The recent issue of Forbes Magazine has a (for Forbes!) surprisingly balanced article about the German health care system. Germany has universal coverage, and the private and public insurance options coexist.
Guess what? There are no death panels. In fact, the Forbes reporters are so impressed by how well the system functions, that they see it as a model for what health care reform could look like in the US.
Germany spends 10% of its GDP on health care compared to 16% in the US. With a two-tiered system, you might think that those who rely on the public option would feel disadvantaged compared to their private counterparts, but that is not the case:
More than any model in the world, the German system offers a glimpse of what health care could look like in the U.S. That's assuming any bill survives the popular revolt. Unlike many countries with national health--Canada, say, or the U.K.--where private insurance generally supplements public coverage, Germany has two separate systems that coexist, with private plans indirectly benefiting from the cost controls of the public system.
Whether they have public or private coverage, most Germans love their care. In a recent survey by m&m Management & Marketing Consulting 84% of private insurance clients expressed satisfaction; so did 85% of those who rely on the public system.
There is nothing magic about the German system. We already have the basic framework in place here in the US. But we lack the political will.
How does Germany do it? By doing what Medicare does and more. It sets fixed reimbursement rates for hospitals and wields a stick Medicare lacks: extracting price concessions from drug companies. But Germany's quasi-public system has more leverage because it accounts for a larger share of medical spending (albeit the power of the purse is dispersed among 16 states). German general practitioners earn $80,000 or more a year, with three-fourths of their gross income coming from publicly insured patients. In the U.S. general practitioners (including family physicians) gross an average $161,490. In Germany private repayment, though, is always more generous than what is dished out by the public system.
I've heard Senator Mitch McConnell on TV warning Americans that a public option would ruin the "best health care system in the world", and Americans would have to accept inferior treatment and long waits to see a doctor. The German experience shows that reality is just the opposite: shorter waits and better care.
One of the primal fears about reform in the U.S.--that it would create a two-tier system where privately insured patients would get better care and shorter waits--is largely a nonissue in Germany. The public system is so dominant that when it comes to the treatment of chronic illnesses, it matches and, in some cases, beats the care available with private coverage. As for long delays in treatment, 68% of public and private patients surveyed by the Commonwealth Fund reported waiting less than four weeks to see a specialist, compared with 74% in the U.S.
The piece is worth reading in its entirety, and should be required reading for Olympia Snowe and her Republican colleagues in Congress.