Cablayan LNHA, MHA

Healthcare Systems

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Germany vs. USA – A Comparison of Health Care Systems

July 3, 2014Erwin Cablayan2 Comments

germany vs usa health care systems comparision

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?


This article has 2 comments
  1. Max Hotopf
    July 4, 2014

    Germany, unlike the USA and like all other West European nations apart from Ireland offers more or less free healthcare at the point of access to its citizens. That is a major plus.

    As a Bismarckian system, patients have far more choice in Germany than they do in the UK or other NHS systems and there is a payor provider split (as in the USA). So private players can and do have a major role. Patient choice makes Germany more expensive than the UK and other NHS systems but keeps practitioners on their toes.

    Germany has been slow to move to ambulatory surgery leading to higher costs, ambulatory surgery rates are probably half US rates. That partly reflects a culture in which Germans expect to stay in hospitals and reha units. Germans find it just as hard as Americans to make reforms. Watch them fail next year to cut bed numbers!

    But overall costs are lower than the USA and it is a fairer system. Imagine you are poor and need healthcare. Which system would you want to be in? The USA, where you may have little access to serious acute treatment or Germany where that simply isn’t an issue. It is a no-brainer. Or imagine you are middle class and suffer from one or two chronic illnesses. In the USA you will have a constant anxiety that your insurer may stop letting you access treatment. No problem in Germany. Now imagine you are wealthy. Here I’d say it was a draw. German healthcare is as advanced and as high quality as the USA. Treatment costs will be a lot cheaper. That reflects the fact that medtech prices are much lower than in the USA and the insurance system is less complex. Doctors are also paid a lot less.

  2. Raymond Wilcher
    July 5, 2014

    The Affordable Healthcare can be easily fixed and benefit everyone to the last person. Our problem is, “every move the president makes, they try and find a way to push him back two – three steps backwards. President Obama is the ONLY person that has in somewhat of a way that has kept his word to help the American people the right way. As big and powerful the United States is, something right yet is so wrong. The Affordable Healthcare is something every American should be onbroad, this is something that the U.S. should be striding to have the best of, just we have with everything else. The entire world is sitting back watching and laughing at the ass we are making of ourselves. This was the very first thing Castro done, the first words he spoke in the first minute as the ruler of Cuba. Ensuring his people would have affordable healthcare. Our leaders don’t want us to have yet they goes to Cuba, Mexico and abroad to get good and affordable healthcare. Now what’s wrong with this picture?

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