take special hormones and guess what no insurance paid for it. I had to paid this special treatment I need by my own. And it costed me 478€. Every time!
    Many insurance companies have access to your medical record. There are companies who calls doctors to worsen patients diagnosis because the companies get some bonus from pharmaceutical companies. Many companies work with pharmaceutical companies that you can only get these medicines for a special price instead of other good medicines. So lobbying as it’s best.

    It’s different in France. If you are jobless you only pay when you need to go to see the doctor and you get a big amount of your money back. In France you see the surgeon before and after the surgery. Everyone is treated the same way in SHI. Everyone get the same privileges, except if you invest in a additional insurance you can get a single bedroom for example. But this insurance costs a lot less than SHI in Germany. And it’s voluntary. I only had to pay 24€/Month and I got all my treatments paid. Even dental care 100% money back. I didn’t have to pay 400€ to get my hormones.

    And if you think that you are not being fired when you call in sick. Well it’s everywhere the same. If been fired 5 times since I live in Germany due to my chronicle illness.

  52. i really enjoyed the rage of some us-citizens here with their "you have lower homeownercounts that we have etc". yeah… its easy to be on top with stuff when its cheap.

  53. I think the underlying issue is the society's approach to the question of solidarity. I'm not saying that we Germans are "better" at this per se. If a tornado hits Oklahoma or a Hurricane destroys a village in Florida, I always see pictures of great solidarity between people, so solidarity definitely exists in American communities to a great extent. But when it's about solidarity in a more abstract and less direct sense, when it's enshrines by law or given legal guardrails the way it works in Germany with insurance providers, there seems to be great scepticism from the general population in the US. It should also be noted that this system was introduced in a specific socio-economic setting in Germany and was maintained and occasionally improved for over a century.

    I pay 120€ a month, even though I am not sick, now, or in the foreseeable future. And that money is used, every month, to provide healthcare to other people I don't know. And perhaps I won't be needing healthcare for the next years or even decades. But on the fundamental level I understand that this system and this approach to solidarity is the only sustainable way to maintain good healthcare within my country.

  54. Bismarck invented the health care system to avoid socialism in the Second German Empire. And so it was. And it works until today.

  55. meanwhile brazilians are trying to get rid of public service because it's a "communist threat"
    i wonder if they know that in the U.S you'd have to pay a huge amount of money just for calling an ambulance…

  56. You do get basic treatment covered by SHI but there is still the problem that no hospital has time for you. They are under extreme stress and underpaid.

  57. If almost 10% of the population is uninsured, that means 10% of the nation's health issues will be treated by the ER at about 10 times the cost.

    What is less efficient than a bureaucracy? 5 bureaucracies. Aetna pays 81 cents to health care providers per dollar collected (19% admin costs). Medicare has a 3% admin cost.

    One system of paperwork for a doctor's staff to learn means much lower admin costs for doctors. The multiple paperwork systems doctors and hospitals have to deal with raises medical costs up to 30%.

    Also note that while Germany is kicking the US, it sucks compared to public.

  58. Nice video. The USA healthcare lobby has done a wonderful job in framing the debate on who pays instead of cost, effectiveness, and efficiency.

  59. Publicly traded, for profit health insurance companies do not offer one single thing to the average American. They drive up costs and deny payment when you get sick. They are just a giant paywall between you and your doctor. They're they snake oil salesman of the 21st century.

  60. Joe Biden had the chance with Obama to implement a public option, cost controls, etc. and they didn’t do it. Time to step aside so we can finish the work for you with Medicare-For-All, a fully public insurance system but doctors, hospitals, clinics, etc. stays private but get reimbursed by Medicare.

  61. German here:
    The biggest problem in our System is, that it has these two classes. The private insurances pay more to the doctors, which has 3 effects:
    1. public insured people get way longer wait times, because the doctors keep slots free for private patients who might come.
    2. public patients get shorter appointments with doctors, wich can lead to insuffient care.
    3. More and more Doctors move to urban areas, because more rich people(and thus more private insured patients) live there.

    This result in extreme cases in which people have phoned a doctor, and get an a pointement in months ahead, but then remember they got supplemental private insurance for that procedure, phone again and get a same-day appointment.
    I would never want the current system of the US, but Bernies plan any day.

  62. I had to stay in hospital for about 5 months and stayed in a rehabilitation centre for 2 more years and basically had to pay nothing except the 10€/day fee for 28 days each year

    I think 2 weeks of rehab in the US would have financially destroyed me

    I don't mind waiting for an hour or two to see a doctor, if I get free healthcare

  63. For mostly atheist and agnostic believer as germany were, oddly enough they are the most christian, as in what Jesus command "help the poor, weak and needy, give food to.the hunger, " etc and all that.

  64. Something important to add: There is an ongoing discussion about bringing everyone into the same system. There a numerous differences for people with just public insurance. Waiting time might not be 4 month but anything longer is simply unacceptable. There is lot’s of free appointments on specialists side, I myself could get an appointment like immediately or tomorrow at least, just because I own a private insurance. Seeing my parents waiting for month with serious diseases makes me wanna sacrifice all my own advantages, many people do think the same way. In fact, every doctor has a quarterly limit to spend on people with public insurance. As you might guess, the limit is way too low so after the middle of a quarter, you have to start begging your doctor to get some expensive, but necessary treatment or examination. This is unworthy.

    So yes, in comparison the German system might explain what you miss in America. But it’s actually better to look for other european countries like the Netherlands or one of the scandinavian countries (this is actually a general advice – the all are better in almost everything when it comes to social living and politics).

  65. I'm too lazy to google it, but maybe someone here knows how many BILLIONS in profits the pharma industry makes in the US every year. (one billion auf deutsch = eine Mejarde)

  66. As a German dude, it was quite interesting to watch that. But, why the heck, do you use so many (more or less) bad stock videos? That's absolutly weird to watch. It feels quite feigned.

  67. And here they only talk about PHI and SHI. But there is another quite relevant third system: the SAI. The Statutory Accident Insurance was established in Germany by statute in 1884. It is now a national, compulsory program that insures workers for injuries or illness incurred through their employment, or the commute to or from their employment. Wage earners, apprentices, family helpers and students including children in kindergarten are covered by this program. Almost all self-employed persons can voluntarily become insured. If you have an accident on your commute to school for example, there are special hospitals in Germany run by the SAI only for such cases.

  68. The german insurance system is very good in terms of giving a good, basic level of medical service to almost 100% of the population free of charge.
    The problems start to emerge with longer, less available or more expensive treatments, at which level, many argue, the system is broken, maybe rotten from inside.

  69. The long waiting times at doctors also come from an undercoverage of doctors in many regions, which is not fault if the insurance system, but many other factors which i honestly dont know enough about.

  70. Sadly the American system seems to be run on greed. They're more interested in the bottom line than actually doing the job. Keeping people healthy.

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