How Germany’s Universal Health-Care System Works

Seventy percent of Americans
say the U.S. health-care system is in a state of
crisis or that it has major problems. That’s why we’re hearing a
lot about Medicare for all, including some plans going as far
as banning private health insurance companies altogether. On page eight of the bill, it
says that we will no longer have private insurance as we know it. And that means that one hundred
and forty nine million Americans will no longer be able to
have their current insurance. That’s in four years. I don’t think that’s a bold idea. I think it’s a bad idea. Problem. Senator Sanders, with that damn
bill that you wrote and that Senator Warren backs, is that it
doesn’t trust the American people. I trust you to choose what
makes the most sense for you. Not my way or the highway. One country found a way to
provide universal health care coverage while maintaining a competitive insurance
market that offers citizens more choices: Germany. Here’s
how they did it. In 2017, U.S. health care spending came
to around $10,200 U.S. dollars per capita in Germany. It was a little under $6,000. Overall, Germany spent about 11.2 percent of its GDP on
health care, while the U.S. spent 17.1 percent. Germany manages to cover
100 percent of its population. In the United States, about 8.8 percent of the
population remains uninsured. That comes to about 28 million
people with even more people underinsured. Despite spending less, Germany
has better or comparable health outcomes to
the United States. Studies show that in Germany, there
were fewer deaths that could have been prevented with proper
access to care. In 2013, there were 83 avoidable
deaths out of every 100,000 people in Germany, while the
United States had 112. Life expectancy in Germany is 2.5 years higher than the United States,
and the infant mortality rate is lower in Germany, with 3.3 deaths per 1,000 live births
as opposed to 5.8 deaths in the United States. Additionally, the maternal mortality rate
in the United States is more than 2 times
higher than in Germany. So how does Germany manage to
have better health outcomes while spending nearly half as much
as the United States? Germany is a system that would
look familiar to Americans in that everybody buys health insurance from a
private company and then the doctors and the hospitals and the
labs are almost all private. That’s T.R. Reid, author of the
book “The Healing of America.” He traveled the world exploring different
health care systems and how well they worked. But it works better in
Germany for a couple reasons. One is everybody is covered. Everybody is required
to have insurance. Everybody’s in the system. The insurance companies can’t turn you
down because you had cancer last year or something, they
have to take you. They have to cover you. Everybody has access to the same
treatment and all the doctors. You can go to any doctor without
any limits set by the insurance company. In Germany, health insurance is
mandatory for all citizens and permanent residents. There are two different systems that
residents can turn to for insurance. SHI, which stands for
statutory health insurance and PHI or private health insurance. German citizens are eligible for PHI if
they make more than a roughly 60,000 U.S. dollars per year or if
they are self-employed . Citizens making under that threshold
must pay into S.H.I. S.H.I is made up of a network
of competing, not for profit private health insurance funds known
as sickness funds. In S.H.I., dependents are covered free
of charge and monthly costs are capped around 840
euro per month. Even though S.H.I sickness funds
are not government agencies, many Germans think of them as part of
a public system because of heavy regulation. Keith Tanner helps expats
navigate the German health care system and he considers SHI
sickness funds quasi -public organizations. Basically, they have to
do what they’re told. They they are told by the government
in what range they can charge. They they’re told what health procedures
they can fund and they are told by the government who they
can accept as clients so they’re really just carrying out orders. They’re basically charities. They don’t exist to make a
profit for investors like American health insurance companies. They’re there
to keep people healthy. That’s what they’re there for. They follow all sorts of
rules that American insurance companies wouldn’t dream of. This system is funded through
compulsory contributions based on a percentage of citizens’ salaries with
employers sharing the costs. There are also built
in safety nets. The government will pay into S.H.I. on behalf of the
long term unemployed. Despite being non-profit organizations,
sickness funds compete for customers by offering specific
coverage and perks. This competition has changed over the
years as the system has allowed citizens more choice. As of 2019, there are about
100 statutory health insurance companies, but there used to be many more. When Germany’s system was first
established in the late 1800s, sickness funds were linked
to a person’s profession. It used to be that people were
assigned to a specific sickness fund based on their
occupation or region. Now Germans can choose where they enroll
and they can change funds on a yearly basis. As a result, sickness funds begin
marketing themselves in order to retain customers and
attract new ones. This also led to the funds
merging so they could become more competitive. Some of the sickness funds
offer perks that might seem similar to credit card rewards. You still can get a bonus for going
to the gym and a bonus having a checkup. This is in
the public system. And if you get a certain number
of bonus points, then you get a voucher. But kind of trivial stuff like
200 euros a year or something like that. 200 euros a year. Nothing which is particularly relevant
to the person who’s paying their 840 a month. As of 2017, roughly 87 percent
of Germans receive their primary coverage through S.H.I. and 11 percent of
the population through P.H.I. The remaining population, such as
soldiers, police officers and refugees receive health insurance
through specific government programs. All individuals
insured through P.H.I. pay a risk related premium with
separate premiums for each dependent. These risk based premiums mean that
costs will increase as the insured gets older. As a
result, the government regulates P.H.I. so people don’t become overburdened
by premiums as they age. The biggest issue with private health insurance
if you opt out of a public system is affordability
in old age. If you don’t impose these financial
constraints on insurers, then the government will be lumbered about a whole
lot of old people who reach 85, 90, 95. It’s gonna be totally able to
pay for their health insurance, so it’ll all fall back
on the government. Once someone switches to P.H.I., they can not switch back to S.H.I. in the future. But Tanner says
there are ways around that. If you’re a freelancer in the private
system, you just can’t get a job paying less than the threshold. Any employee earning under about 5000
euro a month is required to have public. If they own more than
that, they can opt out. So if you are a freelancer, you
want to go back into the public system for some reason. Then you’ll get a part time job with
a friend, pays you 500 a month for a few months, and then
you react in the public system. So there are ways to do it. The
only reason you probably want to do that, though, is if you have
lots of children, because children can be covered free in the public system,
in the private system, have to pay separately for each child. Germans can also buy supplemental
private insurance while staying in S.H.I.. For example, many Germans
buy supplemental dental insurance. The public system pays like for
major dental work, about half the cost and then you get supplementary to
take it up to 80, 90 percent of the cost. Germany’s system is not perfect. With so many different insurance
companies, there’s a lot of bureaucracy that contributes
to costs. One of the financial things thinking
it’s a big system administered by more than 100 organizations is
called krankenkassen, each of those has a head office and a president
and vice president and a financial officer, a whole lot
of unnecessary bureaucracy. This may be one of the reasons that
the German system is not as cost effective as other
European countries. More than 30 percent of both
Germans and Americans felt bureaucracy was a major issue
in their country’s system. Wait times can also be an
issue for people in S.H.I. Thirty seven percent of Germans cite wait
times as one of the biggest problems within their system, while 22
percent of Americans feel the same. Generally I think people are quite
happy with the public system. It works reasonably well. The major issue in big cities
— I’m in Berlin, Munich, Düsseldorf, Hamburg. It can take quite a while
to get an appointment with a specialist. It is the case that
the doctors prefer private patients because they own up to three times
more if they see a private patient. So what can the United States
learn from the German system? Germany has managed to balance
cost controls and universal coverage while also maintaining competition. And Germans generally
like their system. In one survey, not a single German
said they had to wait more than four months for an elective surgery,
while four percent of Americans said that they had to wait that
long for the same kinds of procedures. And only 7 percent of
Germans said they experienced a barrier to care because of cost in
the past year compared to 33 percent of Americans. Those citizens really like it. They like the fact
that everybody is covered. They like the fact that
the costs are totally predictable. You know what it’s going to cost
you and how much your insurance company is going to pay you before
you walk in, unlike the United States. They think it’s normal that
the insurance company pays every claim. They can’t believe that insurance
company might deny a claim. And they think it’s normal that
they get to choose the doctor. They don’t understand America, where
the insurance company says we won’t cover a doctor Jones. You have to go
to Dr. Smith instead. So the main thing I learned in going
around the world is you have to make the commitment to provide
health care for everybody. That’s the destination. It turns out there are many
different routes to that destination. I found, you know, the Canadian
model, the French model, the British model, the German model. They all get to this goal
in different ways and different models. So I don’t care what the model is. I think it’s important that you
make the commitment to cover everybody. And this is something
the world’s richest country has never done.

100 Replies to “How Germany’s Universal Health-Care System Works”

  1. As a German, I‘m not able to comprehend how a highly developed country like the US lets their citizens go uninsured. My whole life I have not met one single soul who had to worry about getting the most advanced treatment available. I cant imagine to live in fear of getting sick.

  2. And this is why we should have no homeless people in germany, but there are still people living on the street begging for money

  3. It is funny how they presented Spain at the beginning of the statistics, (lower costs per cápita for healthcare), and then took It away in Life expectancy, satisfaction, etc. Way higher than Germany, but following the model of Bernie Sanders.
    I lived and worked un Germany and prefer the spanish model. Less boureaucracy, etc.

  4. Germany here, two years ago I went to the hospital for pneumonia, had just half of my lung capacity when I went in. Spent 11 days there and got operated twice.
    At the end I had to pay 110 euros, 10 euros per day for catering in the hospital. Imagine this my American friends.

  5. Yes it is better that the us healthcare system but, private companies that aren’t allowed to make a profit always find a (criminal) way tot fill their pockets. It certainty is not a perfect system!

  6. Naja.. Es ist nicht mehr so perfekt. Das Problem liegt an der Art der Krankheit und dem Geld. Ich bin Arbeitslos geworden und dann wirst du als 2 Klasse Patienten behandelt. Dieser Bericht ist sehr oberflächlich, er zeigt viele Faceten nicht. Wenn du eine Wurzelbehandlung brauchst, und dir diese nicht leisten kannst, dann gibt man sich keine Mühe, wenn ich Zeit habe, mache ich mal ein Right to you Face! BOOM Die Hardcore Wahrheit über das Gesundheitssystem in Deutschland. In Deutschland geht es über 30 Millionen schlecht, doch die Wahrheit wird meisten immer verschwiegen. Leider.

  7. This is so true. I moved to Germany two years ago, I have never been so well taken care of. I can go to whichever doctor I want to, I was in the hospital and I wasn't worried about how am I going to pay for it. The patient is at the first place here.

  8. This German health system will get changed in the next 10 years. Due to ignorant German citizens and politicians , million of immigrants not paying into the health care system. I know, sounds racist, but it's the tendency and logic.
    Germany goes downhill. I've been watching the tendency for years. Germans won't benefit from this generous system any longer… Sooner or later.

  9. Education and health should never need to make profit, hospitals and universities shouldn't face market competition. In Austria we have the same system if I would get bad burned I would be flown to a specialized hospital. When a friend was ten years old he broke his leg while being on a mountain, a helicpoter came to pick him up. Hes parents paid no cent for the transport. I studied on a great university (google WU Wien) for only 14€ per semester. And yes therefore I am willing to pay (but I would have no choice) a higher income tax rate (a so called progressive tax system the highest would be 55%) than someone who is only a plumper. So I am giving back to society since they paid for my chance to have a better education. Our streets, highways, railways, bridges etc. are also financed by tax money which leads to a well looked after infrastructure. Some Americans call our system communism, which is wrong. Btw we have 5 weeks of paid holidays and get 14 salaries a year. To me freetime is in this stressfull world one of the most precious belongings. And this should not be seen as USA bashing, I only want to show how other countries you woudln't read about (we are a small "Schnitzel") deal with their health care system.

  10. This is why Sanders is the only candidate.
    For one thing, he understands that you can't compromise with American insurance companies before you even start writing the bill.
    For another, he's the one proposing a system that has a chance to out-perform even Germany or Denmark by bringing in dental and mental health.
    It's perfectly fair to argue that we can let private and charitable actors into the system, but in practice, in the US, the huge corporate insurers are a threat to any progress, as Obamacare proved both during Senate deliberations, and through the sabotage that health insurance companies are committing against Obamacare now.

  11. We have private companies in Switzerland. But basic services are the same for everyone. And everyone can afford it. It’s not perfect but works great

  12. USA don't have health insurance for everyone, is like watching a science fiction movie, where people still don't have spoons to eat.

  13. Germany does not "manage to cover 100% of its people" it is required as per law to do so. How that is implemented is a different story. We have private as well as public health care.

  14. Oh Germany had universal coverage since 1883? Well you Americans will catch up some day 😉 or just live with the uninsured, avoidable deaths and medical bankruptcys. I guess thats totally worth for having the choice between different overpriced private healthcare plans

  15. Hi. I am so sorry, but maybe it should be mentioned that it is the same in Austria! I am from Austria, and it is exactly the same here, everybody has the access to a perfect health care here… 🙂

  16. Being British I do like our system however like the German system it isn't perfect, I lived In Wales where the NHS is devolved to the Welsh government and the doctors I was registered at the wait times for an appointment were insane! I remember on 3 occasions booking an appointment, the first I had to wait 9 days, the second 11 days and the third 21 days to see a male doctor! Whilst I do appreciate the healthcare service we have over here it certainly isn't perfect and does need radical reform.

  17. A few things here (from a German):
    I think it's important to note, that the German system has had a reform rather recently (I think it was somewhen in the last decade) which has in my opinion worsened the German Health Insurance System. For one the Statutory/Public Insurance choice didn't exist before. Everyone had to have Statutory. Now it's split into a two class system. That way wealthy people get faster (and sometimes better) treatment and the Statutory Insurances are worse off in funding since your payments are based on income and the higher incomes choose private insurance because of the better coverage. Also before there was better coverage for dental and eye care if i remember correctly.
    It's also interesting, that Austria has basically the same system (or rather basically the system we had before the reform) and they have better coverage and pay less.

    In short: Private insurance sucks.

    Still considering all that of course i would not give up my health insurance for anything. It's great that i can go to the doctor without having to worry about paying anything. To me it's unbelievable and crazy that the US does not have proper health care and it's abominable that people have to go bankrupt or even die because of medical bills.

    P.S.: Man it's sad to see that even CNBC treats Bernie so unfairly by only showing one side of the argument…

  18. The German health care system is collapsing and most often works really poorly. Have been working in the system for about 2 decades and agree with the vast majority of my colleagues and coworkers that is has deteriorated incredibly. Only people who have nothing or little to do with it believe it’s good.

  19. I live in Germany and happy to have our insurance system, however I have to complain about the doctors. Many of them prefer the private patients, they don't take time for you and some of them, especially those with good ratings, accept only the patients who have private insurance.

  20. Right wingers in the US is the most brainwashed bootlickers on the face of the Earth. They've convinced themselves that keeping this exploitative healthcare system alive makes them "more American. Bernie 2020 <3 medicare for all.

  21. It's really funny to me that america is so behind in social programs that germanys current build seems appealing, while germans are trying to get rid of their two tier health care system in favor of a more social program.

  22. Funny how they convey German to English translation by transition from “Germanica“ to a Arial san serif font 😀

  23. Americans want the freedom of choice between which price gauging mafia will rip them off. Maybe you guys should get rid off all these lying bought and paid for politicans and elect the first President with a working brain we are gonna see in this lifetime. Bernie Sanders.

  24. The major European democracies have a better health care system than the US. Non of them can understand how the US can get it so wrong.

  25. I live in Germany and have govt. health care. I pay around 370 euros per month for govt healtcare and my employer pays same. So its still over 700€ per month. For same money if I get private healthcare its way better with less waiting time as well as better facilities.

  26. medical workers (dr. nurses, etc) dont make as much money as they do in US, and they pay less for drugs. they in general spend less for the same things. hence, the difference.

  27. I don't get why murica is still hating unversal health care. and if you have a health insurance in the US you still you have almost to sell an arm and a knee to get basic treatment. so you think twice before seeing a doctor, wich meaks you even sicker and unproductive.

    In Germany public healthcare cost about 20% of my income which will be split by me and my employer. So at the end I have the pay only 10%.
    If I go to the doctor he will not charge me for the visit and when I need to get some special medicine, the doctor will prescribe it to me, I go to the pharmacy and I pay max. 5€ per item on the prescription.

    For example, I need this:

    (blood pressure medicine) Hydrochlorothiazide/valsartan 12,5mg/160mg, 100 untis/pills:
    USA = about $100 to $160
    Germany = €5

    (Diabetes medicine) Metformin 500, 100 untis/pills
    USA = about $13 to $25
    Germany = €5

    Total: about $149 (doctor visit not included) vs. €10 (doctor visit included)

    Last year I had a panic attack but I thought I'm having a heart attack due to my high blood pressure, so I called 112 (Germann 911) they send an ambulance and the found out it isn't a heart attack, but they brought me to the hospital anyway for some further examination. I had EKG examination, blood analysis, x-ray and so on. They charged me €10 because I had to stay overnight

  28. The idea of insurance is to pay for other insurance members, not for the investors of the insurance company.

  29. If my mom wasn't german and thus had access to german healthcare, she would be dead.

    I can't believe there's a country that claims it's the best one in the world while its citizens can't go to a Hospital because they simply can't afford it. America what is going on

  30. The worst part of all is that private insurance can stop covering you, ie cancer! Where social medicine will never cut you off and will continue to provide quality care. Care that may even offer a cure via Eastern/Western medicine. Something insurance companies continue to refuse to cover, leaving you at the wimps of pharmaceuticals with immense side effects that damage healthy organs! Another point to keep in mind, is that insurance companies are elite based, as is pharma! Universal health care will give us better protection. Protection from our government, where using our health care in their political fight like a border wall for example, will stop them in their tracks!

  31. The world health organisation ranked America as 37th in the world. Chile and Morocco were ranked better. Worst health care in developed world. FACT

  32. Some individual medical providers in Germany decide to ONLY treat PHI patients (as outlined, because significantly more profitable for them)

  33. I'm German and I needed a surgery two years ago. Only thing I had to pay for was the food I asked my mum to buy me, because the stuff they serve in hospitals sucks.

  34. As a german, I can say that many so called doctors are the crappy here. I was wrong diagnosed, not diagnosed for years, wrongly treated here…not to mention the long waiting hours (1 and a half hour can be normal)
    I am not even going to doctors anymore unless I am near death because they are mostly useless.
    I went to an eye doc in America and it was much much more better than in Germany. In Germany I was diagonsed wrongly by three! dioptries. Also, many doctors here are just rude.
    I am quite disgusted with healthcare here.

  35. I am German and have quite a few not life threatening but still severe diseases and disabilities and every single medication or hospitalisation I had I probably didn't even have to pay a dollar.

  36. And we in Germany say our healtcare is sh*t
    But it largely has to do with low payment, too few workers in the healthcare sector and too low pensions

  37. Pharma and healthcare companies in the U.S. rely on sick people. There is no incentive, i.e. profit in a healthy population. Sick people means profits!

  38. As an American, who lived in Germany and had private health insurance, every year that I did not see the doctor, I received a check for about $800.00. It was a nice little incentive to stay healthy. Also, I got 30 days vacation and the state where I lived had 21 religious/other holidays, so 51 days off a year. I ate healthier food too. I never felt so healthy.

  39. Why everyone asks?? Well it’s because here in America you are not seen as patients, but as walking dollar signs….they don’t really care about your health, only how much money they can make off you.

  40. That's something called civilisation. The way how we treat other humans, especially the "week" ones, with respect and humanity is only scale that gives us the right calling ourselves humans. I am atheist, but wasn't there something in the bible about "treating others as you would like to be treated"?
    Isn't paradox for the land, that rich as USA and strong religious, not having essential evidence for humanity?

  41. Germany is not the only country that provides universal access to healthcare. The US is way behind with respect to genuine concern for its citizens.

  42. When you get Americans (actually I should say GOP Americans) to accept your system is better than theirs the next position is "well I don't want to pay other peoples medical Bills, its socialism".

    They would rather go to hospital with the knowledge that could be bankrupt in a few months that accept a better system because it is social medicine. Imagine if the US army worked on the same system, they will protect some states but not others ????

  43. I believe a single payer system is the most obvious way to go in the U.S. All we need to decide on is which model would we should use because clearly what we got going on now has failed.

  44. Nice job showing a rebuttal to bernie's healthcare plan and not showing the idea behind it. 🙄 As to be expected from NBC

  45. "More choises" means better healthcare for the rich, without being a part of the working
    society and contribute to a universal health insurance.

  46. When you ever been sick in a german hospital with SHI with six sick people in one Room you understand the difference to PHI in a single room by your own (of course you have the oppertunety as a SHI person to pay a extra of about 3000 Euro per month to have your own room, for PHI it is for free!)

  47. German healthcare-system is also not doing well. I would definately not use it as a good example.
    We have a great lack of nurses, doctors and money to pay them properly. A collapse is only prevented by a tremendous amount of unpaid overtime hours and poor payment.
    To fix that we would need to increase our monthly insurance dues drastically.
    Though i already pay around 10% of my monthly income for insurance (my employer pays another 10%).

    – From a medical doctor at a german university hospital.

  48. When you have a PHI in Germany you get different and better food in comparison to a SHI person without extra costs in the same hospital!

  49. It’s very simple. American politicians are in bed with large Pharma, the money these lobbyists make from insurance and pharma companies has turned their moral compass. There is absolutely no way a decent moral human wouldn’t want everyone to have medical care unless it took money from their pockets. It’s greed..plain & simple.
    America keeps telling the world that they are the greatest country on earth..they’re a long way from that title

  50. I am a german and i am in the public insurance system. I pay about 7,3% of my income. If i am sick i go to the doctor. The visit is completely covered. For drugs i pay about 10 Euro. The rest is payed by the insurance. When i am to sick to work the doctor gives me an excuse and i give this to my employer. End of story. I am paying more than i „use“, but it is ok. I know that i am covered when i have a serious disease. I dont have to think about costs.

  51. I am from the Czech Republic. I had a serious accident, injured my arm severly, had 2 operations, had to take medicine, spent few weeks in a hospital. Did I pay anything extra except 4 % of my income as mandatory healthcare insurance? No. Later I got diagnosed with a serious illnes with my blood, I take medicine ever since, visit specialist often. Again, at no extra costs as if i got a flu. Now that is what I call social security.

  52. Hmm…private health insurance providers can exclude certain diseases or raise the costs in case you want certain diseases covered. And there are uninsured people in Germany. It's rare, but even this system fails people.

  53. I'm german and SHI injured, the last summer a I had serious problem with my shoulder, it take me 3 weeks to get a kind of x-ray, if you are PHI injured they ask you if you want to come today or tomorrow, they get up 3 times the money for the same work if you are PHI!

  54. The American people are stupid regarding health care. They are being ripped off and yet they still vote against their own interest. Every western country except the US has universal healthcare. In France we have a hybrid system taking the best of private and public health. Everybody is covered and dependent on your income and desire then mutual insurance is purchased. The NHS in the UK is funded by national insurance collected at income source. It's underfunded by the present goverment but it's still damn good.

  55. That's the reason why I hate this SHI system in Germany, people with certain diseases avoid the PHI because of higher rates and go into the SHI where no extra costs, also people with many children also avoid the PHI, because you have to pay extra for every child in PHI, In SHI no extra costs for children.
    The result is the PHI have the right cheap Patient and the SHI have the wrong expensive patient!

  56. smth to ad to the private insurance model in Germany-
    You can also be "born" into it or get it by proxy. When a parent goes private and they have children under 18 years they're required to privately insure those children as well. And when those children turn 18 they can decide whether they remain private or swap to public.
    Furthermore, if you're privately insured but you didn't get sick during the year (aka you didn't make any big claims to your insurance) you actually get some of your money back that you paid them for the year.

    What they didn't mention though is that you can NOT go to every doctor you like when you're publicly insured. ast least not for free. some doctors specifically only take private patients cause they 1) get more money from them (aka they can write higher bills, smth that really needs more regulation) and 2) they can do certain procedures that would be too expensive or is very uncommon for public doctor.
    being privately insured in Germany usually means you get access to the doctor and/or treatment you need much faster, you can demand which surgeon you want, get a single bed room in a hospital etc and you also have access to things public wouldn't pay for. BUT you gotta be very careful with your insurance policy and read the fine print cause certain treatments will only be covered e.g. 90% so you need to be aware that you have to chip in (e.g. physiotherapy).

    overall Germany has a good system cause when people need help they always get it.
    It only gets more complicated when things become chronic or you have smth that is very uncommon because whatever is not written in their rule book dictated by the law won't get covered and this can lead to massive issues as well. (the law just can't keep up with certain things quickly enough)

  57. The swiss system is even better than our German system. Everyone MUST pay into SHI, if you are wealthy and want private insurance, you can get that on top.

  58. the German health care system is struggling as well though and it's getting worse. too few nurses, too few doctors, too many patients and the hospitals are turning into businesses putting immense pressure on doctors to discharge patients as fast as possible. it's still a great system, but it's far from perfect and needs change soon.

  59. also the majority of new procedures, new products, new research comes from the US because they have more money to spend

  60. As you mentioned in your video the German Healthcare system was the first of its kind in the world and was only changed and modernized around the edges over the decades. The main reforms were just expanding the system by introducing new public funds for new professions until the seperation by profession was eliminated.

    The reason no political party dares to run on substantially overhauling that system is not because we Germans think it is the best possible system but because the system kinda worked for everyone for so long. Never touch a running system.

    We didnt "manage" to keep choices etc. That is just how the system developed when there was no other country to copy or learn from.

    I find it outrageous that richer people can opt out of public health insurance funds. I would rather have one income-based health insurance fund for everyone (Single-Payer like Bernie's M4A). Nationalized health care like in the UK would be great. The system we have Germany kinda works so better not touch it … But it could work better.

    You in the US have the opportunity to build a system learning from what works in other countries but also from the problems and you shouldnt half-ass it like we did in Germany.

  61. I'm from a country where it's not mandatory for us to have health insurance. So I used to pay nothing monthly for the insurance.

    And now I'm living in Germany as a student with 720 Euro/month from my student blocked account. I used to have private health insurance here and paid like 30 Euro a month. It's an acceptable amount but just a bit annoying because the cheap private insurances (which are popular among language students) are not so well recognised. After I got accepted in uni, I had to change to public one… from 30 Euro to 130 Euro a month… Well, from having to pay nothing in the home country to having to pay ~18% of my money each month… is quite a lot but I really feel that the 18% is worth paying (even though I don't go to see doctors so often) because I know that they take good care of their residents and make sure everyone deserves what they're supposed to get.

  62. It works because the US is pumping 3.6 trillion dollars into NATO so European nations don't have to defend themselves. Money that would be spent on defense is now used for "healthcare ". You're welcome. Again. For the 3rd time.

  63. Commitment to universal coverage is the first step to fixing our healthcare system. Start with a public option and more regulations on private insurance, and if we could get the majority of people behind it, make health insurance a requirement.

  64. This is just a silly way of getting around actually just having Medicare for All. It's government, not being CALLED government. How silly. Just stop. Just give us Medicare for All, already. Stop with the insurance. We don't need it, or want it. There is no reason to have "competition." There is no reason to make it complicated. There is no need for "choice" that no one would understand anyway. If you make the program properly all-inclusive, what is there to "choose" between? People think they need choice, so Germany gives them this silly false choice to keep them happy. Ok, whatever. I personally would see that as being patronized. Just… create the damn system and give it to everyone. Done and done. Stop trying to complicate and trick people with feel-good but meaningless words. BTW, Medicare for All as proposed INCLUDES DENTAL.
    Just give us Medicare for All and stop trying to game us!

  65. These 840€ St 3:43 are for the whole Social-Care-System. You pay these for a lot of Services: Almost free Healthcare; Getting paid if you're sick and can't go to work; Pension at the age of 67; 60% of your last net income for 1 Year (or even more) in case you loose your Job, after this time rent for a small flat and ~430€ per mounth; Care in high age, and a lot, lot more…
    If you earn less money, you also have to pay less for these Services.
    The German tax System is simular:
    You pay pretty high tax rates, but you get for this: Free education at kindergardens and universities; free Job schools, money for further education so you don't need to get a part-time-job while studying; Kids at school get free Tickets for public transportation; Hightest quality Maintenance and expansion of infrastucture; etc….
    And also here: if you're married, you have children, you're income is low, you're single parent or widowed, you pay much, much less taxes.

    The German way is, that everyone has to give, so everyone has a benefit from the good economy.

  66. America claims to be the biggest defender of human rights in the world. Yet, every large- and medium-size American city has tens of thousands of homeless citizens who don't have shelters, much less healthcare.

    During cold winters and hot summers, many poor people die from the extreme cold or heat.
    Why can't the U.S. government guarantee even this very basic human right to its own people?

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