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I'm from Germany and here it's exactly the other way around. Public health insurences (there are over 100, but they are all organized in an umbrella organizati

by foepys 6y ago

I'm from Germany and here it's exactly the other way around. Public health insurences (there are over 100, but they are all organized in an umbrella organization) give out licences to doctors to be allowed to practice on publicly insured patients. The doctors get some amount of money they can spent on patient-specific prescriptions, but in general the doctors only prescribe the active ingredient. When the patient goes to the pharmacy to get their prescription, the pharmacy looks up the insurence and hands the patient the medicine that the insurence dictates. A doctor can prescribe a specific medicine but has to pay for it themselves (mostly from the money the insurences previously provided, see above). Insurences check about 10% of all hospital bills and just don't pay what they deem unnecessary. Hospitals are therefore careful not to do things the insurences didn't approve of. There is an open catalog of therapies that the public insurences will definitely pay and how much it may cost, so it's not a secret. They will also push for modern treatments if they reduce recovery time and have less risks. There is a lot more to the system but that's the gist.

gumby 6y ago
Ironically despite the lower cost, the German medical system also provides a wider range of services than are provided in the US. For example my mother in law had an unusual cancer and after her treatments she had a rest spa paid for; once the treatments could no longer help she had in home care. In the US, good luck.
nicbou 6y ago
I came here to extol the virtues of the German system. There's a lot more to it: - It's priced according to income, not health condition - You will never, ever be refused necessary healthcare, and you'll know it's covered before work begins - You are not punished for using your insurance, and the premiums won't change - There is no deductible, except a 5-10€/month co-pay for prescriptions - Your employer/employment has no impact on your coverage, or the insurer you choose This is for the public system. The private system is a bit more complicated, but generally, the same rules apply. The only difference is the pricing structure, and the possibility of having a deductible (usually ~1000€/year). American expats tend to have trauma that affects their insurance choices. My job is to reassure them that our system is completely unlike the American system. If you want a plain English overview of the system, you can have a look here: https://allaboutberlin.com/guides/german-health-insurance https://allaboutberlin.com/guides/german-health-insurance
- ballenf 6y ago
  One important caveat to the German system is that if you make over a certain amount and are healthy, the private system will actually be cheaper since it's not tied to income.
  - MuffinFlavored 6y ago
    I'd say the average programmer makes $120k/yr USD after about 5 years in, which is roughly €100k EUR. What would a German citizen making 80k-100k EUR pay in healthcare monthly? I think my employer subsidizes about $200/mo into a medical program for just myself. Curious how it stacks up to Europe (which seems to do health care better than the US by leaps and bounds?)
    - estaseuropano 6y ago
      The article linked in the comment chain you responded to gives numbers. For public insurance (which covers all essential care with no deductibles) > The ninimum is 200€, [...] If you make more than 58050€ per year, you pay around 400€ per month. This is the maximum contribution (Höchstbeitrag). If your salary is higher than 58050€, you will not pay more. For private insurance (possible if you earn above 64k or are a freelancer) its not linked to your income so rates vary. > Private is cheap when you are young If you are young and healthy, you could pay as little as 175€ per month (350€ for freelancers) for private insurance. If you make a lot of money, this is much cheaper than public insurance. But there are deductibles and fees can go up if you have frequent health issues. Freelancers cannot be covered by the public system so it only works when you're an employee, otherwise you're on private insurance.
    - kioleanu 6y ago
      An employee would pay a little under 350 euros and their employer an equal share. It is calculated as 7.3% of your salary until your salary passes about 56k euros. Then it’s calculated as 7.3% of 56k regardless of much you earn. Not working spouses are automatically co-insured without any extra cost

by foepys 6y ago

gumby 6y ago

Ironically despite the lower cost, the German medical system also provides a wider range of services than are provided in the US. For example my mother in law had an unusual cancer and after her treatments she had a rest spa paid for; once the treatments could no longer help she had in home care. In the US, good luck.

nicbou 6y ago

I came here to extol the virtues of the German system. There's a lot more to it: - It's priced according to income, not health condition - You will never, ever be refused necessary healthcare, and you'll know it's covered before work begins - You are not punished for using your insurance, and the premiums won't change - There is no deductible, except a 5-10€/month co-pay for prescriptions - Your employer/employment has no impact on your coverage, or the insurer you choose This is for the public system. The private system is a bit more complicated, but generally, the same rules apply. The only difference is the pricing structure, and the possibility of having a deductible (usually ~1000€/year). American expats tend to have trauma that affects their insurance choices. My job is to reassure them that our system is completely unlike the American system. If you want a plain English overview of the system, you can have a look here: https://allaboutberlin.com/guides/german-health-insurance https://allaboutberlin.com/guides/german-health-insurance

ballenf 6y ago
One important caveat to the German system is that if you make over a certain amount and are healthy, the private system will actually be cheaper since it's not tied to income.
- MuffinFlavored 6y ago
  I'd say the average programmer makes $120k/yr USD after about 5 years in, which is roughly €100k EUR. What would a German citizen making 80k-100k EUR pay in healthcare monthly? I think my employer subsidizes about $200/mo into a medical program for just myself. Curious how it stacks up to Europe (which seems to do health care better than the US by leaps and bounds?)
  - estaseuropano 6y ago
    The article linked in the comment chain you responded to gives numbers. For public insurance (which covers all essential care with no deductibles) > The ninimum is 200€, [...] If you make more than 58050€ per year, you pay around 400€ per month. This is the maximum contribution (Höchstbeitrag). If your salary is higher than 58050€, you will not pay more. For private insurance (possible if you earn above 64k or are a freelancer) its not linked to your income so rates vary. > Private is cheap when you are young If you are young and healthy, you could pay as little as 175€ per month (350€ for freelancers) for private insurance. If you make a lot of money, this is much cheaper than public insurance. But there are deductibles and fees can go up if you have frequent health issues. Freelancers cannot be covered by the public system so it only works when you're an employee, otherwise you're on private insurance.
  - kioleanu 6y ago
    An employee would pay a little under 350 euros and their employer an equal share. It is calculated as 7.3% of your salary until your salary passes about 56k euros. Then it’s calculated as 7.3% of 56k regardless of much you earn. Not working spouses are automatically co-insured without any extra cost