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Health Care in Germany. By: Randi Schutz. Background.
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Health Care in Germany By: Randi Schutz
Background Germany has Europe’s oldest universal health care system, dating back to Otto von Bismark’s social legislation which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. These bills originally applied only to low-income workers and certain government employees, but gradually expanded to cover the virtually the entire population.
How it Works Germans are offered three mandatory health benefits, which are co-financed by employer and employee: • Accident insurance – covered by the employer and covers all risks commuting to work and in the workplace. • Long term care – covered half by the employer and half by the employee and covers cases where a person is not able to manage their daily routine (cooking, cleaning, bathing, etc.). • Health insurance – two systems: public and private. Health care in Germany is not run by the government but by national and regional self-governing associations.
Public Health Care • All salaried employees have public health care. • Workers pay about 8% of their gross income to a nonprofit insurance company called a “sickness fund.” Their employers match this amount. Workers can choose among 240 sickness funds. • This is about the same percentage of income Americans pay, but U.S. employers pay more, about 18% of the employees gross income.
It is a “pay as you go” system. There is no saving for rising health costs at higher age. • There are never any deductibles. • Germans may visit any doctor they like, including specialists. They do not have to see a general practitioner before they may see a specialist. • It is easy to get an appointment and find a specialist. There are 2.3 specialists per 1000 people. • Consumers can and do penalize bad service.
Private Health Care • Only those with gross incomes over $72,000 a year (2008) can opt out of public insurance. • The premium is based on an individual agreement between the insurance company and the individual, the amount of services chosen, and the individual’s risk and entrance age. • The premium is used to build up savings for rising health costs at higher age. • 10% of the population has private health insurance.
What about the unemployed? • Depends on whether the individual has previously worked or not. • Those who have previously worked are included in the national insurance system, but the benefits agency pays rather than the employer. • Those who have never worked (about one-third of the unemployed in Germany) are covered through a social fund (the Sozialamt) which arranges cover directly with doctors or through one of the AOKs (Allgemeine Ortskrankenkasse), the local funds of last resort.
Some Stats . . . • 10.4% of Germany’s GDP goes to health care, compared to 15.3% in the U.S. (2006) • Germany spends $3,328 USD per capita on health care, while the U.S. spends $6,716 per capita (2006) • 3.5 practicing physicians per 1,000 people, and 9.9 practicing nurses per 1,000 people (2007) • 5.7 acute care hospital beds per 1,000 people (2007) • 8.2 MRI units per million people (2007) • 16.3 CT scanners per million people (2007)
Are they happy? German satisfaction rates in 1996 showed that the Germans are pretty satisfied with their health care. About 11% of Germans said they were dissatisfied.
Works Cited Green, David G., Ben Irvine, and Ben Cackett. "Health Care in Germany." Civitas N.p., 2005. Web. 11 Sep. 2009 <http://www.civitas.org.uk/pubs/bb3Germany.php>. Health in Germany." Wikipedia N.p., 7 Sep. 2009. Web. 11 Sep. 2009 <http://en.wikipedia.org/wiki/German_Health_Care>. Knox, Richard. "Most Patients Happy With German Health Care." NPR N.p., 3 July 2008. Web. 11 Sep. 2009 <http://www.npr.org/templates/story/story.php?storyId=91971406>. "OECD Health Data 2009: How Does Germany Compare." Organisation for Economic Co-operation and Development N.p., n.d. Web. 11 Sep. 2009 <http://www.oecd.org/dataoecd/45/55/38979836.pdf>. World Health Organization N.p., 2009. Web. 11 Sep. 2009 <http://www.who.int/en/>.