Overview of Germanys Health Care System
Germany has the oldest universal multi payer health care system in Europe. Essentially, every German citizen is eligible to be enrolled in the social health insurance network, which is composed of 192 privately owned sickness funds or insurance plans. Despite the fact that they are privately owned, they are publicly accountable and administer a public benefit. About 89% of the Germany population is enrolled in the social health insurance network (Green, Irvine 2005). For the high income, there is the option to opt out of the social health insurance and purchase private voluntary health insurance. Only about 9% of the German population made enough money to opt out of the social health insurance (Green, Irvine 2005). There is free government care for about 2% of the population. Germany is a system that spends quite a bit of money but which didnt do all that well according to the overall rankings by the World Health Organization (WHO). Nevertheless, Germany is generally known for having high-quality, comprehensive health care with few waiting lists, despite its many problems. Germans enjoy access to extremely comprehensive benefits, including a very generous sick pay policy. Essentially, during the first six weeks that a person is sick, their employer pays 100% of their salary; after that, the sickness fund pays 80% of the salary (Green, Irvine 2005).
There are several pressing problems in the German health care system. The foremost problem is that Germany has such an expensive health care system. The foremost problem is that Germany has such an expensive health care system, this is partly a function of the comprehensive benefits and the generous sick pay benefits. To combat this, Germany has imposed high levels of cost sharing in their system, including co-pays and co-insurance. There is an excessive number of physicians, and to prevent oversaturation in area, the German government has closed off 60% of the country to more ambulatory primary care doctors, the closed off areas are those that already have a 10% excess in physicians (Green, Irvine 2005).
Everyone by law must pay into health insurance plans until they reach the retirement age of 65, they are either state-regulated or private (Grant 2008). After retirement, contribution payments for the state-regulated plans stop (although private patients continue payments), but coverage is continued until death (Grant 2008). The vast majority of people are obliged to use state-regulated plans and, depending on their individual circumstances, they can choose from one of about 400 options. The government regulates the fees of state-regulated plans(Green, Irvine 2005). Every doctor normally has a sign that says he/she is accredited by all insurance providers, however some doctors take only private patients (Grant 2008). Germany has several types of state-regulated plans. Some large companies offer their employees in house plans. The state covers health insurance contributions for the unemployed and low income people (Grant 2008).
Although some hospitals have certain wards designated for the use of private patients, people in state-regulated insurance plans and those with private insurance use the same hospitals (Grant 2008). On the whole, non private insured patients who are not privately insured are at no medical disadvantage and receive the same standard of care as the private patients. Normally, doctors work either in hospitals or in private practice (Grant 2008). Those working outside the hospitals have their own offices and are self-employed (these include general practitioners, specialists, e.g., gynecologists, internists), but they all refer patients to a hospital if necessary. Some of the specialists, notably gynecologists and ENT surgeons, have reserved beds in a hospital, where they perform operations and visit their patients, leaving the rest of the care to the hospital staff (Green, Irvine 2005).
Grant, Sue. “Healthcare In Germany”. Med hunters (2008) web pg 12 Sept 2010