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Having survived in both systems with four kids, one of whom has continuing health care needs, I can say from my experience that the German system is much more convenient and responsive than the American system when it comes to routine care, but it really failed us on several occasions when it came to more serious matters. The above study seems to confirm that experience. A routine visit to the skin doctor is much easier in Germany, but if I actually had skin cancer, I would want to be in the U.S.

I think the main (maybe falsely perceived) flaw of the American health care system is not so much the quality of medical treatment. The information I get (admittedly based mainly on evil German media and the television series Scrubs) suggests, that it's much more expensive to get a decent health care in America than it is in Germany.

Bartolo

One could think that if the health-care system in the US is more expensive than in Germany that
a. Either Americans are generally wealthier than Germans and thus can afford such health-care more often
b. The American social-system is not so bad after all
c. Possibly other explanations I haven't thought about, yet

As an American living in Germany who has also dealt with both systems for routine/non-serious care, I'd have to say that I have found it *way* easier to get routine care here. Routine care is definitely more convenient and less expensive - even though I'm privately insured here, I've always ended up just paying out of my pocket because it has normally cost only 40-50EUR for a visit as opposed to the $100-120 that I often paid in the US.

I also pay *far* less for private insurance here - I have a policy with AXA PPP, a UK company, and pay 85EUR/mo for comprehensive coverage.

The doctors I've had to deal with here have all been perfectly competent and the facilities were also great (despite the "socialized medicine" stereotype). But I also had the same experience with the NHS in the UK while I was a student there (which has an even worse reputation, especially from Brits), so maybe I'm just lucky :)

On a side note, I've come to appreciate how ALL drugs have to be sold by a licensed pharmacist - even though it is annoying sometimes not to be able to buy cough medicine (for example) at the supermarket, I think it's probably better that someone who (at least in theory) knows alot about the drugs sells them.

Chrisimo

I think the American health care system is not so bad after all. America has been the world's leading industiralized nation for a while now, which I think is impossible for a country that doesn't care for the health of its people. The average American may also be wealthier than the average German, (comparing GNP implies that) although I'm not certain about the distribution of wealth.

Still a possible explanation c. may be, that personal health is the last thing to cut back on.
If I were seriously ill I'd forgo many other things to pay for my treatment.

Oh, there's a lot wrong w/the medical system here and much of comes from lawyers. OB/GYNs find the malpractice insurance so expensive, some of them, as in my doctors case, have stopped delivering babies.

Pretty soon, women are going to start giving birth in a ditch somewhere.

@kennon:
"The doctors I've had to deal with here have all been perfectly competent and the facilities were also great."

Be very careful about comparing the medical care which you are receiving as a privately insured patient with the "normal" fare. First of all, your age plays a role in the premiums you pay. Better keep an eye on the 85 Euros you are paying at the moment. Second, you have to have an income which is above a level which is well above average or be self-employed. Not all residents of Germany meet those stipulations. And third, you, as a private patient receive preferential treatment over the normal Kassenpatient. I am, by choice, not privately insured since at my current age (59) the premiums for private insurance would be higher.

I will admidt, however, that the temptation to make the switch to private insurance is growing: last year I made an appointment with my physician to get a flu shot (my first, ever). When I entered the practice I was told that the supply of flu vaccine had been exhausted. As I turned to leave, the assistant asked: "Or are you privately insured?". My spouse is a medical assistant (Arzthelferin) and confirms that privately insured patients are routinely given preferential treatment and the reason is simple economics. Private insurance companies (1) pay more for the same treatment and (2) pay promptly (unlike the "gesetzlichen") and (3) do not make reductions in benefits retroactive. Most citizens of Germany do not enjoy the premiere care you do and are effectively banned from receiving such care.

Having had colon cancer, I can attest to treatment for cancer being superior here in the USA. At the time I did a lot of research and was amazed that it took a court decision in Germany mandating new Cancer drugs to be given to Krankenkassen Patienten. Prior to that, because of cost,only old treatment was given. (FU5,etc)
Granted, my treatment cost $8-9 thousand per week, using the newst drugs, but 4 months later, I was cancer free.
I also had my Mother here and she was receiving Kidney dialysis. What a difference between here and Geramny.
A big difference was the Patient awareness through counseling and brochures as well as mandated monthly total blood profiles that were not done in Germany. After her return, her doctor at the local hospital was able to start that procedure.
Also, a lot more tests are done here to cicumvent potential law suits, driving up the cost.

I am not going to claim that the German system was any better, but this is scandalous:

March 14, 2007 SAN FRANCISCO (BCN) - A seriously ill Oakland woman who says she needs medical marijuana to "avoid intolerable pain and death" lost a bid to a federal appeals court today for the right to use the substance. The 9th U.S. Circuit Court of Appeals ruled in San Francisco that Angel Raich, 41, does not have a fundamental liberty right to use marijuana that she believes necessary to preserve her life. ...

Raich suffers from at least 10 serious medical conditions, including an inoperable brain tumor, a seizure disorder, life-threatening weight loss and several chronic pain disorders, the court said. She and her doctor maintain that she needs marijuana to combat the illnesses and pain and that other alternatives are either ineffective or have intolerable side effects. [see also: Gonzales v. Raich]

Cannabis prohibition is a complex problem, with ramifications from international trade to religious freedom issues, but had a patient in her condition applied for an euthanasia chemical, she would probably be more prominent than Terry Schiavo and Knut the Bear by now.

FranzisM

That's from the 9th Circuit? I'm surprised. They're probably the most liberal Circuit in the country (and frequently reversed by the Supremes).

However, I've heard that marijauna helps w/the nausea brought on by chemo (it does, a friend of my parents dying from breast cancer found some relief with it) - but lifesaving? That's a bit of a stretch.

Via Daimnation:

"Canadian values"
Ideological idiocy impedes improving health care in Ontario:

Ontario Health Minister George Smitherman said the government will not consider contracting out knee-replacement operations to a private Toronto hospital.
The Globe and Mail revealed yesterday [March 15] that the province was reviewing a proposal from Don Mills Surgical Unit Ltd., a private Toronto hospital, to perform 1,500 knee-replacement operations.

[...]

"This Ministry of Health gives you and all Ontarians the complete assurance, I will never support the outsourcing of those knee surgeries to any private, for-profit-motivated organization," Mr. Smitherman said. "Our government fundamentally believes that the public health-care system, the not-for-profit public health-care system is the best expression of Canadian values [emphasis added]."..


Despite the fact that there would be a substantial cost saving, and that the province already funds some procedures at this hospital:

The Ontario government has rejected a proposal to have 1,500 knee replacements done at a private Toronto hospital, even though it would have helped reduce waiting times and cost $1,000 less per knee than in the public system.
[...]

Don Mills Surgical is one of three surgical hospitals that operate under the province's Private Hospitals Act...[and amongst other things does] provincially financed cataract and orthopedic services such as knee arthroscopy and cataract surgery...


As the Globe editorialized [full text not online]:

Canadians should not have to wait in terrible pain for surgery because political leaders won't talk honestly about private health care. But that is the situation in Ontario. People wait nearly twice as long as the Ontario government's official targets say they should. Yet Health Minister George Smitherman turned his nose up last week at a chance to pay a private clinic in Toronto to help cut waiting times for knee-replacement surgery...

Madness.

FranzisM

Not sure a verdict in Germany would be much different. While you would get away with marijuana for personal consumption, I think as a rule the health insurance would not cover the costs. A quick search showed that the only exception is Dronabinol, which is available in the U.S. as well.

Pamela, it also helps against the enormous pain, the sideffects of chemical painkillers on the nervous system, and against the stress for those who live together with the individual who suffers that pain. When life becomes the time between the pain attacks, I too would describe anything as livesaving that stopped me from feeling like dying.

As to the liberal bias of the court, I suppose this is because only a patient with strong convictions and a marriage with a lawyer would push such a case that far while she is suffering, and probability suggests that this patient will be found in the area of a liberal court. Most cancer patients are too stressed to dare a treatment they cannot freely talk about, however useful it may be.

blue, this is not about what a healthy individual who knows all the tricks might get away with, but about what a chancer patient with no experience can freely discuss with a doctor. I am not an expert on the gesundheitsreform, but there are private businesses saying all that is missing is doctors willing to do the legal paperwork.

FranzisM

I never understood the prohibition against medical marijuana either. I know Montel Williams, a talk show host with multiple sclerosis, swears by it. I remember when my grandfather was dying from terminal lung cancer - back in the '60s - and the doctors were legally restricted in how much morphine they could give him - to prevent 'addiction' no less.

And even if it is not as medically effective as anecdotal stories make it, for terminal patients, what difference does it make? Get the stuff illegally for her if need be. That's what I did for my parents' friend.

Fortunately a lot of that has changed by now but that kind of sheer idiocy is what led to the hospice movement here. When my mother was dying of cancer, those hospice people saved my sanity, and they did abolute wonders with her pain. She rarely experienced any.

Weird. The Brits invite scholars to cancel them, and the Americans make laws to break them.

"Dear patient, I am sorry I have to say it that blunt, but don´t ask why we have to be dead silent about this stuff as if it was Polonium."

Wow, that's a new definition of unfair. You read about something in the German media, post an article and give only the source mentioned in the text but not the original article (a lot of media wrote about the study). That's supposed to be a proof that the media claim Germany is better... Not nice.

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