I’ve gotten emails and comments from readers (a few self-described as scared) wondering what it’s like living with universal health care. To address these questions, I’ve decided to write a series on health care this week starting with a description of the system here in Germany on Tuesday and ending with a post with personal experiences on Thursday and/or Friday (depending on the response I get to this).
Why do I think this is needed? Because there are a lot of scare-tactics going on in the US debate on universal health care now. Some of you may have heard about Sarah Palin saying the government would create “death panels” to decide whether seriously ill and disabled people would receive treatment or be put to death, or that there are people comparing Obama to Hitler and Democrats to Nazis.
If you’ve got a personal experience with health care in a country providing universal health care coverage (Germany, France, UK, Canada, Italy, etc), I want to hear from you. You can email me your experience at christina [at] amiexpat [dot] com, or you can write it up in a post on your blog and send me the link by email or in the comments to this post. I may have to edit down some comments, or I may end up making this a two week series, who knows? But I want to gather as much personal experiences as I can. The good and the bad. And how do you think universal coverage you’ve experienced compares to the US system? (If you have experiences with both).
I look forward to hearing your thoughts, and hope we’ll have something to add to the debate on heathcare in the US. If we can help allay even one person’s fears, shouldn’t we?
{ 16 comments… read them below or add one }
Hi Christina, so glad you’re doing this. I wrote a post last week about my experiences with the French health care system, which were all positive. http://parisianspring.blogspot.com/2009/07/french-health-care.html
Thank you!
- Tanya
I’m so glad you’re doing this! It’s really great to see one of the higher-profile expat bloggers take this on.
My story isn’t very dramatic. It starts like this: I had a cold.
It was January or February of 2006 and, up to that point, I hadn’t been to a General Practitioner for anything (just annual Gyno visits). I don’t go to the doctor if I can possibly avoid it, but this cold wouldn’t go away. It lingered for about three weeks and had developed into a nasty cough. So bad, in fact, that I had to sleep sitting up in an armchair.
Because I was afraid that it might be turning into bronchitis, I called a friend and asked for a doctor recommendation. Her Hausarzt was within walking distance, so I called and (after apologizing for my German), told them what was going on. They were completely booked for the day, but the very nice receptionist told me to come when they opened and they would get me in as soon as possible.
When I got there in the morning (5 minutes after they had unlocked the door), the waiting room was already full. I expected the worst. I went to desk to give them my card and proceeded to wait for about 30-40 minutes. I saw the very nice doctor and he confirmed my suspicions – bad cold, could become bronchitis – and gave me a prescription. I was in and out within 10 minutes, paid my 10€ co-pay (only once per quarter, if I’m not mistaken) and went to the pharmacy.
My prescription was for a 5-day course of antibiotics and the pharmacist apologized for the cost (5€), then proceeded to tell me how to take the drug (with food, take it all) and after giving me a complimentary packet of tissues and well-wishes (Gute Besserung!), sent me on my way.
Not terribly dramatic, I know. However, I think this is a pretty typical situation for Americans: you come down with something, but don’t go to the doctor because it’s a hassle. Then the something gets worse and you HAVE to go. My experience, except for the being ill part, was as hassle-free as can be. Plus, it was inexpensive, and we’re on that allegedly frightening government plan. It’s worth noting, I think, that Germany has a ‘public option,’ but you can opt for private insurance as well. With higher costs come more benefits, but everyone here is entitled to care.
Hopefully, my husband will chime in. His story is a lot more dramatic than mine.
.-= Sarah´s last blog ..Delicious Chickpea Soup =-.
Thanks for your stories, Sarah and Tanya!
I just wish to point out that Germany’s health system is very different from the “socialized” system of the UK or Italy because from my understanding Hospitals and Doctors are not employed directly by the goverment. Also you actually know how much money goes into the health care system. In Italy and the UK you pay taxes but then the goverment decides how much to put into the health care syetem and it is true that they are not always investing enough. That said my aunt just had to have a 12 hours surgery, performed by the best surgen in the best hospital in Italy and didn’t have to get permission from anyone. Her 15 days hospital stay was $0.
Still if I had to choose I would rather go with a German type system, I think there is more competition and so doctors and hospitals works better. This is what I heard from a friend who moved from Italy to Germany. I only lived in Italy and now the US so I can’t compare directly.
This is a really interesting subject and something I will need as I plan to move to Germany in the near future.
I can write a piece about Canada’s health care and email to you. TBA
.-= Rhona´s last blog ..Am I too old to be making life changes? =-.
I actually already blogged my impressions of German health insurance a couple of days ago. Biggest advantage: peace of mind.
.-= Scott Hanson´s last blog ..My Health Insurance and Welcome to It =-.
I had been having bouts of internal pain (back? belly? it was hard for me to localize) lasting several hours occasionally for a couple years before I finally sought medical attention. When I did, it was after midnight on a weekend. Sarah and I walked the 30-second walk down to the nearest hospital and rang the buzzer to altert the night staff that we were outside. They admitted me immediately (pretty much all I had to do was flash my Krankenkasse card) and made me stay overnight after examining me — even though by then, I could tell that I was through the worst of it (based on my experiences thus far). The night nurse couldn’t find anything wrong but suggested I stay overnight so that the internist could get a crack at me first thing in the morning (he was all booked up and I didn’t have an appointment).
It didn’t take him long with his ultrasound scanner thing to see that I had some pretty big (14mm!) gallstones wreaking havoc in my gallbladder. I scheduled an appointment for a consultation with the anaesthetist and the surgeon to have my gallbladder removed shortly thereafter. I had to sign off on the risks of surgery and anaesthesia, note all my known allergies and family histories and all of that. On the morning of the surgery, I got prepped (I.V. drip and all that) adnd vaguely remember being wheeled into the operating room as the drowsiness set in.
Then I woke up, sore and thirsty and more or less in good shape. I was relegated to a diet of weak tea, weak broth, and two zwieback crackers for a couple days. The first time they let me have some real bread, it arrived with an oversized pat of butter. I ate it all. I was so happy to have something with flavor. The chief surgeon was checking up on me at the time and scolded me, saying “Soviel Butter braucht man nicht…” but (a) it was the first non-zwieback, non-broth food in several days, and (b) they put it on my tray!
I ended up staying in the hospital for shorter than the expected amount of time. They would have preferred to have me for longer, but the chief surgeon reluctantly agreed that I could go home, since we lived so close to the hospital and I was making good progress. I checked myself out after four days and paid my bill later via Überweisung. €40 was all I owed, since I’d paid the rest in advance by being employed in Germany and belonging to a Krankenkasse operated under state guidelines.
I think those are the important things to keep in mind: health care here isn’t free, and it sure isn’t one-size-fits-all and medical professionals are not employees of the government. But it sure did work for me when I needed it.
I guess I don’t agree with that phrasing, applied to Germany. Germany doesn’t provide universal health care in the sense that the government pays for your care and pays the salaries of the workers and equipment in use at medical facilities. Rather, Germany requires you be insured. You can purchase insurance through government plans or private insurance. But you will purchase insurance, and when you use it, you generate income for the medical system. To what degree hospitals are privatized or subsidized by the German government is another topic and I’m certainly not informed enough to comment on it. But I do think it’s important to make the distinction between providing universal care and requiring income-earning members of society to pay for their care.
Oh, and about the stones: I asked them to let me keep them. I got the four largest ones to take home with me in a jar. Ask me to show them to you the next time you’re over to visit, or check out this slideshow.
.-= cliff1976´s last blog ..Delicious Chickpea Soup =-.
I have written quite a bit about my pregnancy experience in Germany, and I have to admit, over all, I enjoyed Germany’s system better than the US. We were covered by a public plan, and I was always able to get an appointment when I needed it (for the pregnancy, pediatrician, mid-wife, general doctor) and even though the wait was sometimes longer than I wanted to stare at art in a waiting room, it was no longer than the doctor’s offices in the U.S. Yes, we paid for it via taxes courtesy of Kevin’s position, but not having to wonder how much more it would cost at the office (beyond my 10 Euro of course), was great. I also believed that I received better care with a better outcome during labor and delivery. My follow-up care was better. The Boy’s care was outstanding. Kevin’s knee care was good. We had a great experience in Germany.
I also lived in France for a bit and became pregnant while there, and also received great care in a timely manner.
In both cases, I never worried about insurance covering procedures, though we did have to pay for my son’s circumcision (unnecessary surgery anyone?), I never had mounds of paperwork, no worrying about if my doctor was “in network” or out, and never huge additional bills to pay for procedures, visits or tests. We were not crippled by costs, and we received excellent care.
.-= Maria´s last blog ..Think About What You Saw =-.
@marilena: Thanks for your insight.
@rhona: Great, I’m looking forward to hearing from you.
@scott: I’ll be sure to link to your article from mine.
@cliff: Thanks for your story. Your disagreement with my phrasing is fair. I found choosing the wording for that sentence tricky, as each country has a slightly (or very) different system and there wasn’t an easy way to quickly write it in a sentence. I figured I’d clarify everything in Tuesdays post anyway, and I meant it here in a, “Germany provides health care for everyone by requiring that everyone have health insurance” kind of way.
@maria: Thanks for your story, Maria!
There’s a great article at FiveThirtyEight describing the differences in terms for health care programs.
http://www.fivethirtyeight.com/2009/08/not-all-socialist-countries-are-alike.html
.-= Sarah´s last blog ..Delicious Chickpea Soup =-.
I just posted on this over on my blog thanks to your initiative. We had American friends visit this weekend and had a good discussion over how it works here in Germany and common misconceptions.
.-= Juliette´s last blog ..Health Insurance in Germany: our experience =-.
Our health care/insurance industry in the United States must be reformed! It is absurd that Americans live in fear of getting sick and losing everything they worked hard for, i.e., home, if stricken with a catastrophic illness or injury. Too many people, because they’ve either lost their jobs (and insurance), or had a salary cut because of the economic downturn, cannot afford preventive healthcare and dentistry. My husband is a German citizen (we live in the U.S.), I’m an American and I am quite familiar with the German healthcare system. I’m so dismayed at the flurry of misinformation being disseminated in this country.
Thanks for the opportunity to comment.
My primary health care experiences in Germany (we’ve lived here 5 years now, I’m American, husband German) has been with my two children. In summary, -very happy-. Pre-natal care was great with frequent appoinments, ultrasounds, any needed tests (although often a longer than I wished wait in the waiting room) at no extra costs. Both sons were born via C-section, I stayed 6 nights (1st son)and 4 nights (2nd son) in the hospital with excellent doctors and nurses, good food and the whole stay cost 10 euro and ~ 30 euro (I requested a semi-privat room for baby #2) respectively. I cannot compare the hospital to those in the States but I have heard from friends that perhaps in germany they -may- be a little less modern, we definately had no privacy curtains and if I had wanted a single room, i would have had to pay around 150 euro a night. Perscriptions for children we don’t have to pay at all. We have just the ‘basic’ german health insurance. I’m quite happy with the health care here!
.-= baroquebabies´s last blog ..Set the table with felt =-.
@sarah: Thanks for the link. Nice article.
@juliette, rebecca and baroquebabies: Thanks for your stories, I’ll be quoting them in the personal experiences post at the end of this week.
I see noone has mentioned worker’s comp yet, so to make things complete I’ll mention it.
I had one experience with worker’s comp back in 2004, which I briefly blogged. I tripped on the stairway at an S-Bahn station on my way to work, and it was uncomfortable enough that I went home from work early and say a doctor. It was officially a work accident, so instead of a Krankenkasse, a Berufsgenossenschaft (literally “occupational guild” but officially “institution for statutory accident insurance and prevention for trade and industry”) or BG was responsible for paying for my care.
There are 35 BGs divided by industry and are fully financed by employers. They their own rules and bureaucracy, so that meant I had to see a BG-sanctioned doctor. He found no serious injury and prescribed a week off of work for rest. I never had to file a claim or pay a bill. That was it.
As a employer, the BG is a bit of a pain. It’s a club we have no choice but to join (kind of like the Handelskammer or “chamber of commerce”), and we don’t have any say over our rates or how it’s run. And filing accident reports is what you would imagine for a German bureaucracy. But we know our people are well cared for when they get hurt, and that’s the most important thing.
.-= Scott Hanson´s last blog ..My Health Insurance and Welcome to It =-.
My experiences (as US citizen) of medical care was with the British NHS. When I first became involved in having to use the system, I was a little shocked. Things were different. But in the long run…I had peace of mind that I would not lose my home due to medical bills I couldn’t pay if god forbid something did happen. There was NO paperwork to be filed. I could see my doctor as often as I wanted with no co-pay. I didn’t have to wait for hours and hours to be seen.
I now live in Holland. Holland did away with their socialized meds program a few years ago now because they deemed it too expensive, however, people can still get basic care here. My insurance is much like that of the US. I pay quite a bit monthly 175Euros ($250) and get very good care. Still, I have quite a high deductible.
I am cheering for the NHS. It may not be perfect but it is the peace of mind it brings that I think is most valuable.
I am pessimistic that America will move away from it’s current model. Too many scared people who are reluctant to change. That is too bad and one of the reasons I will not move back there. Ever.