German Healthcare System | American's view after 2 months in hospital Das deutsche Gesundheitssystem
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- Опубліковано 15 лип 2024
- #germany #healthcare #germanhealthcare
I'm back in Germany!
Healthcare is a hot political topic in the united states today. American politicians routinely point to systems around the world as a model for the United States. Today I sit down with John, an american expat of nearly a decade, and discuss one of those systems.
About John
John has a degree from the university of Alabama, and a masters degree from a German University. He has been working as a computer programmer and software engineer since doing freelance work in college.
Check out a previous interview with John
• Cologne Germany | Advi...
Global Vagrant Instagram Username:
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If you enjoyed the video be sure to like, and subscribe for more uploads. If you have any questions please feel free to ask in the comment section. Remember this is just the opinion of both John and myself as we see things. We are not and do not pretend to be experts in healthcare or Germany.
Thanks for watching and as always God bless
Maybe next time when talking about a complex topic try to have one person at hand who knows at least the basic facts. Then you don't have to speculate about stuff you easily could have looked up in Wikipedia and embarrass yourself when it comes to the facts. Personal experience bits are fine, but as soon as you went to pure fact stuff you got sooo much wrong or misinterpreted! In german there's the word "Halbwissen" that expresses that kind of half-fact-half-speculated "knowledege"
You are 100% right!
Especially "Fundiertes Halbwissen" - certified half-known half-speculated facts;-)
Right...maybe you should have talked to somebody who knows something about.
Absolutely! Lot of BS! Nurses are not allowed to take your blood in the hospital? We have a shortage of doctors? Fox-News Quality!
@@Face1979 Nee, Fox-News hätte daraus ne Mörderische Psychokrankenschwester gemacht, die versucht Patienten leer zu pumpen...
a bottle of insulin costs ~ 300 $ in America, 38 $ in Canada, 16 € / 17.82 $ in Italy, 13 € / 14.48 $ in Germany "including prescription fee and shipping" same manufacturer, same product, same content, it's rip off
Why the health system costs less and is of higher quality on average? 1) EVERYBODY pays in, in one form or another. Health insurance is mandatory. Period. That means there is more money in the general system, even if those who are paying, are paying less individually. 2) The insurers negotiate the drug prices. Because they have masses of people behind them, the insurers have big-time clout and get lower prices. 3) The government buffers the price of medical education so that anyone who is talented enough can afford to become a doctor. That means there are quite a few doctors, and many of them are very good at what they do. The German idea of the "Social Market Economy" also carries through in a measured way into medicine: There are "market" forces at work in this area, but they are limited and supervised. The health care economy has the duty to serve society, no matter what that does to the "market" ideology.
Anybody with good enough grades can go and be a doctor? University is universally free in Germany, no need for any special programs.
Nobody can‘t become a doctor because they‘re lacking money.
Otherwise you‘re on the mark!
The two discussion partners do not seem to be aware of the major problems the German health system has. If you look under the surface and behind the phrases ("Everyone gets the best possible care"), you can see that the system is slowly but surely dying - at least the statutory health insurance system. Private health insurance does not have these problems. Statutory health insurance has not been able to finance itself for decades. That is why there have been constant cuts in the scope of services since the 1980s. Since the late 1990s, the problem has worsened dramatically. Therefore, the billing system has been "adjusted" in such a way that it is no longer worthwhile for many doctors to treat patients with statutory health insurance. More and more doctors are therefore deciding to only treat private patients. This contributes to the shortage of doctors and the long waiting times for patients with statutory health insurance. In addition, a system of hidden rationing was introduced, which meant that doctors could no longer use many innovative methods. Especially with cancer therapy, patients receive a treatment that is partially completely outdated. The expensive genetic engineering treatments that are emerging are increasingly exacerbating this problem. As things currently stand, these procedures will not be available to patients with statutory health insurance, which significantly reduces the survival rate for cancer. The same problem occurs with new, complex diagnostic methods. On the subject of a shortage of doctors, many young doctors no longer want a license that would allow them to treat patients with statutory health insurance. They prefer to focus on the patients with private health insurance because they only make enough money with them. All in all, the development leads to the following result: An underfunded system for patients who are fed off with minimal care, but have to pay ever higher contributions for it. A modern system of private doctors and hospitals for private patients, equipped with high-tech medicine. I could go into more depth on each point mentioned and give many examples. So overall, it's understandable that the vast majority of doctors in a survey indicated that healthcare is deteriorating dramatically.
@@Kl-bx9gv Boy, you must have stock in private health care insurance!!! I really, really dislike the private insurers and wish they would disappear. And no, I won't go into my reasons, but they are legion. As for the extremely expensive types of medical treatment: That is indeed a problem, and I suppose at some point either not everyone is going to be able to get every theoretically possible treatment, or there will have to be laws passed that reduce the costs. If that means the treatments are discontinued, then so be it. This is an occasion for one of my favourite sayings: "You really don't think you are going to get out of this alive, do you?!"
@@k.schmidt2740 I have no investments in private health insurance. I also have little sympathy for these insurance companies. Nevertheless, investments are worthwhile and that is part of the problem. However, I find it a pity that you did not address any of my points directly. On the problem: The healthcare sector is one of the most profitable areas in the current economy. This means that billions of euros flow out of the system and into private investors, which drives up the costs enormously. At the same time, there are misguided incentives that drive doctors out of the statutory health insurance system. The resulting shortage of doctors reduces the quality of the healthcare system. If we want to keep our healthcare system efficient for those with statutory health insurance, a number of steps are necessary: First of all, private investors must be prevented from making enormous profits from the system, for which the statutory health insurance companies or their members ultimately pay. That would free up a lot of money that would be better spent in other areas (such as nurses' pockets). Furthermore, it must be prevented that innovative drugs are sold at extremely high prices, which test the limits of the solvency of insurance companies. Finally, one would have to think about introducing insurance for all citizens.
@@Kl-bx9gv I agree with your second comment above wholeheartedly. What I did not like about your first answer is that it seemed as though you preferred the private companies - which I definitely do not. I see the effects of both versions of the system, as I am insured with the statutory insurance and my husband is "private". That means his insurance company pays fees that mine would usually reject out of hand. On the other side, I don't have the impression that he gets better care than I do. It's just sometimes a bit faster and costs much more. I would support finding a way to insure all citizens under the same terms and conditions. The one thing that I did mention was the hair-raising costs of new therapies that are neither possible nor probably even desirable for every insured person. That is a problem that should indeed be addressed head-on and legislated.
Why insurance is so cheap: everyone pays for it, if you’re sick or not.
Unfair for those that aren’t sick? Yes, but you can be sure, they’ll pay for you if you eventually get sick.
unfair ??? are you crazy you pay and know if you need care you will get care . I love to pay and be healthy but at the same time i don`t worry about getting sick . And in germany the healthcare is private but it's profit non profit option . there is no government run healthcare . It`s an insurance so be glad if you are healthy and don`t need the services
Everybody gets sick. Unfair he say... 😂😂
Sickness is just a matter of time.
you also pay for your kids. its not unfair. i rather have it that way instead to worry about evry operation. now in covid 19 you can see the diffrence.
@@wanderslust1781 I hope you continued reading my comment past the
"Unfair for those that aren’t sick? Yes"
because the "you can be sure, they’ll pay for you if you eventually get sick." is the thing that matters.
What is the difference?
US: Business first
Germany: Health first
Not true, business and health, it's all on the same side of the coin.
Some comments:
1) In Germany, you can freely choose the doctor you want to go to. You can switch your GP, etc.
2) Germany has 4.2 doctors per 1000 citizens. For reference, the US has 2.6.
3) If you’re privately insured, you do get some perks. Mainly that you get appointments quicker because the doctors can charge more (a lot more). Also, you can get an option to be treated by a senior doctor in a hospital. But if you are in an emergency situation, it doesn’t make a difference if you’re publicly or privately insured.
4) However, once you choose to go private, you can’t go back. And typically your rates go up as you get older. So it can be a dicey gamble. Also, if you have kids, they have to be insured with the parent who earns more. In the public option, kids are free, not so if you’re privately insured.
so, now we watched an interview without any knowledge about the topic.
I think within the first 7 Minutes most answers started with "I don´t know...*speculating, estimating, thinking*" and the reply is *so that´s how it works*
i like how cautious john is with the information he spreads. also the "i have no idea" instead of having to have an opinion.
Public health insurance is 14% of the individual's salary exceeding 450 € a month, split in halves between employer and employee. The employer also has to pay full work-related accidents insurance while the employees pay their care insurance themselves. Employer and employee also share unemployment and rent insurance halves. Altogether, church tax and added solidarity deduction, Income tax and social insurances are roughly 33% of your income when you're unmarried and childless. Taxes do progress with your salary, though.
Thanks for the feedback and insight. Really interesting discussion.
Well, I´m have a private health insurance. I´m paying about 580 Euro (100%; age: above 50 :-)). At the public health insurance I would pay the max amount of about 760 Euro. If you´re employed, your employer pays 50%. If you´re self employed, you have to pay it yourself (100%, like me).
The max income tax ("Einkommenssteuer") in Germany is 45% (Income tax only! Without any other taxes). If you´re single, no kids with a reasonable payed job, you will pay about 35% income tax only (On average. Because the tax rate is staggered. Starting from about 54.000 Euro, you have to pay 42% income tax for every Euro you earn more).
Paid sick leave... and usually people also can deduct things from their taxes
@ right. So the most people only pay about 15-20% income tax.
@@dannidjkml1960 Top Rate tax payers (45% above 60000 € income as a single above 120000 € as a couple) approx. 5% of the whole working community paying approx. 42% of the whole income taxes; the group below with income between 30000 and 60000 (single/couple) which are 20% of the whole working community pay approx. 43% of the whole income taxes in Germany. So the top 25% of income tax payers pay 85 % of the income taxes. The figures a little bit outdated but I think the general ratios are still the same. This is only for the taxes, you have to pay for yours employees income, the money you make with your capital has to be taxed either, but this time only with max. Tax rate of 25%.
Good interview to share experiences💓
It takes three years to be a nurse not two. And prescribing medication is NOT a simple thing - you can kill a person by prescribing the wrong medicine. I would highly recommend getting my prescription from a doctor.
The biggest problem in german healthcare is the "Fallpauschale" - fixed price per treatment. We have four times as much heart catheter surgeries, three times as much knee operations, three times as much hip operations - for example - than our French, Dutch, Danish, Suisse or Austrian neighbours. Why? That brings the money into the hospitals they need to renovate their rooms, or get the house technics on top. If we abolish the "Fallpauschale"- system ( DRG-system) we would do less nonsense and had emmediately enough nurses and doctors.
Nah. Drug prices are not regulated. However, the statutory insurance companies negotiate contracts with the producers and have much leverage in these negotiations, since they have a lot of members. In addition, if it is a patent free drug, you will get the generic (none brand) drug (which is the same substance and has the same efficiency). There is regulation (regarding what a physician might charge you). But all in all, overall lower cost is probably owed to the fact that everyone has to have an insurance. Insuring everyone spreads the risk an drives the costs down.
All in all i have been here (Stuttgart) for 34 years.... i would say if the average american making less than 100,000 would LOVE to have my health insurance period.
PHENOMINAL Video. Very informative and might I say great guest choice. Also, I like the stranger things like music at the end as well.
Thanks broski
The maximum daily hospital cost that you have to co-pay is 10 €/day for up to 24 days per year. After that your insurance HAS to cover all additional hospital costs.
Only elective non-medical surgery, as well as a few dental procedures are NOT covered by the health insurance, either public or private.
Hospital and ambulance transport is also covered completely, dito physio therapy.
German pharmacy products are limited in cost due to the insurance companies cooperating in keeping the costs low. The pharmacy companies can not simply increase the prices however they want.
Private insurance simply goes a bit above and beyond what public insurance covers.
Yes, some hospitals specialize in certain procdures, thus they are better known for their successes. Yes, you can choose any hospital in Germany to be delivered to. But obviously some of the highly specialized ones might not have an immediate appointment for you. But no matter which hospital you choose, all costs will be covered by your insurance (elective surgery not included). Some insurances even cover the transport from one city to another across Germany. But in essence most procedures will be at absolute minimum adequate to outstanding in German hospitals.
You can continue to get more opinions from different doctors.
Yes, currently there is a shortage of medical personnel, especially general practitioners in rural areas, as well as nurses in hospitals. Yes, nurses can take blood in hospital.
Some practices decide they accept only privately insured patients. Yes, they can do that, but only about 15% of all insured people in Germany are part of the private insurance companies. So private only practices have a much much smaller market. Yes, filling out forms has become too much of a chore even for doctors.
Head doctors check on the patients once a week usually. Other doctors definitely have the right to decide on procedures for you. Only nurses can not decide on procedures.
Nurses are allowed to apply pharamceutical products assigned and prescribed to you.
Immigration might influence the cost negatively in the very short term. In the medium or long term immigration will actually HELP the German healthcare system. Anyone employed legally is going to participate in paying for the cost. As so many others have said most immigrants will be young to middle aged, as such their chance to fall seriously ill is fairly low so their burden for the insurance companies is going to be low as well.
Dang... I should do an interview with you about healthcare! Thanks for the detailed feedback amazing
no, ambulance transport does cost 10 € also
Not to forget: salaries for medical personnel are also negotiated through the work of the unions.Even if our doctors and nurses are not all on strike for better salaries and working conditions at the same time, but are drawing up an emergency plan, the willingness to strike for their cause has increased.
Gute Besserung!
Two things I want to mention:
Nurses in the hospital can take your blood if they have the so called "Spritzenschein", meaning they are trained appropriately. Doctors earn a lot more in germany than you think (12.000 € / month and more), they get money for their work as professors at universities, for publishing books or articles in renowned magazines, for other things like visits in saudi arabia and so on. They are not poor compared to US doctors.
All the best for you John. I wonder why migration should only lead to higher costs. In fact most people migrating to other countries are younger and have less need for medical services. When they are integrated in the system and start to work they effectively strengthen the system as they also pay their fair share. The question is, whether it is really cheaper for a society to privatize individual healthcare risks ...
Exactly. And also Germany's population is aging so we need migration to offset that. Health minister is even going to less developed countries to advertize recruitment programs for trained nurses which I find ridiculous and harmful to both side. We should invest more in better pay, working conditions and more training for nurses here rather than further exploiting other countries drawing away badly needed personal from there AFTER their home countries already invested into their training etc just so we can keep conditions low here.
Edit: Also it is usually not cheaper to privatize. At most it is equal. Regulation usually makes the key difference and it doesnt really matter if organizations are run publicly or privately if the same standards and regulations apply to both (like how public health insurance in Germany is actually private as well but heavily regulated as opposed to private private health insurance). The problem with privatization however is that is often not the case and they are allowed to run a muck to increase short-term profits which comes at a higher cost for the public.
If the lower payment results in less people who want to become a doctor?
If you want to get into the medical study with your final school degree, you need to have visited "highest" school type (we have different public school types) and there the highest final degree: a 1.0 (marks from 1-6, similar to A-F) as middle degree through the last 2-3 years of school + final test (Abitur). Otherwise there will be too many better students than you how apply for the avaible study places in medicine. Sometimes, if you are lucky, that"line" (NC) drops down to 1.2. Another option to get into medicine studies is via a waiting list. You can easily wait for 6-8 years, maybe never get a place.
There is a huge discussion about this issue.
For becoming a German engineer, you just need to pass the Abitur or a "lower" Fachabitur.
So shortly: No, becoming a doctor is still one of the most requested academic jobs (together with law school ("Jura"), psychology and pharmacy).
you need to consider that wages in germany are lower than in the usa. that is even more true for "high paying jobs" than for low to average skill jobs. doctors are among the highest earning people in germany. you cant get much more for a regular job. if you want to live a life in which money is no issue, you should aim for being a doctor or lawyer or something like that. you could say that the lower wage may drive the best of the german doctors to work in the usa instead of in germany, but at the same time germany leeches docors from lower paying countries especially within the EU.
These questions are way to specific to ask a normal person! 10-15 Euros a day in Hospital, nurses do a lot of stuff as they have professional training of at least 3 years, EVERY priscripted drug is 5 Euros period (!), you can ONLY have private insurance when you earn a certain amount (!), the Pharma Industry and insurance health companies are a NON-PROFIT Sector. Done! Yours, a Black German
5-10 euros for prescriptions. I pay 10 for mine, but that is the max. You got the hospital stays correct, and if you are chronically ill, after paying a certain amount, you do not need to continue to pay for extra stays the rest of the year.
*friendly German cripple *
Additional information on private insurance: Self-employed persons and civil servants can also use private insurance. The problem for civil servants: the private (supplementary) insurance only pays if the state insurance provider pays its share.Employees often stay in statutory health insurance if they calculate precisely, even if they reach the required salary class, since they will then either have a family or be older and they will no longer really save money.
The Price for the Patient is 10% ( minimun 5 Euro / max 10 Euro) per prescription drug. Nearly everything you have to copay for prescriptions, hospital stays etc. is tax deductible. in addition all copay is caped at 2% of the total family income (1% if you have a chronic disease). Once you reach the 2% with your Family you can get a "Befreiung" for the rest of the Year.
Unfair? That is THE SENSE of an insurance that takes effect IF something happens. Is that what you do with car insurance? "Sorry, that's unfair, I haven't had an accident in the last 20 years, why do I still have to pay contributions?" And you're not bankrupt BEFORE you get to the hospital because the ambulance costs 5000$! American logic is sometimes priceless ... ;)
One great fact of the public insurance is, that your wife and your kids are included in the insurance if they don't earn their own money.
Every hospital has a specialty here in Germany. The house doctor will send you to the hospital needed in your case. There are station doctors, upper doctors and chief doctors in the hospital actually. Nurses can do a lot, but the station doctors do it bc it is mandatory in a hospital. The upper doctor is responsible for the station doctors. The chief doctor does the oversight, the research and the difficult cases. The head nurse is like the upper doctor. In a university hospital, there are medical students. They aren't doctors yet, but practise medicin at different stations, under the oversight of station, upper and chief doctors.
Wow, neither one of you have any idea about how the german health systems works 🤣😂 that was 20 minutes pure speculation 🙈
yeah I'm five minutes in and he'S like 'if your young and healthy you might go private for a cheaper option' .... that's when you know they have no clue.
The government only sets a catalog for all treatments. The prices are regulated by the insurance companies and the licensed physicians. There is a certain amount of points available for a year and and a doctor earns points depending on his practice and number of patients. The value of a point will be finalized at the end of the year - which is annoying when all doctors worked 'to much'.
The hospitals get a fixed rate per disease (Fallpauschale).
One big advantage of the German system is that you get paid for six weeks while you're sick. After that you are eligible for Krankengeld, a payment by the health insurance (GKV) for another 78 weeks.
another one is transparency of the costs and one can calculated them, impossible in US
Guys, perspectives are nice, but do you even take the time to research for facts? The whole picture is correct, but you've got so many details wrong...
exactly, i think the title of the video was wrong. it's his personal experience with our medical system, not a general description. And like you said: he didn't do a lot of research.
There are just a limited places in the universities for medical students, because it is a complex study. Medical students just do not sit only in an auditorium listening to lectures. Thus, medical students which are actually accepted at university are selected based on their grades in the Abitur. Usually medical students in Germany therefore are the best students of a given year in public school.
With public type insurance a person pays around 7.5% and the employer pays 7.5% ..... no co pays and medicine cost max 10 bucks..... the system works real well. Remember the key thing is by going to the doctor when ever you want will help identify problems before you get to a critical point
Well the costs are not he same in the states. Just for the ambulance you would have to pay around 1000 to 3000 dollars, for one ride. For the operation and the treatment all in all 150.000 dollars out of your own pocket. If you are poor or do not have an insurance at all... well homeless or dead.
Private insurance is cheaper when you are young and becomes more expensive getting old. You get the bill from the doctor and pay. You send it to the insurance to get reimbursed. The doctors like it, because they get the money fast - from you. therefore you get a date with a specialist faster than somebody from the general health insurance. I asked the cardiologist here for a date and it was 13 months. When my general practicioner asks for that it will be appr. 3 or 4 months. When he thinks its urgent it will go by a special agency that make sure i get a date within 2 weeks. When he thinks its life threatening, its on the spot. Happened to me. I have the normal insurance.
The difference between the private and the public option wasn't explained pretty well...So, if you have a public option, you pay a percentage of your salary (meaning low earners pay less, high earners pay more, if you are unemployed the state eventually covers you). If you have private option, it's a progressive system, meaning you pay very little when you are young, but then more and more the older you get. Because of this you are only allowed to go private once you earn a certain salary (or are employed by the state). And no, you can't just switch back to the public option once you get older, when you do that, you have to pay for the missing years (not sure how that exactly is calculated).
Because of this, even people who could afford to go private don't. Instead they keep the public option but add an additional private insurance on top, which gives them the perks a private insurance offers without having to leave the security the public option offers.
Oh, and a special case are soldiers. They can "buy into" an insurance. That means, that while they are still with the military, the military takes care of them, but if they leave the military, the insurance they originally bought into covers them and their families.
Also important to mention: There are different insurer you can pick from. The difference between them isn't that big, because the public insurers are heavily regulated non-profit organisations, but you DO have a choice.
Oh, here is why our system is cheaper:
1. Our insurers are non-profit and heavily regulated
2. together they build a strong negotiation block when it comes to the cost of drug. Basically they can pressure the companies into reasonable pricing.
3.Those companies are often German companies, too, operating under EU regulations.
There is also something along the line of regulated pricing for how much a bed in the hospital, and x-ray aso is allowed to cost. Those are not fixed, but there is a price limit. So nobody is able to hike up the price after the fact and send you some crazy high bill.
The thing with the variance is also nonsense. The reason why it is so big in the US is partly the high number of pregnancy complications (which are less a result of some people getting amazing care - it's just a birth after all - an more a result of so many people getting really sh... care), partly the high number of soldiers who die early, partly the low food and environmental standards (ie poor people are more likely getting exposed to lead) and yes, a small group of people who get great care, but they don't get considerably older than the same group of people in Germany. Yes, the US has some high-class surgeons, but they are not the only ones who do and frankly, those high-class surgeons would only be able to treat a few people anyway, no matter what. In Germany, they treat the people who are in most need of this care, in the US, they treat the people who can pay for them. I know what I prefer.
No, that is not correct, doctors aren't allowed to only take private patients, they have to accept public ones. Granted, it is difficult to proof it if a doctor deliberately deters public patients, but honestly, since nowadays over 90% of Germans have a public insurance, they would have a hard time to do that.
Regarding the Salary for doctors: Nope, this doesn't stop people from wanting to become doctors AT ALL. Remember, university in Germany is more or less free, but some studies are so desired, that they put a so called NC on it, to sort out applicants. Medicine has not just the highest NC possible, it also requires an additional test to pass.
What he said about nurses is a pile of nonsense, too. There are different kind of nurses. There are some who do pretty much nothing else but drawing blood (you often encounter them on blood drives), there are others who are specifically trained to help out in the OP aso. And those specialised nurses are naturally better paid, too.
Honestly, it would have made more sense to ask this guy about his experience than about a background he obviously only has dangerous half-knowledge about.
Btw, Germany has more doctors and more hospital beds per capita than the US has.
Being privately insured also opens you up to doctors doing unnecessary tests and treatments on you. Many will try to charge you for anything they can.
If a nurse in Germany is allowed to take a blood sample depends very much on the degree of her training. If the nurse passed the required exams she can take blood samples and give injections.
roughly 15% and its split between employer and employee
The difference of the cost between the U.S. and Germany is the profit that goes to the shareholders in the U.S. That's why it is almost twice as expensive.
Oh by the way nurses do indeed draw blood... and the doctor does not have to write everything, he does sign it though.....
So very true about the variance just between the states- the lifespan varies Hawaii is 82.3 and West Virginia is 74.8. We have ten states with lifespans above 80 years which is comparable to other EU countries. People forget the U.S. is a huge country with 330 million people. Germany is half the size of Texas with a population of 83 million. Texas has a population of 29,000. Apples to Oranges. Russia has universal healthcare and their lifespan is 72 years. If you get cancer in the U.S. you will have the best outcome, number 1. That says something about the quality of care that should not be ignored. Germany and U.K. are not even in the top ten.
Dang. A collapsed lung is no joke. Hope you are alright again.
My best friend from high school had that happen to him shortly after we graduated, about 20 years ago and it wrecked his whole life. It wasn't so much the physical effects, but he developed a debilitating psychological disorder. He is in constant fear of not being able to breathe anymore and is taking heavy psycho medication to deal with the anxiety.
He has searched for lasting help in dozens of hospitals and has basically seen every doctor in the whole county and beyond and they labeled him a hypochondriac and won't even see him anymore.
He is on disability and although he has a place, he almost lives like a homeless guy, because he sleeps in his car on the local hospital's parking lot every night, so he can run in there if he can't breathe again.
I tried helping him years ago and went in to the hospital with him to talk to the doctors on his behalf, but all I managed to do was that they let him stay in there for a few nights before throwing him out again.
Gahh that is terrible! Sorry to hear that about your friend. Seems like something had to induce the collapsed lung? Maybe whatever made it happen is gone now and he wont have to worry about it anymore.
@@globalvagrant1392 From what he told me, they never found out what did it. It just happened out of the blue while he was at work.
It totally shattered his confidence in his own body and ruined his life.
For more than half of his life now he feels as if he is living on borrowed time and as if it could be over any minute, without warning.
Some factors why health care in Germany is less expensive than in the USA?
Much, much lower cost for legal issues.
Greed!! I don't say that German doctors or hospitals or insurance companies are less greedy. Their greed is just far more restricted!
Solidarity! People in Germany are willing to pay their share, and they accept that stronger members of the society pay more than others.
Much, much lower cost for legal issues.
Employees and employers pay both exactly 7,3% of your salary... For example: if you earn 2000 euros a month (before taxes) you pay 146 euro to the SHI and you company does the same🤙 it is deducted immediately from your salary, so you don't really miss it😉
If you want to learn, you have to ask about the positive aspects. Not only cons and problems ....
I can only agree with the other German commentators. You could have gotten a lot of reliable information by checking the internet for details on the German health insurance system instead of making wild speculations and senseless assumptions. For you being (supposedly) an IT specialist, that's a sorry performance. I'm glad, though, that you got better again and saw that our health care system works!
I don't know if anyone touched the topic of how much insurance costs are *to doctors* in the USA, because of the litigation system, that has no cost attached to losing a case. In most other countries, if you sue, and lose, you have to pay costs to the other party.
Otherwise, as many others have commented, these guys made a video with almost zero 'solid' content..
you have 1000 patients and 10 doctors, 2 of them private. If 5% of the patients have private insurance, i can imagine that faster appointments and more intensiv care per patient is possible.
If 20% of patients are private, that already reduces the options.
If everyone is private.....then its the same as if all are public....you cant demand private care, if EVERYONE ELSE is private too. You all are on the same level. You could invent a higher class, lets say private+ ...but then everyone wants to be private+ and you have the same situation after short time.
Thats why i think a System where everyone, who can afford privat and have private, is kind of being scammed. You pay for something, that you cant really get, because so much other people have it too.
Auch in den USA ist der Zugang zu Medizinstudiengängen reguliert. Nur einige Universitäten bilden aus und immer nur eine bestimmte Anzahl an Studierenden. Dazu kommt, dass das Studium nicht kostenlos ist, - im Gegenteil, sehr teuer ist, 120.000€ Schulden sind normal -, und tatsächlich bis zur Approbation länger dauert als bei uns, weil vorher noch ein Collegeabschluss gemacht wird und der nicht unbedingt in Fächern, die Medizin bezogen sind.
Wie nahezu alle westlichen Länder leben die USA hier auf Pump. Manche Studienwillige gehen z.B. nach Grenada, um dort günstig zu studieren oder man lockt Kapazitäten aus dem Ausland an, die dann nicht erst noch umständlich Prüfungen in den USA wiederholen müssen, um approbiert zu werden.
Insgesamt bemängele ich die Darstellung hier als absolut subjektiv.
Aufgrund einer einzigen Krankenhauserfahrung in einem einzigen Krankenhaus in Deutschland wird aufs ganze Gesundheitssystem geschlossen und verglichen mit dem US Gesundheitssystem, - auch wieder nur aus einer einzelnen Perspektive, nämlich der des gut versicherten US-Bürgers.
Ein Beispiel ist z.B. die Äußerung ab 15:50 zu den „few doctors and few nurses“.
Der Interviewte lag in einem öffentlichen Krankenhaus in Deutschland und erhielt den Service eines gesetzlich Versicherten ohne Zusatzversicherung, - also das niedrigste normale Level deutscher Gesundheitsversorgung, - vergleicht das aber mit Krankenhausaufenthalten in den USA als versicherter Patient, - also einem mindestens mittleren Level amerikanischer Gesundheitsversorgung. Er vergleicht hier Äpfel mit Birnen.
Ich bin privat versichert, war vor kurzem in einer privaten Rehaklinik, in der der Arzt-Patienten bzw. Pflegekraft-Patienten-Schlüssel sehr viel besser war, als das z.B. meine gesetzlich und ohne Zusatzversicherung versicherten Eltern erlebt haben. Mit den Verhältnissen, die ich erlebt habe, müsste der Interviewte eigentlich vergleichen, denn das ist das Level, das er bei der Situation in den USA anführt.
Unerwähnt lässt er auch, die Unterschiede in der Berufsausbildung bei Rettungsdienst, Krankenschwestern oder Arztassistentinnen. Bei uns ist im Rettungsdienst immer auch ein Notarzt auf Abruf, dafür dürfen die Rettungsassistenten und Sanitäter bei uns weniger. Das ändert sich gerade, da die Ausbildung im Rettungsdienst erweitert wurde, aber dennoch wird immer ein approbierter Mediziner im Hintergrund bleiben.
Auch das Krankenpflegepersonal darf erst einmal sehr viel weniger als in den USA und muss bestimmte Qualifikationen, z.B. zur Blutabnahme, erwerben. Aufgrund einer totalen Überversorgung mit Ärzten in den 1980er und frühen 1990er Jahren, hat man da entscheidende Entwicklungen ausgelassen, die andere Länder längst vollzogen haben, nämlich auch andere medizinische Berufe zu akademisieren und ihnen Aufgaben zuzuweisen, die nicht unbedingt die Expertise eines Arztes brauchen (z.B. Wundversorgung, diätetische Beratung usw.). Bei den Hebammen geschieht das gerade, bei den Physiotherapeuten ist es im Gespräch, der Abschluss des Arztassitenten (Physician Assistant) wurde vor einiger Zeit neu geschaffen.
De Interviewte scheint auch von ausschließlich urbanen Verhältnissen in den USA auszugehen und vergisst, dass ländliche Gegenden in den USA chronisch unterversorgt sind. Etwas, dem man in Deutschland mit der Niederlassungsordnung entgegen kommen wollte, die natürlich problematisch wird, wenn es generell zu wenig Mediziner auf dem Arbeitsmarkt gibt, auch weil alle westlichen Länder weit unter dem Bedarf ausbilden, einige - wie z.B. Luxemburg - gar nicht. Der Grund sind nicht die fehlenden Kapazitäten, sondern dass ein Medizinstudienplatz den Steuerzahler ca. 25.000€ im Jahr kostet, weshalb man sie künstlich knapp hält und darauf setzt, dass Budapest, Bukarest und Sofia mit ihren deutschsprachigen Studienprogrammen in die Presche springen.
The healthcare system in europe is not for profit the hospitality is for the people help them.In america comes first the profit in europe the healthy.
it's pretty easy. The system is bdugeted. So every treatment of a patient above the budget of the quarter is basically free service of the doctor. While treatments of private patience are budget free and the doctors can charge way more for treating them, in some cases 7 times more for the same treatment. Also Doctors often bill fake treatments to private patients, or the will bill the same treatment by two different names or they will bill treatments extra that are allready part of another treatment code. They do that as the privat ensurances will just cover it, as these ensurances don't want to loose clients by sending them back to the doctor asking them to call the doctor a thief and damage the patient-doctor-relationship in the process...
Ask people working in private health ensuraces!
That's why privately ensured people get a much nicer treatment by the doctor! They are not on a budget and they can milk these peoples ensurances.
On the otherhand all the medical practicioners are just a foot walk away provide the service by heavily cross subsidizing their existence via high profitable private patients!
There is a big perceived injustice about the split in the system, allmost every mandatory ensured person hates expirience privately ensured people getting immediate access to the doctor while sitting in the waiting room themselfs.
It's also illegal to do so, but doctors compete for private patients!
Now just think about it what form of ensurance did the politiciance who created the system chose for the political class?
Nurses take your blood, not the doctors.
I believe Doctors can charge money for every visit, not only the first one. And actually i believe there is some training that nurses can take blood, but not sure if its in the hospital. And prescriptions can only the doctor do. There is also a TV usually in your room in a hospital. But private insured get single bedroom. Private has also to pay more for medications i think, depends on your contract. While public insurance only charges you 5€ per medication. And sometimes the insurance companys have contracts with the producer so you dont even pay these 5€. Pharmacys make most of their money with ppl buying non prescripted drugs. Like Aspirin or something. Also i believe the 10€ per day in a hospital is only for the first 3 weeks. These 10€ and the 5€ for prescriptions you only have to pay until you reach a threshold of like 2% of your income or kinda. After that its covered. Just get receits with your name on it from the pharmacy and send it to your insurance company. If you reach the threshold you get a card that shows that you dont have to pay it. But the process renews every year. You can also do everything at the end of the year or send it right after you got it, doesnt matter. Works even a year backwards i think and they send your money back if you paid too much.
You can also get very good doctors without private insurance. How do you define "best"? These guys who leaded like 5 hospitals before they opened their own practice? Yeah most of the time they think they cant fail and you cant even discuss things, because he already decided. I usually prefer normal doctors. And in a hospital the best suited doctors is also doing the surgery. So it doesnt matter.
"I believe Doctors can charge money for every visit, not only the first one." Not for the normal citizen with a mandatory health insurance.
Until 2013 there has been a fee to visit your GP of 10€ once in a quarter. This has been scrapped because the red tape was more than the income. In Germany when you feel sick you normally go to your GP/family doctor first. He/she will send you to a specialist if necessary.
@@uweinhamburg Ok i didint know that. Btw you can also go to a specialist right away. Only in very rare cases they want you to see your family doctor first ;-). And i believe its not just 2 different opinions you can get for free. You can go to 10 different Doctors and nobody will notice it i think. But not sure about this. I usually dont need 10 different opinions.
@@mucxlx You can go directly to a specialist but there are two reasons why people are discouraged to do so. A) GPs often can send you directly to a specialist and it can shorten your waiting time to get an appointment B) GPs are seen as something like a collecting point for your health information as there are no central registers and a GP can see the connection between different illnesses which you may not see.
German Nurses can do the same Stuff than others in america...
The problem with nurses in germany is they dont get paid good as all, its a hard job and if you get paid bad and doing long shifts its not a job alot wanna do.
Völliger Blödsinn. Meine Mutter war bis 2017 Krankenpflegehelferin und hat mit Schichtzulagen über 3000€ netto verdient, ein Krankenpfleger oder Altenpfleger hatte noch mal mehr und ein Fachkrankenpfleger, Stationsleitung usw. noch einmal mehr. Ich habe selbst studiert, bin Beamte im höheren Dienst und verdiene nach Abzug der Krankenversicherung sogar weniger, obwohl ich 6-Tage-Woche habe und 12 Stunden Bereitschaft täglich. Nicht der Verdienst ist das Problem, sondern dass zu wenige den Beruf lernen und zu wenige eingestellt werden, so dass der einzelne Krankenpfleger zu viel Verantwortung tragen muss. Man hat an manchen Stellen einfach vergessen nachzubessern, Z.B. wurden die Zivildienstleistenden, die Helferdienste in jedem Krankenhaus übernahmen, nicht ersetzt, sondern ihre Aufgaben einfach auch noch dem Pflegepersonal aufs Auge gedrückt. Das Hauptproblem aber ist die Bürokratisierung. Von 60 Minuten Arbeitszeit gehen knapp 40 Minuten für Dokumentation drauf. Es ist wichtiger aufzuschreiben, dass ein Patient seit 12 Stunden nicht auf dem Klo war, statt ihm einfach mal die Bettpfanne zu bringen.
sorry to hear about your situation John but good to see you're own the road to recovery. That layering idea is a must. The fact that nurses can't take blood is ridiculous. Nurses in Australia can do heaps of stuff. Sounds like too many people in one system to me that don't have enough skills.
Not comparing to the US, the shortage of doctors and nurses seems to be a problem. I also find it a bit hard to believe that their doctors are as skilled when from my perspective it seems like they are so underpaid.
@@globalvagrant1392 USA 24.5 physician per 10.000 people, Germany 38.9 per 10.000 how bad must the shortage in the US when you think that 50% more doctors are a shortage?
@@DSP16569 I've heard we have a shortage as well didnt realize it was greater than Germany's. I will say I havent much experience being in the hospitals in the US.
@@globalvagrant1392 I would guess that the German public just has a higher standard for this kind of stuff. If some areas (especially with an aging population in rural areas) cannot provide the kind of healthcare we would expect in a reasonable amount of time and proximity that is seen as an issue that needs fixing or rather creates resentment when it doesnt get fixed.
Like having to drive over an hour to the next hospital and have no general practicioner in a walkable distance (including maybe a short trip with public transport) - especially since public transportation is also comparatively bad in some areas where a bus or train only comes through twice a day and some villages dont even have. In the US I dont see much debate about that in particular because everyone is so occupied with the insanity of the system as a whole. I would guess all the bills that come with hospital or doctor visit are a much bigger issue than driving an hour to get there - let alone specialists (especially since everyone in the US has a car and is used to driving much larger distances on a regular basis).
In fact, registered nurses are also allowed to take blood. I can only assume that he confused care nurses with registered nurses, because you usually don't recognize who has what training.
To sum this whole talk (interview?): sloppy!
Terms like efficiency are conflated with effectiveness.
As another commenter put it: halbwissen
Let's leave it at that.
There is one great problem for the German healthcare system, the ageing population. Most patients are very old, 65 and above, which puts a high burden on the staff. The nursing staff is currently undergoing a change of training, at least some are supposed to be with a university degree. At the moment most have an apprenticeship of 3 years, plus specialities as a theatre nurse or Intensive care.
Real private hospitals, where all care has to be paid privately, are in the field of esthetic surgery or wellness. Private means that the carrier of the hospital can be a company, the largest is Helios with 89 hospitals.
In regard to treatment, neither hospital nor doctor are allowed to make a difference, this would be unethical and you would be struck off the list. If you have or can choose a hospital, you can go to the web page of the hospital and check how often they did this or that procedure and compare.
The decision of how many doctors with a certain speciality are allowed in an area is made by an administrative board of doctors, the decision about which treatments are offered and their price is made by this board and all health care providers together. Then individual health care providers discuss the price of medications with pharmaceutical companies.
A prescription is usually for a substance, the pharmacy checks what is the medication your health care provider has listed for this substance.
This is a generica unless your doctors chooses a specific medication or you pay extra.
Sorry to say that, but there are a lot of false statements and informations in that „interview“.
Why are you making a video when you are uniformed ??? Why are you thinking that German or European Doctors are not better or worse on what they earn?
You forgot one important thing !!! And that is that
WE ----ALL--- HAVE HEALTH INSURENCE !!!
44 million Americans are uninsured, and eight out of ten of these are workers or their dependents. Why is being uninsured a problem? About 44 million people in this country have no health insurance, and another 38 million have inadequate health insurance.
Hey, thanks for the comment. Just having a chat because john has been in and out of the hospital so much lately. Neither of us are experts. I was bringing up the point about salary, not to say one is better or worse, but because of a demand thing. It seems that if the government artificially holds the salary of doctors low, then this should decrease the supply of doctors and create a shortage of doctors. Not trying to compare America and german healthcare either. Not trying to say one is better than the other. Believe me I know americas healthcare has problems. Cost in particular is something that makes me pull my hair out when I think about it lol
@@globalvagrant1392 I did check that what you wanted to compare . Did you count how much it cost to study to be a Doctor in the USA and here in Germany? In Germany is Free !!
-If you study medicine in Germany at a governmental university in any state, except Baden-Württemberg, you will only pay the semester fees to cover the costs of administration and registration - usually no more than 250 euros per semester (about US $ 290)
-The average cost of medical school in The USA was $32,495 for a single year of study at public medical colleges and $52,515 for a single year at a private medical college. The average cost of medical school, like the average cost of college in general, has continuously increased over the years
here to compare worldwide How Much Do Doctors in Other Countries earn
ttps://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/
shortage of doctors in Germany? sorry but Germany is placed 12th on the list of docters per capita with 4.33 per 1000 while the Us is on 51st place with 2.59 per 1000 citizen...so your personal perception is wrong.
shortage of doctors? There are more doctors per capita than in the US...
Yea someone else brought that to light. Not trying to compare to the us, because I dont know much about either lol thank god I havent had too many medical issues to have to deal with it. Apparently we do have a shortage here though.
There is a shortage of doctors in certain areas, especially rural ones.
@@globalvagrant1392 You both knew nothing more than assumptions, estimations and believings...as a matter of fact, within the first 8 Minutes of this vid, every answer starts with "I don´t know/I don´t really know" and his face says "I don´t even care, because I think the US system is better" although he would´ve been stone dead in the US...
Why is German Health Care so cheap ? The Doctors association and the Health Insurance ( there are many of them , public ones , private ones ) negociate ( fight ) for the money every year behind the Doors . its less the Goverment . Drugs the same , you as a sick person pay 5-7 Euro per medication / Unit but it can be that the drug will cost the Insurance 100 , 200 Euro per Unit , new ones will be way more expensive than older ones ( because it can cost 100 Million or more to develop a new Drug , they want to have this money back )
Every Doctor has a Budget for Drugs he can prescribe , the Family Doctors Budget is much lower than the Budget of a eg Heart Doctor , every Person who is sent to a Heart Doctor is badly ill / sick and needs Drugs which tent to be Expensive , its much more complicated than hat eg if much old People visits the Family Doctor he has to deal with it and prescibe cheaper drugs with nearly the same effect ( and his Budget is a little higher too ) . Often cheaper Drugs not have not less quality , much less effekt , they are older , have already reached ROI ( Return on Investment )
Hospital the same , if a Hospital wants to have 30.000 for a operation the Health insurance will pay that unless they see that another hospital for the same Operation wrote 25.000 on the bill .
Then they ask the hospital , why is this , why are you more expensive , they have the oversight .
On the other Side , the Hopital wants to have people in their beds they want to earn money , they tend to let stay the People longer in Hopital than needed , but again , if they overdo it , the Health Insurance will ask again : Why so long ? and probably cut their Payments when there is no medical Reason.
OK basically you can say : In the USA you go to a Doc , he will say you what is necessary to heal you , if you need a operation you can ask a hospital how much it probably will cost , you can ask your health insurance ( if you have one ) how much is covered .
If you need a drug the Doctor presribe often a drug which is expensive , because he gets a reward from the manufacturer of the drug if he prescribe it
In Germany you can say : You as a sick / ill Person dont have to negoiate with a Doctor or a Hospital about Prices , everything whats necessary to save your live , to protect your health , is covered by the Health Insurance .
The only thing the Goverment says is : Health Insurance , you have to ensure this ... , its a Human right to have an unharmed and healty Body
Look , if you are badly ill / sick , your live is in Danger , you willing to pay nearly everything you can to save your live ( because if you are Dead you have nothing from your money ) , you are in a very weak position to negociate
Thats not the Case in Germany , if a Doctor dont accept the prices which are negociated between the Doctors Association and the Health Insurance he must go private
But unless he isnt very very good in his Job , no one will visit him ..... , because the " normal " Doctor cost nothing ...
And thats OK , if you are very very good this should be rewarded but mostly private Doctors are for the unnessesary Stuff like Face lifting , beauty operation , you wanna that Bullshit , you must pay for it ...
A Doctor in Germany is not payed for Small Talk , for image , he is payed to Heal you
And whats wrong about it to wait some Time if youre not critical and the critical cases come first ?
In Germany its free to go to a Doctor and the people go to the Doctor even with minor Problems , so they have more to do
If you dont wanna wait go to a private Doctor and pay for it
But thats not all : Higher Education in Germany cost nothing in a Public College , they may not have all the fancy new Stuff like the private ones but they are not bad
In the USA a College will cost 10.000 - 20.000 a year ( i believe )
In Germany every child which is smart enough to pass the Tests ( and willing to learn ) can go to a Public College , even if the parents are to poor to support their child
The College student can get " BaFöG " , basicially a Loan from the Goverment which parts of it has to be payed back if he graduates and is at Work
Its cheaper to get a Doctor in Germany
OK , in Germany you pay higher taxes , OK , the Gasoline príce is doubble so high , but we drive smaller Cars , they use less Gasoline per Mile than the US ones .
If you think about it , isnt it worth to pay some more taxes and you can be sure that you can go to a doc whenever its necessary ? even if you a Jobless ? That your Children are not restricted in education , even if you as parent have not much money ?
The Majority of Jobs are not payed well , the Number of Jobs where your salary is , lets say , 100.000 Dollar or higher , is limited .
You can always loose your Job , eg you are badly sick for a long Time or your employee goes bankrupt or you have an Accident , its not your fault ( in most cases )
Thea really should have done at least some basic research first.
A little input to the private healthcare vs. public Healthcare:
Basically there is the public healthcare.
Anyone can be part of it. It will cost you 15 - 16 % of your monthly income, half of it payed by you employer.
This will pay for the ecessary things, there are some limitation where you have to pay a small amount for medis, called 'zuzahlung', thats 10% of the costs, but at least 5 and max 10 Euro. Another cap here is 2% of your yeraly income payment per year, medi for children are free.
Additional cost are a 10 € / day in hospital ( but max 280€ per year) and Rehab (max 14 days).
More Payment is for glasses, hearing aids and most expensive, dents. There is only very basic models that get paid fully.
Anyhow, it is possible to upgrade your healthcare with additional private Insurances, you need totally pay yourself.
On the other hand there is the private Healthcare. To have the Option to join you need to be either self employed, or to earn 62.500 € / year. Costs vary , at least you should think of 500-600 € /month plus additional costs for kids, and unemployed family members. Subjects of this Insurance vary. You need to consider that these rates go up with your age.
One big diffrence is that your private healthcare pay more to the doctors, hospitals etc. as the public healthcare do (2 times, up to 3,5 times.). But these big companies still do make a lot of money.
Whilest there is no real diffrence in the real important caring for you (that is operations, medikations etc), you may find some services advanced when you are a private patient, speaking of waiting ties, doctors haveing special days only for their privet patients etc. Remember: this is absolute not true in cases of ermergency.
I have to agree with the comments made by others below: how about talking about facts and not "gut-feelings." For example, to say that there's a "shortage of doctors" in Germany isn't even remotely connected to the truth. For the time period 2007-2013, the number of doctors for every 10,000 citizens is 38.9 in Germany vs. 24.5 in the U.S. In other words, Germany has more than 50% more doctors per capita than the U.S. does. Another statistic that is playing out right now in relation to Covid-19 is that there are 8 hospital beds for every 1000 people in Germany, while there are only 2.8 hospital beds per 1000 people in the U.S. (2018 figures), and that's not taking into consideration that many rural areas throughout the U.S. have absolutely no hospitals (and therefore, no hospital beds). Not good if you get sick...
Seriously, youre comparing Germanys almost for free Healthcare experience with the Us Healthcare Bancrupcy scenario?
THEN you critizize staff and doctors? Those are POLITICAL issues which doesnt describe the actual experience, right?! ( you mentioned personal bancrupcy….)
Did you need more than 5 min from the head doctor? Did the other patients with you need it?
Cmon guys, the CREME DE LA CREME of doctors and staff shouldve been provided?!?!
REALLY GUYS, you mentioned PERSONAL BANCRUPCY!!!
Go back to the US and go thru the same experience again, then come back and compare…
Most developed countries provide a basic, affordable Healthcare system for ALL, it should be the initial base of ANY political structure, left right or otherwise, dont you agree?
You will get basically the same treatment anywhere in northern Europé an Scandinavia.
Good luck going up against the establishment, If you decide to adopt whats already´ve been working for decades in the rest of the World.
But thats what your gunlaws are about right?
To go against military and police forces backed up by CIA and satellites...
Really sad! We payed for him....
I hate the term expat. Just call yourself an immigrant. Expat sounds so elitist and douchy.
Both of you are not well informed. The system is not that complicated. Most paperwork is done by the nurses. I dont like the underlying assumption that the US healthcare system is the best worlwide. German doctors have to excellent in school to be able to study medicine. German doctors are among the best worldwide since their education is very good. We have many specialized experts and highly regarded researchers.
You should ask a German who knows the facts.
Rubbish. A doctor does not type anything. That is still the job of sekretaries. Nurses take blood in a hospital too. To the costs: Do your math. Every emploed person has to pay for healthcare. You can't escape this, except you only earn up to 450 Euro. So it is cheeper, but not the service. There is actually a very shortence of all not good payd jobs in the medical system. That has to be changed.
An amazing amount of false information and lack of research. Very disappointing.
Why you give an interview about stuff you know nearly nothing about ? You are wrong about so many things.