06-19-2008, 07:52 AM
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Commentator
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Join Date: Jun 2008
Location: Boston
Posts: 1,257
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here are the program's results for the Germany:
GERMANY
Quote:
Percentage of GDP spent on health care: 10.7
Average family premium: $750 per month; premiums are pegged to patients' income.
Co-payments: 10 euros ($15) every three months; some patients, like pregnant women, are exempt.
What is it? Germany, like Japan, uses a social insurance model. In fact, Germany is the birthplace of social insurance, which dates back to Chancellor Otto von Bismarck. But unlike the Japanese, who get insurance from work or are assigned to a community fund, Germans are free to buy their insurance from one of more than 200 private, nonprofit "sickness funds." As in Japan, the poor receive public assistance to pay their premiums.
How does it work? Sickness funds are nonprofit and cannot deny coverage based on preexisting conditions; they compete with each other for members, and fund managers are paid based on the size of their enrollments. Like Japan, Germany is a single-payment system, but instead of the government negotiating the prices, the sickness funds bargain with doctors as a group. Germans can go straight to a specialist without first seeing a gatekeeper doctor, but they may pay a higher co-pay if they do.
What are the concerns? The single-payment system leaves some German doctors feeling underpaid. A family doctor in Germany makes about two-thirds as much as he or she would in America. (Then again, German doctors pay much less for malpractice insurance, and many attend medical school for free.) Germany also lets the richest 10 percent opt out of the sickness funds in favor of U.S.-style for-profit insurance. These patients are generally seen more quickly by doctors, because the for-profit insurers pay doctors more than the sickness funds.
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AN INTERVIEW WITH KARL Lauterbach, one of Germany's foremost experts on health policy, is a professor of health economics and epidemiology at the University of Cologne and a member of the German parliament. Here he discusses the German system of social insurance, developed by Chancellor Otto von Bismarck in the 19th century, and what lessons America could learn from it. This is an edited transcript of an interview conducted Oct. 25, 2007.
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When a true genius appears in the world, you may know them by this sign, that the dunces are all in confederacy against them.
- Jonathan Swift
--- "Thoughts On Various Subjects, Moral and Diverting."
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