Last week, the United States went foot-to-foot with Germany in a narrow win for the Germans in the World Cup, but how do the two compare in the world of health care? In my last blog, we discovered some key differences between the United States and the rest of the world in quality of care.
We can trace Germany’s current health care system back to the trade guilds developing a health care plan that inspired the government’s system which “combines decentralized power and decision-making with an effective negotiating system that takes place at federal, state, and local levels,” according to the Context Institute, which adds that “there is a sense of solidarity among Germans that everyone should have access to medical services, regardless of employment income, or ability to pay.
Many, such as The Atlantic’s Olga Khazan, view the German system as one we could stand to learn a thing or two from: “Every German resident must belong to a sickness fund,” she states, “and in turn the funds must insure all comers.” According to Khazan, “It’s not as radical as single-payer models like the U.K.’s where the government covers everyone,” but instead there are “about 160… nonprofit insurance collectives in the country.” Khazan adds, “There are no network limitations, so people can see any doctor they want. There are no deductibles, so Germans have no fear of spending hundreds before their insurance ever kicks in,” and states that Germans have the easiest time among developing countries at getting into a same-day or next-day appointment.
However, not having networks is not always a good thing. Khazan mentions that due to a lack of provider networks, “there are few ways to limit repeat procedures,” and are trying to implement parts of the HMO model in the U.S. The American Institute for Contemporary German Studies sums up the comparisons between the two countries’ systems by stating, “The United States faces severe challenges in access to health care, cost effectiveness, equity, and to a lesser extent in coordinating care. Meanwhile, the German system is confronted by problems in coordinating care and controlling costs.”
The cost issue is a major point, one that will determine the sustainability of quality in health care systems around the globe. We will explore that key issue more in depth in future blogs. What are your thoughts so far on the questions of efficiency and overall quality?