I lived in Germany for fifteen years. Some observations.
First, it’s built on “fairness”...everyone pays the same percentage (no free rides unless you are unemployed). Whatever you pay, your employer pays the same amount.
Second, you have a list of medical procedures authorized and a maximum cost authorized. No matter where you go in Germany...it’s the same cost (Berlin cost is the same as a small village of 300 folks).
Third, Doctors, nurses, and hospitals have a rate of income or profit. Hospitals don’t modernize that much because they don’t make the profit to do that. Doctors are underpaid (by American standards), so they tend to look for employment outside of the country....and leave (Australia, US, Canada). Nurses are unhappy with their set pay scale, so they leave. You have to bring in third-world doctors and nurses....to make things work.
Fourth, drugs are typically prescribed with generic drugs listed as first. Drug companies are not making much of a profit with this system...so they don’t care much for development.
Fifth, if you go into a hospital...you typically get a four to six person room. This means your 10-day stay might be with a guy who has terminal cancer and is yelling hourly about his ‘pains’, and you just sit there and keep counting the hours before they will allow you to leave.
Sixth, the percentage of pay into it? It was supposed to be maxed out (even the gov’t agreed on that). So a year later, they’v creaed these fees ($24 a month on top of your percentage that you already paid). Within ten years, it’s likely to be $35 a month, on top of the percentage.
I could go on and on. The German system isn’t a failure....but it’s really much of a success.
I will offer this analysis after standing in a German waiting room though. If we simply added nurse-practitioners into the mix and forced folks with very routine problems to be seen by them, and then limit the ratio of doctors into this whole game-plan....we’d probably cut the cost of care by thirty percent. If we created an independent court system for any malpractice legal case, and set limits on what lawyers can charge or get out of this, then we’d cut another twenty percent of cost.
Not entirely true.
Your third point:
I guess they make less than in the US but I’ve never seen 3rd world doctors or nurses. Doctors don’t make that much from the “socially” insured but more from the privately insured which they give extra treatments (privately insured include all policemen and other officials).
Your fourth point:
That’s the case in the Netherlands but unfortunately not in Germany. Drug companies make a huge amount in Germany. This is something that really has to change.
Your fifth point:
True, but you can “upgrade” your social insurance privately (”Zusatzversicherung”) to get a single or two bed room with preferential care and other “add-ons” like biannual free check-ups with blodd analysis and all that. Costs for that are miniscule like 8 € a month. Same goes for dentist stuff, which will get you premium treatment and e.g. free professional tooth cleaning twice a year (around 18 €/month). Other upgrades are for people who need glasses...
The German system is not that bad. If you buy some of that upgrade packages, you are pretty well set with first class treatment. I like it more than the American system. If I read e.g. that someone in the U.S. goes to the dentist and gets a $1000 bill or two weeks in a hospital cost $50000 - no thanks.