Healthcare in Germany vs. The US: Dramatic Differences Favor the German System

World Health Care Systems

Taking into account that this PBS Frontline production is several years old, and was produced before the Affordable Care Act was signed into law, some of the details shown in the video are certainly not current. Still, the comparison between the German healthcare system and the U.S. healthcare system shows a wide gap in service, in cost, in consumer satisfaction and in results. Meantime, the positive parts of the German healthcare system are far better and far fairer for the consumer than the system in the United States.

The German Healthcare System vs. The U.S. System

The PBS reporter states that the philosophy in Germany since the time of Otto von Bismarck (Prussian leader in the late 1800s) has been that "A government has to provide mechanism so all its people can get medical care when they need it (PBS). "The Bismarck model is used all over the world," and thanks to that model, all citizens in Germany are provided with healthcare services (PBS).

In Germany, those who are wealthy can get private healthcare, but "…about 90% of Germans choose to stay" in the government system, the reporter explains. The German healthcare system provides coverage for mental health, basic health issues, dental and optical, plus for "alternative therapies" like homeopathic care and even going to a spa for health considerations (PBS).

Private doctors and private hospitals provide the services for the 90% who use the government system. And according to the reporter, the waiting time to see a family doctor in Germany is about 10 days to 2 weeks. Germans pay premiums based on incomes to private insurers; for example, someone earning $60,000 annually would pay half of a $750 a month fee (employer would pay the other half); that's about $4,500 a year in Germany. In the U.S., a family would pay a third more (PBS) and an individual pays about $6,697 (Klein, 2007). In Germany citizens pay about $15 every three months, which covers their "co-pay" (PBS).

In the United States, losing a job means losing health insurance, in most cases. In Germany, losing a job doesn't mean losing health coverage; a professor interviewed by PBS notes that the unemployed are at "an increased risk of becoming ill." Interviewing an American who has lived in Germany, the PBS reporter heard that American say "…the cost is a fraction of what is covered in the states; prescriptions are covered with very, very small co-pays," and he said the quality is "excellent" (PBS). Standard prices for medical services are negotiated ahead of time (cutting administrative costs to 6%, "a quarter of what they are in the U.S."), and healthcare providers must stick to those prices.

In the UK, just 2 or 3% of citizens skip doctor's visits when ill but in the U.S. "…a full 25%…didn't visit the doctor when sick because we couldn't afford it…and 23% did not fill a prescription…" or show up at a follow up treatment recommended by a doctor (Klein, 2007). And although Americans pay "more than twice as much as anyone else, we have the lowest satisfaction with our healthcare system," according to Klein, a Washington Post reporter.

In conclusion, the latest data on the Affordable Care Act shows that over 5 million Americans have signed up for health insurance through the market set up by the legislation, and notwithstanding snags in the system as it went into effect, the "Obamacare" law is delivering much of what it promised to deliver (you can't be denied coverage because of existing conditions, etc.). But meanwhile, the polarized situation between Democrats and Republicans in Congress gets more attention than the healthcare issues. The House of Representatives, led by conservative Republicans, has voted 50 times to either de-fund the Affordable Care Act, or drastically change its components.