My father died last tuesday after a long stay (almost 6 years) in a nursing home in my hometown in Murnau, Germany. He suffered from a gradually worsening dementia, Parkinsons disease and several strokes. He passed away in his sleep. Sad as that end was, I would like to commemorate him by posting a diary here (my first, so please bear with me) on some particularities of the german healthcare system which might be of some interest to all you American Kossacks. After all, you seem to be on the verge of reforming your healthcare system and godspeed with that!
In Germany - as in most other european countries - we have a mix of government mandated health insurance, which basically everyone gets, and optional private health insurance, which generally has better services but also costs more (for most people, that is).
But there is also an additional mandatory insurance which pays for costs incurred due to nursing (correct term?). And this insurance really made a difference for my father. What this insurance does is that it pays a fixed amount each month depending on the nursing needs of the insured. These needs are broken down into three classes (1 to 3) with class 1 being for the "lightest" cases and class 3 reserved for people who need constant care such as feeding, washing and more.
The real beauty of this system is that it leaves it up to the person insured (and his family) whether to opt for home care or care in a nursing home - when caring at home you can hire service providers and get reimbursed for their fees.
Since this insurance program is heavily regulated there is obviously a lot of red tape affixed to it - figuring out the amount of money due to you is a challenge in itself. But then again in practice it wasn't too hard. Basically what I did after my father became dependent on permanent care was to notify the insurance company which then sent over a doctor to determine the severity of the need for care. We then discussed the options available and settled for a very nice nursing home in only 10 minutes walking distance from where I live. The home was run by the Red Cross and did a very good job. My father had a really nice apartment with a balcony overlooking the lake and he could bring most of his previous furniture. The staff were very professional and considerate. And with his pension (as a teacher he was state employee) together with the money from the insurance he could even afford some extras like thrice-weekly physiotherapy and a young man to come and take him for walks in his wheelchair when I didn't have time.
Looking back, I am really grateful for this kind of insurance which does a lot to keep the sting out of getting old and helpless. I think it is really important to give older people not only the care they need but also the feeling that they are not financially dependent on charity or their next of kin for the high cost of good, professional care when they need it. It has so much to do with dignity.
My father also had pretty good healthcare (he was insured privately) with his doctor visiting twice a week and several operations done in his last years (he had a stent implanted to relieve excessive pressure in the brain) but that he would have had in the government health care system too.
I myself am insured in the government-run insurance program since no private insurer will take me due to my AS (ankylosing spondylitis) and am pretty satisfied with that. My wife and daughter are insured there as well at no additional cost which is really nice.
Both the government health care system and the private insurance system are run by private companies with the main difference being that the government system can't turn anyone away and also insures all dependent family members. Were I privately insured, my wife and daughter would also have to pay premiums.
All is not peachy however (is it ever?) since in the last years some services of the government health care system have been cut back and provisions have been added forcing us to co-pay on some services. All in all however we feel very secure in this system - secure in the knowledge that severe illness or disabilty will not be financial catastrophes as well.
And that's it from me. I hope I have not bored anybody and wish you all the very best for your efforts in reforming your own healthcare system.