12-23-2016, 02:03 PM
(12-23-2016, 12:57 PM)Dill Wrote: I'm glad you mentioned "single-payer." Germany does not have a single payer system. Everyone is insured through an insurance company, not the state.
The two main differences are these:
1. There is a partial mandate--EVERYONE making under a certain yearly amount (at the moment 50,000 Euros) must have insurance.
2. For those making less than the cutoff, there are coop insurances, run by the insurers. E.g., ours was Barmer Ersatzkasse. We voted for a board of directors every few years, received budget reports in the mail, etc. These insurers are not government payers, but as I understand it, if they run over budget, the gov. makes up the difference. So there is a two-tier system, with rich folks buying private insurance or just choosing to go without, and the lower earners who must have insurance but also have the cheap, coop option. Rich folks can't just buy the coop insurance. But my wife and I went above the cut off point two years after our arrival in Germany and were still allowed to keep our cheap BEK because we were already on it.
Again I reiterate--it was so nice NEVER SEEING A BILL from doctors or hospitals. Perhaps therein lies the secret of bringing down US health care costs. If 10 million Americans spent a year in Germany and returned to the US, our health care system would be changed for good.
I might add, I have several Japanese friends who are also very critical of "the worlds greatest system." One was studying to be a nurse in Pittsburgh. She became pregnant from her American boyfriend and went back to Japan to have the baby, because she felt the care there was not only double cheaper but of higher quality.
Perhaps Americans would find this sort of option more palatable than single-payer. It would at least widen the debate over options.
You lost me at, "I'm glad you mentioned 'single-payer.'" Sounds like "socialism."
