In the last article, we examined the United States healthcare system and its surrounding aspects. Today we move across the Atlantic to the land of Germany. Now, after looking at the United States healthcare system, the German healthcare system will be completely different. The German healthcare system is actually one of the most efficient in the world is Germany has one of the best population health outcomes over many different countries. So let’s get into it.

The first thing we need to understand and looking at the German healthcare system is sickness funds. A sickness fund functions much like an insurance provider here in the United States. The German sickness funds are something that every citizen has to be a part of. There are more than a hundred different sickness funds across the country. Now, every citizen has to be part of a sickness fund, but there are some exceptions that come with people wanting to buy private insurance. However, every citizen is required to buy health insurance. The way prices are negotiated for sickness funds in Germany is that half of the money is paid by workers and half is paid by their employers to the sickness funds, and the government will pay for the children and the unemployed. So we see that the government is still taking care of those specific underinsured populations much as the United States does under Medicare and Medicaid. Now, a measurement that we can use to measure the efficacy of the German healthcare system vs. the American healthcare system is how many months of life can be increased by spending $100 on healthcare in each country. Now, in Germany, if you spend $100 on healthcare, you’re expected to increase your life expectancy by four months, but in the US, you only increase your life expectancy by half a month. So we see that from this measurement, the German healthcare system is eight times more effective than the United States healthcare system, and there are many reasons for this.

Moving on, it’s important that we understand how finances work in the German healthcare system. The German healthcare system creates prices for medical needs based on negotiations between sickness funds and doctor associations. Doctor associations are groups of physicians that will decide prices for them and decide their salary and things as such. These two groups are those who decide the prices for medical treatments and pharmaceuticals in that country. Now because of these negotiations, we can look at the German healthcare system as self-governing. In addition to the sickness funds and the doctor associations, there’s also the Federal Joint Committee and the German Hospital Federation. Both of these organizations also fit into the self-governing system that is the German healthcare system. The Joint Federal Committee is what creates health policy, while the German Hospital Federation is looking to be a regulatory commission that makes sure the quality is ensured. Additionally, some of you may be thinking that there is no competition between these markets, which is simply un-American. But, there is still competition between sickness funds for membership which means that sickness funds are competing between each other to get members. This leads to sickness funds having to increase the benefits offered and cost and all sorts of things to try and get a membership. Thus, the competition is still there, which ensures that sickness funds are performing well. The network of relationships between these different organizations and the network of contacts is what binds stakeholders to that network, making it a bounded system. The bounded system itself is what engenders health outcomes and also betters how the German healthcare system runs as a whole.

The Lancet

Looking at payments, 11.3% of the German GDP is healthcare which is a lot less than the 17.9% that the United States spent on Healthcare from its GDP. The German healthcare system is actually the largest health system in Europe. In terms of the uninsured, the German healthcare system has 99.99% of its population insured, which is about a thousand times less in regards to the percent uninsured by the German healthcare system compared to America.

Lastly, looking at the healthcare Workforce employed by Germany, it’s able to be seen that there are a greater number of doctors and nurses per 1000 people than the OECD median. In addition to this, they’re 150000 medical professionals.

The German healthcare system is a great example of a smooth-running, healthcare-providing machine that effectively takes care of the entire German population. In comparison, the other countries we will talk about, the German healthcare system is far ahead of the game.

Sources

Busse, R., Blümel, M., Knieps, F., & Bärnighausen, T. (2017, July 3). Statutory health insurance in Germany: a health system shaped by 135 years of solidarity, self-governance, and competition. The Lancet . https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31280-1/fulltext.

Corbett, A. (n.d.). Comparative Health Systems. https://www.coursera.org/learn/comparative-health-systems.