Monday, August 17, 2009

Health Insurance in Germany: our experience

I don't want to go on forever about this but it's a hot topic lately, and it pertains to feeling at home in Germany. I want to say that in terms of our health care/insurance here, I'm pretty happy. Reading this prompted me to say my piece. (broad brushstrokes here, mind you)

Health insurance in Germany is NOT socialized. Germans get upset with that term as they do not want to be a 'socialist' country. The German government also does not pay for citizen/resident health insurance, they just make it illegal for somebody not to have insurance of their own, through a privately run company. The government has also stated the minimum requirements of a health plan and how much it can cost based on a person's income. This guy's post talks a little bit more about how that works.

We're an exception to his statements in that Stefan is a government employee who's position allows us to qualify for the "privat" insurance even though we're not fantastically rich or self-employed. Privat sounds like "private", but it's a false friend for English speakers in that all insurance here is private, it's just that "privat" means you can get a whole lot more in one policy than the 'basic' government required plan (used lightly here b/c 'basic' actually covers a TON over here). A lot of people get the basic type of plan (give or take a few small things) and will get an additional extra policy to upgrade a few things. (Stefan's mother does this.)

Our privat insurance is such that the government pays 45% of almost all of our medical costs. We then get a policy to cover the remaining 55% plus the few small things the government doesn't cover. If and when we have kids, the government will cover a bit more and the insurance company a bit less. Again, this is only because my husband is a government employee. Otherwise it would all be covered under a private company's policy.

All things considered, the coverage I have right now is probably the best I have ever, or will ever, have. Absolutely everything is covered and we have no co-payments. If I had a rare disease and the only treatment available was in Timbuktu, my insurance would pay for that treatment and my transportation to and from Timbuktu. That's pretty nuts. We're also not paying a fortune for it.

I had a short hospital stay last year and - while clean, professional and friendly - it just wasn't what I was used to from my days in the US. There were no privacy curtains, it wasn't as modern looking as US hospitals I'd seen, the food all seemed like it came from a can, and it seemed like just anybody could walk in and out of the place. We were satisfied with the care and pleased with the demeanor of the staff, it was just different than I expected. This may not be the case of every German hospital, but it seems to be commonly accepted practice here. I suppose if this were to be true across Germany, a more no-frills approach to hospitals would make their bills lower.

I also know some presecriptions can be expensive and tricky to get approval for. That's a downside. It's also bad that when I walk into a doctor's office and tell them I'm a "privat" insured patient I can count on getting an appointment faster than if I weren't. Doctors can charge privat patients more, but the patient doesn't really care too much because their insurance pays all of it. There are fine points to all of this, but overall, it's not a perfect system, but it does work pretty doggone well.

So that's a short-ish version of my health care experience in Germany. As far as other experiences: when living in Denmark 18 years ago we saw doctors based on our address and it was covered by the government. We didn't really like the care we got there. Maybe it's different now? England: I've yet to meet an English resident who loved the NHS. I'm actually scared to live there if I only had the NHS to rely on for my health care. Canada: long lines, long waits, quotas, etc. I hate how ridiculous it is for my grandmother to get fast care without my aunt there to advocate for her. My uncle left Canada to practice plastic surgery in the States so he could function on his terms and not the government's. He actually only wants to do reconstructive work for injured and abused patients or those born with birth defects - he wasn't allowed to do JUST that in Canada thanks to quotas. Go figure.

I would like it if the US government would get involved in some way, even if it's just a start. Obviously no idea is perfect, but neither is ignoring a huge problem. I had nearly a year of no insurance in the States and it was scary. So many developed countries around the world have had the government step into the health care fray and either completely control it or just make regulations about it - I think there are plenty of examples to learn the pros and cons from and think to just do nothing is really stupid.

That's my two cents.


Harvey Morrell said...

Thanks for this comment. I've been puzzled in the current health care debate in the U.S. why no one ever mentions the German system.

Laura said...

Good post, I've lived here (I'm American) five years and have been very happy with the health care (at least pertaining to children). I had great pre-natal care, two C-sections, and a super peditrician. No costs for the pre-natal care, no costs at all for kids perscriptions and the C-sections and many nights in the hospital (they don't kick you out after 2 days!) was less than 50 Euro. Fantastic!

Karoliina said...

I get so stuck on little details. It's such a bummer, really. All I can think of after reading this is what kind of a rare disease would take you to Timbuktu as the ONLY place where they can fix you. It's a disturbing thought really. I must stop thinking about it right now. Stop. Right now.

Oh, I read somewhere that women in the last month of pregnancy suffer from memory loss - not serious - just enough to mess up their brain. And it continues until about six months after the birth if the woman is breast feeding. I find it fascinating and yet so BAD because it's totally happening to me. And look, here I am STILL thinking about Timbuktu.

BTW, two days after the "carrot cake incident", I noticed the cupcake tray was in the oven. My engineer husband had spent two days thinking about it and finally came up with a way to get it in there without breaking the oven.

juliette said...

K - so I was already laughing about the memory thing and the fact that J got the thing in the oven...and Sarah had a look of amazement last weekend when I told her your harrowing tale...yes, I'm laughing out loud now! =)

Diana Strinati Baur said...

Danke schoen. I try to explain this to people all the time, but it falls on deaf ears. Oy ve. It's a universal policy which everyone has access to. yada yada yada. It's regulated and workds pretty darn well considering yada yada yada. I know. I was really happy with my care in Germany and we were gesetzlich versichert (that means part of the regulated system, NOT government run, for all you out there). Anyway, I do love your blog and I am going to rush over and hook you up on my blog roll, I see I am already on yours, thank you for that!! Your taste is lovely and your blog is SWEET. I don't quite know where in D-land you are, but I hope you have ein schoenen Tag....

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