German Health Insurance : A Case Study

Medical costs are getting too expensive. Ever fought with your insurance providers because they refused to pay for care, or struggle to find an “in-network” provider? I know a woman whose name I will change for her privacy and the struggles she is going through are a perfect example of an issue many people face when dealing with insurance; Nancy’s (name changed for privacy) story is a perfect example of how our healthcare system is no longer working for the people. Nancy is this woman whose husband recently passed away. Nancy used to work for county and county workers cannot receive social security; and Nancy is too

Germany’s healthcare system is split into two types of coverage which is public and private health insurance. Health insurance companies are not able to deny people coverage due to pre-existing illnesses or to discontinue their treatment because of high costs. The public health care insurance is provided by statute to individuals who are not eligible for private insurance which is people who are salary and make under $50,000 annually. As people age and become ill, they are able to opt out of their insurance and turn to the government’s option. As the economy continues to fluctuate, the population of Germany relies more heavily on the legislative insurance which consists of 85-90% of the population.

Healthcare systems vary from country to country (Chatterjee 24). The Bismarck Model utilizes private providers (Reid 17). For the most part it is paid for by employers and workers both (Reid 17). The Bismarck Model is not-for-profit and everyone is insured (Reid 17). Countries that follow the Bismarck Model of healthcare include France, Japan, Germany, Switzerland, and Belgium, and somewhat Latin America (Reid 17).

The main economic challenge for the healthcare system in the United State will be the rising expenses associated with Medicare and Medicaid. The Governments share of healthcare spending is predicted to rise to 31 percent by the year 2020 (Keehan, Sisko, Truffer, Poisal, Cuckler, Madison, Lizonitz, and Smith, 2011). This may jeopardize the economic stability and financial security of the nation.

If Germans become unemployed for any reason, their health insurance does not change at all. In contrast, if a citizen in the U.S. finds themselves unemployed their health insurance is eliminated with the job. They may qualify for unemployment, but rarely does this have any impact on health insurance coverage (Saul, 2014). Children and retired people do have options for health care coverage in the U.S. if not already covered with Medicaid and Medicare. Although if a person is retired, they do not qualify for Medicaid unless they are over the age of 65. This is quite different than Germany, where all citizens are insured no matter if unemployed, retired, young, poor, etc. The United States could definitely learn a thing or two by looking at Germany’s health care system.

This could be seen as immoral to some people of our culture because they want healthy citizens to enroll to get out of the debt that they have accumulated by opening up plans to people who already have preexisting conditions. Although people who just learned they will be facing significant health cost should not have the right to then go out and purchase health insurance because it is unfair to insurance companies that they have to cover extreme costs and untimely lose even more money from their company in the long

Known as the “Bismarck Model” according to reports, is a government –regulated healthcare system in a socialist country that provides healthcare for its entire population:

The U.S. is an industrialized nation that continues to be behind on providing health care coverage to all citizens. However, the German health care system came up with a plan that ensured all citizens are provided with some form of health care coverage; nevertheless, the U.S. continues to dispute health care reform and how to provide coverage to all citizens. “Health spending per capita in the United States is much higher than in other countries – at least $2,535 dollars, or 51%, higher than Norway, the next largest per capita spender. Furthermore, the United States spends nearly double the average $3,923 for the 15 countries ("Health Care Cost," 2011, table 1)”.

1. There are four generic plans for health care reform discussed in the text. The Canadian system is discussed, along with the German system, the British system and the American one. The current health care reform, the Affordable Care Act, is significantly different from either of the three other systems, but also represents a significant departure from prior American practice as well. The ACA features a mandate that each person must have health insurance. There are provisions to make it easier for companies to provide this, and for individuals to have insurance subsidized by the government. The plan also includes a number of reforms to Medicare and Medicaid to cut the cost of those programs, theoretically to pay for the ACA. The individual mandate is a contentious part of the program, but is essential because one of the objectives of the act is to provide health care for all Americans (White House.gov, 2013).

as defensive medicine practice, new technology, malpractice lawsuit and the uninsured. New technology is the biggest factor of the rising cost of healthcare to treated patient of their illness. New technologies have seemed to be the driving force of high healthcare cost in America. The technology accounts for 38 to 65 percent of healthcare spending in America (Johnson, 2011). The annual spending of health care increased from 75 billion in 1970 to 2.0 trillion in 2005 and is estimated to reach 4.0 trillion in 2015 (Kaiser Foundation, 2013). U.S. citizens spent 5,267 per capita for health care in 2002- 53 percent more than any other country” (2005). “America spent 5267 per capita and in Switzerland they spent 3074 per capita” about 1821 cheaper than ours (Starfield, B 2010). Controlling the technology isn’t easy thing to do because of technology prices are set by manufacturing and the installer of the new medical equipment’s. However, there other way

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.

A key feature to this system, much like the Beveridge Model, is that it is strictly non-profit and government-run. No one is denied coverage in the Bismarck Model. Most hospitals are privately run. Countries that operate their health care systems using the Bismarck Model include Germany, Switzerland, the Netherlands, and Japan. National Health Insurance Model

Waiting lists for treatments are rare. Medical facilities are equipped with the latest technology and the statutory health insurance scheme provides nearly full cover for most medical treatments and medicines. Almost everybody in Germany has access to this system, irrespective of income or social status.

Countries that have universal health plans, like Japan and Germany, have better life expectancy rates, spend less on health care, and have more than double the number of its citizens insured (Stephens & Ledlow, 2010). While the debate over

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what