The American public-affairs documentary series Frontline just broadcast a show comparing the American health care system with 5 other healthcare systems from around the world, Germany included. The entire show is available free online, so if you want to see the segment on Germany, visit this website and click on the third segment. I haven’t watched it yet, but I’ll get back with comments when I have.
UPDATE: I watched the segment. It’s hosted by T.R. Reid, an American journalist who’s written a few books about The Foreign Countries (Europe and Asia). As you can see, he’s a pretty relaxed guy. He wants to tell stories, not deliver detailed statistics that would bore viewers. The segment seemed largely accurate to me, with three minor caveats.
- You generally do get to keep your health insurance if you lose your job, but that only happens automatically for some people; for others, doing so can involve a lot of complex paperwork (g). And, in any case, you’ll have to formally apply for unemployment benefits to maintain your claim to health insurance. So it’s not quite as seamless as it may appear.
- Reid interviews Karl Lauterbach, who is described as an "expert" on the German health care system. However, Reid doesn’t mention that Lauterbach is a member of the SPD (g), and thus has a partisan perspective. Nevertheless, I found Lauterbach’s description of the system’s basic philosophy and operation accurate.
- Reid doesn’t mention the differences between private and public health insurance. German doctors protest that they treat both classes of patients equally, but some studies indicate that private patients get faster appointments and more time with the doctor.
Now, for what it’s worth, my personal experiences. I’ve been covered by both private and public health plans, and haven’t noticed any difference in coverage or the eagerness of doctors to treat me. In fact, the public plan’s easier to manage, because you never see a doctor bill. If you’re privately insured, you have to pay for your treatment up-front, and then seek compensation from the insurance provider. However, if you don’t send in many bills during a particular year, the private plans give you a fat premium rebate.
As in England, your first job is to establish a relationship with a GP. If you get a good one (like mine), you never have to wait more than a week for an appointment, and he or she will squeeze you in if you have an urgent problem. If you need specialist treatment, you get a referral from your GP. I’ve never had a problem getting an appointment with a specialist within one or two weeks. Emergency rooms in big-city hospitals are much less full and chaotic than they are in the U.S., but you’ll still have to wait hours for non-emergency treatment. If you’re publicly insured, all you do is present your "chip card" (which has your basic data on it) everywhere, and sign a few papers. You have to pay a co-payment of 10 euro every quarter.
German doctors are more businesslike than their American counterparts; they generally get straight to the point and don’t sugarcoat test results or pretend to be your friend. If they want to do a test on you, they’ll issue brisk orders: "OK, undress and get on the gurney, please. Turn to the right. Now, this may feel a bit uncomfortable. Hmm… Okay, everything looks fine. You can get dressed now. Have a nice day!" Bing-bang-boom. Most doctors’ offices are run very efficiently, and you won’t spend a minute more talking to the doctor than necessary, although they will always answer your questions, and I’ve never been denied a referral for anything.
Like the American Reid interviews in the segment, I’m satisfied with the healthcare I receive in Germany. The best thing about it, from my perspective, you’ll never lose it, and never have to worry about it. It’s always there in the background, following you from place to place, job to job.