The German health care system is thought by many to be the best in the entire globe. The health system dates back to 1883 when Otto von Bismarck steered the creation of the universal care system also known as the German care system. It is the oldest in the whole of Europe. During its inception, the German care system was to cover a small minority, especially government employees and low-income earners. With time, expansion measures were put in place, which saw the system covering everybody in German. Notably, the German care system covers approximately 85% of the population, while the other 15% have opted to be covered by private healthcare providers (Skousen). To that end, there are two types of health insurance in German: private and public health insurance. Major milestones have been achieved in the German care system, with the most recent one being in 2009, where the government made it mandatory for all employees and students to have health covers irrespective of their social status or level of income.
The history of United State health care insurance is somewhat different. The health care program that is in use in the U.S today evolved from a rather conventional disability insurance program that was in use in the late 20th century. During its inception, the health cover was intended to help steamboat and railroad workers. Before a better medical cover was instituted, patients had no option but pay for their treatment cost from their own proceeds. Over time, the health care system has developed and changed, but it still suffers major hurdles as not all Americans are covered or can access high -quality health care.
There are a number of differences that exist between the healthcare systems in the United States and in Germany. The first difference is in accessing healthcare. In Germany, healthcare is more accessible as compared to the United State. The difference in accessibility can be attributed to the structures that the governments of these two countries have put in place to support healthcare needs of its people (Skousen). In Germany, the cost of healthcare is very low to the extent that it is almost free. The system that the government has adopted in funding healthcare ensures that every person gets a chance to enjoy the healthcare services with no restrictions (Lewy). The German government has made it possible for all the citizens to have a healthcare insurance. Making all citizens to have a healthcare insurance cover is what has made the German healthcare system to be considered among the best in the world. German citizens have no limitations concerning the number of healthcare procedure that they can access at any one given time. The health insurance in Germany does not limit the citizens on how they can access care especially in terms of the procedures to be undertaken or the number of times that a patient can visit a healthcare facility.
In the United States healthcare system, there are limitations in access. First, not everyone in the United States has access to healthcare insurance (Katie). According to "Implementing Health Reform: the CLASS Act there are many citizens who do not qualify for healthcare insurance. Although the government of the United States has put in place structures to cater for the healthcare needs of the poor citizens, there are gaps in these provisions as it leaves out some people who may need to have the cover but they do not qualify for it. The Medicaid health insurance system is aimed at helping the very poor people to access medical insurance. Other citizens who do not qualify as poor are required to buy their own medical insurance. There are however some people who fall in between the free government healthcare insurance and the government -funded healthcare insurance where citizens are supposed to pay subsidized rates to access healthcare. These people who do not qualify for either of the healthcare insurance schemes earn relatively more money to be considered poor. As such, they do not qualify for Medicaid which is designed to help the poor (Simmons). The amount that these citizens earn however cannot afford them the government -funded healthcare insurance as the money they earn is too little to cater for their cost of the insurance.
Another difference between the healthcare system in Germany and the United States is in terms of cost. The cost of healthcare in Germany is relatively low as compared to the cost in the United States. The fact that all citizens are covered by health insurance means that they will have nothing to pay for their healthcare expenses (Lewy). The healthcare insurance usually covers for all the expenses incurred. One of the reasons why this system has worked so well is because of the massive investment in healthcare that the German government has put in place. German has invested heavily in health care and the results of the investment are clearly visible. In addition to the heavy investment, the German has also put in place a system that standardizes all the healthcare costs such that the cost of similar healthcare procedures are the same across all hospitals across the country. This eliminates instances of exploitation by the healthcare providers by charging very high prices for simple procedures that would have otherwise cost much less (Flower).
On comparison, the cost of healthcare in the United States is very high. This explains why the quality of care in the United States is lower as compared to that of Germany considering that United States invests more in healthcare as compared to Germany. United States dedicates about 20% of its GDP to funding healthcare. This is as compared to 10% of GDP that Germany invests in its healthcare. In terms of cost per person, the United States invests $9000 per person while Germany invests $4000 per person. The United States would, therefore, be expected to have a better healthcare system than Germany owing to its heavy investment in healthcare. The government in the United States has not put in place structures that would help in regulating the cost of healthcare in the country. As such, there is no uniformity on what is charged by the different caregivers and this creates room for exploitation. Simple procedures that would ordinarily cost very little are charged high prices and this greatly affects those without medical insurance (Flower). Even for those with medical covers, their limits are exhausted faster and they soon find themselves having to pay from their pockets making healthcare to be very expensive.
Government Involvement and Decentralization
In giving its citizens the desired healthcare, German health care system has clear set out roles between the state and the central government. The central government has the responsibility of passing required legislations. On the other hand, the state governments supervise the physician organizations and oversee the general management of hospitals. Lastly, the local governments are tasked with the responsibility to manage public health programs and the local health centers. Notably, in German, the healthcare system is highly decentralized (Lewy). Although there is autonomy and goodwill from the different tires that oversee healthcare management in German, government often intervenes and the interventions have been on the rise in the recent past. Legislations such as the Cost Containment Act of 1977 have been enacted to control expenditures by introducing a fixed budget payable to the physician organization. Germany has seen major reforms including an attempt to reduce cost through lowering cost of expenditure on equipment, inpatient admission and general hospital capacity.
In the United States, healthcare is largely offered by private entities of for-profit basis. There is no one system that covers all Americas (Katie). As such, the government does not have the exclusive right or say on what can be offered. However, the national government works together with the federal government to provide healthcare cover to a proportion of Americans.
Overall, the healthcare system in the United States and that in Germany vary in terms of history, access, cost, centralization and the role of government. The United States records high expenditure on healthcare as compared to Germany. Notably, a system where the government provides health insurance to its citizens, as it is in Germany, has lower per capita health cost. On the aspect of consumer satisfaction, Americans are more dissatisfied with their health care system as compared to their Germany counterparts. In German, the waiting time tends to be longer than in United States where systems are privatized. The biggest challenge in America is the access, where there are over 40 million citizens who are not insured. Although, being uninsured does not mean that they do not receive any healthcare at all, it is observed that, Americans who are uninsured a less likely to seek health care intervention. Compared to the America system, the German system offers more services, lesser cost and universal access to medical and health care with any restrictions- German system scores higher in superior health services. Lastly, Americans has shorter life expectancies and higher infant mortality rates as compared to German residents.
"Implementing Health Reform: the CLASS Act." Family Practice News, 1 Dec. 2011. Retrieved on 7th May 2018, from < https://www.thefreelibrary.com/Implementing+health+reform%3A+the+CLASS+Act.-a0278880540>
Flower, Joe. Healthcare beyond Reform: Doing It Right for Half the Cost. CRC Press/Taylor & Francis, 2012.
Katie, Hunt. US Health Care Turmoil: What You Need to Know - CNNPolitics.
Lewy, Jonathan. "12. Treatment vs. Incarceration." Drugs in Germany and the United States, 1819-1945, 2017, pp. 287-298., doi:10.5771/9783845276380-287.
Simmons, David, et al. Integrated Diabetes Care: a Multidisciplinary Approach. Springer International Publishing, 2017.
Skousen, Paul B. The Naked Socialist. The Ensign Publishing Co., 2012. "https://edition.cnn.com/profiles/katie-hunt"
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