5 ms·

"A decent mostly free health system" Where in Germany is that? You either pay a lot for private insurance (especially when you get old) or you pay a lot for s

by ulfw 5y ago

"A decent mostly free health system" Where in Germany is that? You either pay a lot for private insurance (especially when you get old) or you pay a lot for state-backed insurance (which is a lot if you earn above average as most techies do).

oezi 5y ago
Since insurance is capped at around 5k salary you will at most pay 15% of that (750 EUR) for health insurance per month in the universal insurance system. If you make higher salaries then you won't be affected.
- pkaye 5y ago
  > Since insurance is capped at around 5k salary you will at most pay 15% of that (750 EUR) for health insurance per month in the universal insurance system. Does the employer pay any of that? Is that the total for the entire family?
  - suction 5y ago
    Yes, it includes your spouse and any number of children up to the age of 26 I think. So the classical family model with a stay-home spouse and children will be covered by the breadwinner's health insurance. If any family member works full-time, then they have to cover their own health insurance. Exceptions apply. If you make more than 40.000 EUR / year you have the option to get a private insurance policy with more "benefits". Then, the employer will pay out the amount that went to the public health system and you will use it (and whatever you can afford on top) to your private health insurance. When you go private, you're in the wild west, meaning you'll need to be extremely cautious of what contracts you sign. Or you'll end up with a 3000 EUR per month plan at old age, with no way back into the public system. Many people end up poor after retirement because their whole 401k and savings go towards the health insurance which is way to luxurious for their needs and isn't capped.
- rattray 5y ago
  Is that 750 EUR for an individual or a family? Sounds like a lot. For comparison in California, a 35-year-old SF resident earning $250k/yr living alone purchasing insurance through the public marketplace can get a Platinum-level Kaiser Permanente HMO plan for around $650/mo (but over $2000/mo for a family of four). YMMV but I've found KP's service quality to be extremely high, and that plan comes with $0 annual deductible and very low copays.
  - TMWNN 5y ago
    >YMMV but I've found KP's service quality to be extremely high Multiple studies have shown that Kaiser is more efficient and effective than the UK NHS for about the same cost. Examples: * https://www.bmj.com/content/324/7330/135 https://www.bmj.com/content/324/7330/135 * https://www.bmj.com/content/327/7426/1257 https://www.bmj.com/content/327/7426/1257
    - rattray 5y ago
      Fascinating! Thank you for sharing those 2002/2003 articles. For completeness, it looks like a 2004 rebuttal claims that this is due to a healthier population: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1266198/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1266198/ but frankly that does confirm that relatively healthy, employed populations would prefer Kaiser to the NHS.
  - domsom 5y ago
    It's 14.6 % of the gross income, capped around 58k income / year. Half of that (7.3 %) is paid by the employer, the other half by the employee (deducted from monthly wage payments). For that, kids (no matter how many) are covered unless the other parent has a private insurance. Spouses are covered if they don't have their own insurance. Based in Germany, I'd say the best part of it is that it's truly social: The healthy ones pay for the sick ones, all with the same tariff, no questions asked. That's especially true for people who become sick, old, or both: For them, private insurances tend to raise their tariffs exponentially, and there's no way to get an affordable insurance any longer.
- ulfw 5y ago
  Yes. Which ... I am sorry is not "free". We can argue about it being cheap or not cheap or whatever. Sure. But I don't get why I got downvoted for pointing out that it's not free, when that's 100% true. 750EUR public (which doesn't cover everything) or depending on age anywhere from 400 to 1500EUR private isn't "free healthcare". That's on top of high taxes etc. Germany has a lot of great things. Free healthcare ain't one of them. Let's stay honest.
  - oezi 5y ago
    I don't think anybody says it would be free (what is free except air and love anyway?). But it is universal and also available if you are not working, are unemployed or retired. If you are not earning any money, then you still receive the same level of care. You are right that it doesn't cover everything, but in my experience these are primarily things where there is a high level of own influence or electivness (dental implants, lasik, glasses) and or cost/benefit isn't proven. Since a basic level of care is provided I don't mind that.

by ulfw 5y ago

oezi 5y ago

Since insurance is capped at around 5k salary you will at most pay 15% of that (750 EUR) for health insurance per month in the universal insurance system. If you make higher salaries then you won't be affected.

pkaye 5y ago
> Since insurance is capped at around 5k salary you will at most pay 15% of that (750 EUR) for health insurance per month in the universal insurance system. Does the employer pay any of that? Is that the total for the entire family?
- suction 5y ago
  Yes, it includes your spouse and any number of children up to the age of 26 I think. So the classical family model with a stay-home spouse and children will be covered by the breadwinner's health insurance. If any family member works full-time, then they have to cover their own health insurance. Exceptions apply. If you make more than 40.000 EUR / year you have the option to get a private insurance policy with more "benefits". Then, the employer will pay out the amount that went to the public health system and you will use it (and whatever you can afford on top) to your private health insurance. When you go private, you're in the wild west, meaning you'll need to be extremely cautious of what contracts you sign. Or you'll end up with a 3000 EUR per month plan at old age, with no way back into the public system. Many people end up poor after retirement because their whole 401k and savings go towards the health insurance which is way to luxurious for their needs and isn't capped.
rattray 5y ago
Is that 750 EUR for an individual or a family? Sounds like a lot. For comparison in California, a 35-year-old SF resident earning $250k/yr living alone purchasing insurance through the public marketplace can get a Platinum-level Kaiser Permanente HMO plan for around $650/mo (but over $2000/mo for a family of four). YMMV but I've found KP's service quality to be extremely high, and that plan comes with $0 annual deductible and very low copays.
- TMWNN 5y ago
  >YMMV but I've found KP's service quality to be extremely high Multiple studies have shown that Kaiser is more efficient and effective than the UK NHS for about the same cost. Examples: * https://www.bmj.com/content/324/7330/135 https://www.bmj.com/content/324/7330/135 * https://www.bmj.com/content/327/7426/1257 https://www.bmj.com/content/327/7426/1257
  - rattray 5y ago
    Fascinating! Thank you for sharing those 2002/2003 articles. For completeness, it looks like a 2004 rebuttal claims that this is due to a healthier population: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1266198/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1266198/ but frankly that does confirm that relatively healthy, employed populations would prefer Kaiser to the NHS.
- domsom 5y ago
  It's 14.6 % of the gross income, capped around 58k income / year. Half of that (7.3 %) is paid by the employer, the other half by the employee (deducted from monthly wage payments). For that, kids (no matter how many) are covered unless the other parent has a private insurance. Spouses are covered if they don't have their own insurance. Based in Germany, I'd say the best part of it is that it's truly social: The healthy ones pay for the sick ones, all with the same tariff, no questions asked. That's especially true for people who become sick, old, or both: For them, private insurances tend to raise their tariffs exponentially, and there's no way to get an affordable insurance any longer.
ulfw 5y ago
Yes. Which ... I am sorry is not "free". We can argue about it being cheap or not cheap or whatever. Sure. But I don't get why I got downvoted for pointing out that it's not free, when that's 100% true. 750EUR public (which doesn't cover everything) or depending on age anywhere from 400 to 1500EUR private isn't "free healthcare". That's on top of high taxes etc. Germany has a lot of great things. Free healthcare ain't one of them. Let's stay honest.
- oezi 5y ago
  I don't think anybody says it would be free (what is free except air and love anyway?). But it is universal and also available if you are not working, are unemployed or retired. If you are not earning any money, then you still receive the same level of care. You are right that it doesn't cover everything, but in my experience these are primarily things where there is a high level of own influence or electivness (dental implants, lasik, glasses) and or cost/benefit isn't proven. Since a basic level of care is provided I don't mind that.