Ich bin ein Berliner

Okay, forgetting all the debates over how those famous words of JFK really translated, maybe it's time to rethink Germany. As anyone who reads this blog knows, I think about about the sorry state of health care in this country and am fascinated by how they do it in other countries. I've read about the German system before but this morning NPR also had a report on it and for skittish Americans who have such a love/hate relationship with their government, this system seems like a good compromise.

The German system is not really government health care or a single payer system. They still have private health insurers. However, the provider network is a mixture of non-profit and for-profit hospitals and doctors. People still pay into the the system but what the government does is strongly regulate the industry so that costs are contained and appropriate service is rendered to all. The German's believe that everyone deserves health care and care should be the same for all. They find it inconceivable that we have nearly 50 million uninsured people hear.

The woman and her husband featured on NPR live in Germany and have a mixture of coverage. The husband is from America and, because he is self-employed, he's not eligible for the German system so he has to buy private health insurance. The wife pays $200 per month but this also covers here children. Care for the children is free, including orthodontist visits. She pays a $15 co-pay when she sees her physician.

There are some inequities. The husband's private insurance allows him to go to the for-profit facilities and even request appointments with the top surgeons and specialists. He gets to go to the head of the line at appointments and this special treatment does bother the wife but she is still very satisfied with her care. And the reporter of the story mentioned that the government is always tweaking the system whenever there's a public perception that things are starting to get unfair between public and private insurance holders. Also, those making more than $72,000 per year can opt out of the government system and go private but apparently very few do so.

To me, this seems like a compromise worth exploring in America. Everyone is afraid of having the government actually take over and run health care in this country but at the same time, if we're being honest, we have to admit that the current system is not sustainable. Why not have a system where you still have private insurers but where the government sets very rigid standards on pricing of procedures, policies, increases in premiums, and demands coverage for all citizens? Yes, I know this flies in the face of capitalism and the free market economy but again, let's be honest, the health care business is now more free market than the oil industry. When the bulk of Americans get care from a hospital system owned by about 5 major companies and the majority of insurance policies are sold but about the same number of big insurers, that is not a free market. So I say let's clamp down on these people. Health care isn't something that should be up to the laws of supply and demand anyway. We're not talking about whether people can afford filet mignon here. We're talking about general health and in some cases life and death. A moral and just society takes care of its citizens, plain and simple.

The Germans have now had their system, working pretty well, for over 120 years. No one is saying it's perfect. No one is saying it would be easy or painless to change. But as I always said when I was working as a therapist, if you keep doing the same thing, the same thing is going to keep happening. It's time to do something different.