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American Reacts How Germany's Universal Health-Care System Works
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- Опубликовано: 29 янв 2023
- Original Video: • How Germany's Universa...
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The goal of the US health care system is making a profit. In Germany (EU countries) it is keeping people healthy. Good comments btw. 👍👍
Goals are irrelevant, only service provided. If profit motivation results in better health care provision for all, then that is a good thing, regardless of goals.
@@scabthecat stupid comment.. onebofvthe only advanced countries that operates under the profit based system is America.. And it certainly doesn't offer good health care for all. And since Britains NHS has steadily become more privatized it has also started getting worse and harder for us to even just see a doctor.. When we use to have one of the best health care systems in the world.. I'm 43 now and I remember the good old days
@@markmorris7123 In contrast to the US, which operates healthcare for profit, every other first world country has a socialised healthcare system? Are you sure Mark? You throw 'stupid' around, so you have to be sure.
@@scabthecat I'll answer for him if you don't mind.
No, but close.
There's a form of healthcare system, either universal, socialized, single payer, mandatory private + public backing, or another version in virtually every first world Western (loose definition) country except the US.
In Europe for example there are many variations, UK has the NHS (Canada has something similar but slightly different), France has a public single payer insurance system that's technically *not* socialized medicine / healthcare per se as it gives access to all practitioners public or private ; The Netherlands have another type of health insurance system which is more based on mandatory private insurance with minimums and specs set by the government plus public backing, and so on...
Governments and agencies usually bargain hard with drug companies and limit prices in a lot of said countries, generic drugs are strongly encouraged, there are also many public hospitals and public medical education. Most countries have a form or another of capping for out of pocket expenses and publicly controlled / limited costs, or a variation of total coverage for the most serious or chronic conditions.
Sadly, many in the US only see healthcare in a binary way and use the term "socialized healthcare" far too broadly.
I can recommend you a fairly well documented video :
"How French Health Care Compares To The US System"
By CNBC
It quickly explains how the system works, the difference with socialized healthcare and all the benefits it has.
Hope that answers the question.
IIt's not that you only get 840$ worth of care a MONTH. IT MEANS YOU DON'T PAY ANY MORE than 840$ even if you have thousands of dollars of lifesaving surgery!
I was screaming internally lol
Glad you explained.
In addition, if you are not chronically ill you pay a maximum of 2 % of your gross income a year for medicine and medical treatment being in the SHI. You will however just get your money back after doing your taxes, if I remember correctly.
And, 50% pay you, and 50% your employer. At my last Job, i payed 150 Euro per month, and 150 Euro my employer. BUT, the important thing is... Health is the most important thing we have, is to be healthy. Without healthy there goes nothing.... And you never know whats tomorrow.
Sorry for my bad English 😬
Infant Mortality is also higher because U.S. mothers have to work longer, sometimes until the day of delivery. And they also return to work sooner after giving birth.
German health insurance is based on solidarity, not on inequality.
5:00 there are many reasons. In Germany you have to visit the Doctor very frequently, once you are pregnant. While in the US women try to avoid to spend their money. There are also health training programs for the mothers during the pregnancy in Germany, which is covered by the insurance.
The next point is, in Germany you have maternity leave for several weeks by law (i guess 6 weeks before and 8 weeks after birth), in the US you have to work until you are about to give birth, in some cases even at the same day when you get your child, u are still working. Parental leave is also an issue in the US, like there is almost nothing comapred to Germany.
And many new parents actually decide to stay in the hospital for at least 3 days, because the baby will then have had its first two check-ups and, as a new mother, you don't have to worry about a check-up appointment with a pediatrician right away. There are also paid follow-up checks by midwives. Oh yes, and dad usually has enough vacation time to support mom and baby in the first few weeks, not to mention the parental leave that fathers often take later
About doctors doing a better job if they get paid more: I think that most doctors are motivated by other things than money first, but if you are unhappy with your salary that might effect your work, but I don't think that means that American doctors do a better job than Europeans just because they earn more. I think wether or not someone is happy with their salary depends on their expectations, and on how much other people around you are making. An American doctor can make twice the amount compared to a European doctor, and still be unhappy because he is making less than his colleagues.
Also - if US doctor did a significantly better job than German doctors - life expectancy should be higher in the US. It is not.
Germany - 80.94 years
USA - 77.28 years
Also, free education mitigates the much lower salary, and having salaries be less of a contributing factor means that less developed cities and towns are less likely to lose their doctors to big cities.
Of course there are a lot more specialists in the US because of higher pay for specialization, but imagine how many more people could get life saving treatment if that Surgeon doing Breast implants for some celebrities was instead doing cardiac surgery.
@@jarls5890 Actually doctors could do a better job and life expectancy still be lower, if seeing doctors is unaffordable for some proportion of the population
My Dad is a doctor in Europe, he got his degree for free, he and my mom profited massively from the social democrat government's efforts to open up higher education to working class kids. He and his colleagues mostly complain about organizational issues, they're satisfied when they know they can provide the best possible care for their patients without having to argue too much with hospital management or have to deal with workplace politics, kind of unavoidable gripes. Money is good in Europe too, I grew up with a cozy upper middle class lifestyle and my parents prefer paying European taxes any day to living in a society without solidarity, they have plenty, how much can a person even need? Maybe we're different from Americans in that being rich isn't even something most people would want, I've never met anyone who seriously wanted to get rich, we just want a job we enjoy and that affords a comfortable lifestyle.
The education before a birth. The expert planning of a birth. The support system after a birth. The safe space when you are knackered and not ready to self support. You need all those for good chances.
The trick is, that the cost for german healthcare is a percentage of your income ~14% of your wage split 50/50 between employer and employee.
The other major subject is, that you won't lose your insurance when you lose your job, and children are insured with one of their patents for free.
SHI is available to all, regardless of income. PHI is limited to income above 60k, or being self employed. 840€ is the MAXIMUM you have to pay for SHI. At low incomes it comes down to 100-200€ per month. The problem with appointments with specialists is a bit exaggerated. Usually its not longer than a month (if its not life threatening, if it is it's instantaneuous)
I dont know about the waitingtime. In some fields you do wait 6 months or more for an appointment. (wie zb Lungenärzte, Kinder- und Jugendpsychiatrie, etc. pp)
Also if you're so worried about doctors waiting list and have money, get a private insurance, and you get treated faster.
Yes and a lot of people above the 60.000 threshold are still in the SHI and not in the PHI, there is no mandatory change to PHI
Same in the UK, you pay depending on how much you earn, so if you're poorer, you pay much less and so on, and I remember when I started work in 96, because I just started out after leaving school, I wasn't earning much and only had to pay around £5 per week to the NHS, if I was earning more, that would go up a lot, so it's based on how much you earn.
Also like you said, the waiting list is exaggerated, it depends on urgency, in other words, if it's not life-threatening and you can afford to wait, then it's far less of an issue and you can afford to wait a bit, but if it's something urgent, you will get seen right away, and I suspect that's the case with any European universal health care system.
No the 840€ are the absolute maximum you have to pay per month if you earn really good. 7.something % of your pre tax income goes to your health insurance. Costs of healthcare doesn't have a coverage maximum. You will never get a bill for necessary treatments.
Can confirm! I live in Germany had had some surgery done. Never payed anything for emergency or life-saving operations. I payed €300 extra to make a replacement tooth have more natural colored. That is the maximum I have ever payed for health services.
@@SushiElemental Yep. Cosmetic treatments are not covered wich i think is right 😊
@@Humpelstilzchen It depends on the surgery though. A friend of mine had her nose job covered by insurance because the deformation was so severe that it was causing her emotional pain.
@@zerania9514 That's good. 👍 So it was kind of a necessary surgerie when it make her mental problems
Mostly true. But there are many treatments that are not covered by the German healthcare system because they are considered unnecessary, not useful or they are newly introduced and not listed yet. Moreover, glasses are not paid except for children. Dental work might only cover the cheapest treatment and not the fillings that might last a lifetime. So it might be quite wise to have a special insurance on top for these treatments. Mine costs me some 80 € per month. They once had to pay for an operation and occasionally new glasses.
2.24 „I trust you to choose what is the best for you“
Yeah, sounds good, but I don’t even trust myself! 😂 Neither should you 😉
I’m German, and I chose my health insurance when I was 20 something and had just finished University. (while I was studying I was still insured by my family)
That was over 20 years ago. I was young, healthy, happy and never thought that I could get seriously ill. I know, that’s very naïve, but many people are like that. Sh..t only happens to the others, never to me or my loved ones… to cut a long story short, I chose the cheapest health insurance option that was available. 15 years later, I got seriously ill and spent nearly 4 months in hospital, and a chronic health condition was diagnosed. The whole thing would have cost over 200 000 Euro… and I didn’t pay a single cent!
That treatment saved my life, I am healthy now (or rather: free of symptoms) and very grateful about our German system. As young and naïve as I was in my mid-twenties, I would have made an awful decision about my insurance, maybe I would have even chosen against any kind of health insurance. In the USA I would be either dead or bankrupt by now.
14:20 And what about dangerous hobbies, professions? What is healthy food and do you have access?
Who determines what is healthy or not? Your insurance company, your doctor, or the state?
Smoking is an addiction, as is alcoholism, and an addiction is also a disease!
So I don't understand your argument - just let him die!?
Wait times are often longer in the US. Many treatments are denied by insurance, or the cost is not covered.
Many medical innovations, devices therapies, come from Germany.
I’m living in Germany for over 13years. Fortunately, if we complain something about health, it’s always to family doctor first and then the family doctor will give the patient a recommendation paper to bring to a specialist. For example addiction or sort of depression, they will send the patient to a psychiatrist and psychologist for assessment. In short, patients are sent to a particular specialist. Or if we know already which specialist we should go, like problem of lungs, we are allowed also to go direct and decide to go to pulmo and after that, the diagnosis report should have a copy for our family doctor. The state dont decide but regulate in case there is irregularities of the system
The US system is about making money out of illness. Universal healthcare is about provision.
In the US you have to pay for the profits of insurance companies, lawyers (because so many cases go to court), and hospitals.
In the EU you pay for primarily for healthcare.
The outcomes given in the vid speak for themselves. To pay more for a shorter life expectancy is not something anyone wants.
So the US argument about 'choice' means merely choosing who makes vast profits out of you!
I've had cancer three times. The cost of treatment must have been tens of thousands, yet I paid nothing at the point of access. I live in the UK, and am still seeing one of the top specialists in the country, yet I live on a basic pension. I thank god every day for the NHS.
In answer to your question - Its possible people can't afford to get all the check ups during pregnancy that would be free somewhere like the UK. They help to catch a problem before it becomes life threatening. That upper figure is he maximum anyone has to pay no matter how wealthy. You imply that you have absolutely no community spirit in America. We love the way the our NHS is all inclusive and that no one is being left out.
The weird part, about not wanting to pay for others being sick, is that is exactly what insurance is, except it generally takes a cut for profits.
You made a statement, that I have heard from several Americans about universal healthcare on videos. The idea that you might be paying for someone who has abused their health through smoking, overeating, using drugs etc. Those of us who are lucky enough to receive universal health care….that isn’t even a consideration. If my tax dollar is also helping someone in need great! The American philosophy on everything is….ME…ME…ME. “ Why should I help others “. What a sad way to live.
feeling resentment for Ppl having addictions is so American and not okay. obese Ppl aren't obese because they want to. mental illness exists. I'm glad I am paying for Ppl with addiction issues because nobody in this world likes to be unhealthy
I’m slightly out of date with this stuff, but when I knew about it the biggest reason for the higher infant mortality was poor access to good antenatal care. That is, pregnant women are deterred by the costs from getting regularly checked out.
The idea of shared costs breeding a type of resentment to those less healthy is a cultural problem, not a medical system problem. Peopledon't even consider that as a factor. Here in NZ I've certainly never even thought about the fact I'm paying for someone who doesn't care about themself to get healthier... my only thought is that we as a nation should care for others.
Besides... you don't resent bad drivers for ruining the roads you drive on yet you share the cost of that. You don't resent people getting more help from police than you because you pay for that too. Etc. Or do you?
In Australia here. I'm almost 60, I have never had medical insurance, my taxes pay for healthcare, I have never been denied medical care, never had to wait to see a Dr if I was unwell, medication is subsidised so I pay a maximum of $15 for medication no matter the cost of it, even if it costa $100K per month, I'll only pay a maximum of $15. Most hospitals here are public and even the private hospitals use the public hospital system. I cannot comprehend not going to seek medical care if I'm unwell like in the US, the cost doesn't even register for me, it is free, payed by my taxes and payed by everyone else's taxes
If youre insured under SHI, you dont even get to see a medical bill ever..
you dont know how much a treatment costs, cause youre not paying for it directly
Youre covered for pretty much everything without a financial cap..
Youre just covered and your insurance pays for it..
the 840€ are your maximum monthly cost, (99% of people pay less) no matter how much cost youre actually causing for your health insurance..
Could be 0 or could be 50,000.. doesn't matter..
think of it as car insurance, just for people..
Its such an established system (been here since the 1880s) that there isnt really any resentment towards smokers or other people with avoidable sicknesses..
Having healthcare is a non issue here, you just have it..
if youre sick, you go to the doctor.. thats it
I have studied and compared healthcare systems in university, that's sort of my profession. So if you (or anyone else) have questions about the german healthcare system, I would be glad to answer them. :)
The key here is governmental regulation. In the USA, the government regulates almost nothing in the healthcare sector. In Germany, basically everything is highly regulated,especially the prices for medication. For prescribed drugs, the patient usually only pays a few Euros, the rest is paid for by the insurance. In certain cases (children for example), there are no additional payments at all, the insurance covers everything. So you basically go the the pharmacy, show your prescription and they just give you the medicine.
That's another aspect of the german healthcare system: It's free at the point of access. Normally, a patient pays nothing at all or only for a few things (like extra treatments that are not strictly necessary) anywhere. You go to the doctor, to the hospital, to physiotherapy, you are being zransported with an ambulance - all without paying anything. You just need your insurance card and that's it. All the financial stuff is managed in the background between different companies and institutions, all highly regulated and supervised of course. And even if there is a legal problem, it is solved without the participation or knowledge of the patient. Everything is designed to ensure that the patient gets the care he or she needs without complications.
13:37 Context: *Why paying for all, if some may with intent (smoking) do not care and "i" waste my money in the pool to them?*
>> No. Wrong take.
- I understand your point from the US view, or as things are "told to you"
>> But your "thinking" *limits* you to see your over all savings EVEN with those "guys" in
////
_Look:_
We start with Taxes,..bc "US workers love this point"...
>> US average *Income Tax* is *22%*
>> Ger average *Income Tax is *19%*
>> _But wait,..it says Ger has average 38% Tax?!?_
>> Yes, But "Tax" includes several other aspects you seperatly buy on the US private markets, while the Ger worker has the right to *buy* those cheaper with better conditions with several rights to it over Tax paths, the US worker simple does not
_What you mean??!??_
*Look:*
German average Tax *38%* is:
>> *Income Tax:* 19%
> *HC 100% premium:* 7%
> *State-Retirement Insurance:* 12%
So:
Income Tax is *19%*
2x Insurances bought is also *19%*
>> A healthy Give 50/50 Take, pretty fair if you ask me ;)
There is a raw trick to see the *german Income Tax* withing the *Tax number:*
>> *Half of it!!*
_> So if you see a German worker with lets say,_ *42% Tax* means he has *21% Income Tax!*
The other 21% costs his 100% HC premium, which no US worker can get his hands on EVEN paying more then 4 times & State-Retiremen Insurance, after 40years paying in, you can get your retirement money, monthly, rest of your life, global-wide payed out by Germany.
/////
*>> So if you you could say, well in the US, the average Income is way higher??!!*
_> True, but not as possitive as are told or good as you think, look:_
*Cost of living,* is *38% higher in the US vs Germany.
> This means, average worker, needs to earn _38%_ more in the US, to have simlar free money as the German worker related to Cost of living, right.
And than comes into play how much Taxes, Income Taxes and Basic Insurances costs are monthly needed to have your "now & than" *security/freedom* cobvered.
Germany, Single:
7% from 3k is *210* so 100% HC premium in Germany for *210€/month*
US, Single:
Average, *Silver Premium* covering only *70% HC premium* cost: 548€/month
>> Not only does the US side need *double or more money/month* but on top has still to pay 30% bc only 70% is covered IF needed.
/////
Germany, 4 Head family:
2x 7% (both) 3k is *420* so 100% HC premium in Germany for *420€/month, for all 4 incl. 2 kids, bc until 18+ kids run free one on 1 of the parents Insurance!
US, 4 Head family:
Average, *Silver Premium* covering only *70 HC premium* cost: *1.620€/month*
>> So the costs, for the US side *scales up* the more people come into the "Family" while in germany, the kids come in, the more "you save costs" lit.
>> At average we can say, a 4 head german family pays 4 times *less* than the US 4 head family for HC Insurance.
>> On top for paying 4 times more, The US family of 4, has 4x 30% open costs bc their premium (the average one) does only cover for 70% IF not denied.
///
Retirment Insurance savings in the US is at Average a 12-13% from monthly Income.
>> So basicly the same
///
The 38% higher Cost of Living
The Higher "now&than (more now)" HC&Retirement Security Insurances costs/month
The "unexpected" high incoming costs, a german does not have to worry about (30% still paying, Dr's fees etc.).
>> Melt a US workers "Free Money" so much down, that at average a German worker has 190-450€ more _"Free Money"_ as the US worker side, which still has to deal with unexpected costs, can be fired today, which the German worker can not, bc he has worker rights, which grant him by law, a *delay* of *minimum 4weeks/1month* before this goes into effect, ofc *payed.*
////
*Sidenote:*
*>> Germanys HC system made* pre Covid19, *22 Billion Surplus,* saving up for bad times into a pool, bc the money can only be spend for HC related content.
> Contradicting directly, what both US partys said about HC4all costs,... they lie, bc they get payed to from the private HC sectors to keep on grinding out the US pop.
> From a german worker perspective view, the US is a *Hungergames* version, noone truely wants, besides YOU are trying to make up a Buizz to then *exploid" the "cheap workforce" with like zero rights to benefits and scare tactic those workers to work harder or they might get tomorrow if not today fired...
>> *Which is one of the reasons Germans are:*
> Rank 1 Holiday flyers in the world (more (payed) free time)
> Rank 4 population cross saving
I believe in the US, the average cost of giving birth is $18,000. So I supposed if you are one of the 20% who don't have insurance, and you don't have that much money to spare, you'd be doing it on your own at home? Not sure it's a case of "not wanting to spend the money".
In Germany a vaginal birth without medical intervention costs around 3000€ (as far as I remember), but thanks 😢health insurance you just have to pay 10€/night of administrative fees, parking and maybe for extra amenities(like a family room, where the partner can stay as well and gets 3 meals + snacks and drinks).
From all I have learned, I would assume, that the maternal and infant mortality rates are higher in the USA because of monetary reasons, but others than expected:
Regular checks starting around 6-8 weeks of pregnancy, all pregnancy related medication is free, pregnancy education and exercise for pregnant people is either free (thanks to) or supported by the health insurance. Then there’s 6 weeks of fully paid optional maternity leave before the due date and eight weeks of mandatory fully paid maternity leave after giving birth, optional (partly paid up to 67% of one years income) of up to three years of parental leave.
Regular checks post partum by a midwife, that visits you at home to check on your healing, the child and if you settle into your new role and regular (mandatory) checks at a pediatricians (that are more frequent the first year and get less frequent the older the child gets). All medical visits, prescription medication, hospital stays, etc are actually free (at point of service, paid by the insurance) for all minors as well.
I suspect that part of reason infant mortality is higher in America is that the anti-natal care is better in Europe , problems with pregnancy are picked up earlier and managed better.
I'm guessing because the anti-natal is not at a cost that may prevent some mothers taking it?
@@stephenlee5929 nothing pregnancy related (doctors appointments or medication) does cost the family anything, it’s all fully covered by the insurance company, just like all doctors appointments, prescription medication and hospital stays for minors.
20.50 yeah, you are right. I‘m a doctor, and what you are describing is exactly the reason why I would NEVER ever want to work in the US! Here in Germany I know that my patients don’t have to think about money. With very few exceptions, they don’t have to pay anything. And I would hate to worry about a patient, because he/she urgently needs a treatment and can’t afford it.
What he forgot with the "Pack to SDI"
- You can do this only if your not older than 55years.
- If you are Freelancer and have another low salary job than both incomes count and you need to be under the "mandatory limit" with both incomes combined to re-join the SDI.
- When you are back in the SDI and later earn more money (because you work as freelancer again and stop earning nothing to go back to SDI) you pay 15% of your Freelancer income (up to 840 a month) for SDI - Win/Win for both because the SDI has now a high payer more and you pay less than for the insurance.
And with the Age limit of 55 or less the statistical chance that you cost the insurance more than you pay as high payer -in the first maybe 10 years - is still low.
For the SDI it is in their own interest to lower the cost. While in the US the insurance would increase our payment or resign the contract.
The reason is following:
Think of an SDI Company that has 100 insured people under contract.
From the Insurance fund they got 100.000€ per year (yes all numbers are fictional) for these 100 people.
When the treatment of these 100 people cost more than 100.000€ per year they will go bankrupt.
So it is in their interest to lower the cost (legal). And the only legal way is to calculate:
If we do not support a yearly "cancer" check-up statistically 3 of the 100 will get second state cancer (that wasn't found earlier because there was no check) and the treathment (Chemo, OP, Hospital) would cost 50.000 each - what results in a yearly deficit of 50.000€.
With yearly check up for all 100 patients (200€ per check) only 2 early state cancer case will be found and only 1 secand state cancer.
Early cancer treathment costs 5.000€ so this will cost the company 20.000€ for the checks, 10.000€ for the early threatment and 50.000 for the secand state threatment. Summarized 80.000€ instead of 150.000€
So it is in the interest of the SDI to support early checks. Same with "Stop Smoking" messurements by paying Treathments for Smokers that want to stop smoking or threatments for Alcoholics etc.
In the long run paying for "in most cases not needed" checks (97 of the 3 insured have had a cancer check that was not needed) will result in a lot less costs for "not doing so".
i am sick since August last year,
i dont pay for Health Care,
i am still fully insured,
i get my wage paid by the health care provider right now...
i am getting better but cant get broke by medicine bills, because i dont have any medicine bills!
It's all about Governmental regulation, that's why it will never change in the US, the American system is based on Lobbyists , and how many Dollars that lobbyist has, the more money, the more likely the whatever is being lobbied will win.
I only pay 290€ into SHI and I never knew there was a cap of 840€ but that is a lot! So I thought "how rich do you have to be until your monthly contribution is capped"? It's a salary of 12.000€ per month! 😅 Sometimes I just forget that rich people exist 😄
If you count heads, you're probably going to count to 10 and find someone who makes that much.
Some of them you don't even expect. Maybe they are industrial research chemist for a company that makes car tires with a university degree.
But it could also be someone who by coincidence went to a plane Turbine manufacturer and did an apprenticeship, and it also pays that well, after 3 years of work they are senior and make as much as someone with a university degree.
@@ayoCC Well, I'm an automotive engineer here in Germany and not even senior experts with 30 years of experience earn 12.000€ a month in my company. That's just not how it works. There is no open end to the salary of any position in the regular industry here. We get grouped in salary brackets with E17 being the highest (roughly 8600€). Maybe our site director earns that much.
10:03 No. I think they mean that the highest income earner, for example a billionaire, will only pay a max of 830 a month for SHI. Someone who makes about 100k pays about 350 a month for shi.
@@brucemc1581 Why do you think it's 350 a month? I mean can you show me your calculation for this? If you get 100k per year you get 8333€ per month. 7,3% of 8333€ is "only" 608€. So 12000€ per month is the amount where your SHI contribution is capped to 840€.
@@Thorium_Th HI, Sorry. I did not mean this in reply to you, but to the video itself. Anyway... not sure how the calculation works. Does the 608€ cover a whole family?
I don't think that many Europeans look weird at people who are living a less healthy life and think that they are paying for their health care. The low cost per month in exchange for complete health care without insane bills makes this a great deal for every citizen. So its not really a thing. The most we do is tell people close to us that its bad for them. And that is out of concern for them.
Yeah, that's absolutely true, I mean I do hate that so many young people smoke in my country but that's because I'm worried for people's health, do I care that they get some of my 75€ health insurance payments per month (student with part time job)? No, we're all paying our share, we're all in this together.
Minute 4:28 - Why child mortality and maternity mortality is so high?
- It happens that people don't go to the doctor to save money and a lot of mothers end up in the birth moment with some patologies or problems that could have been diagnosed and prevented with some pre birth visits (in Italy whe have one free visit each month from the 3rd pregnancy month, thus 7 free visit at the hospital with no waiting line)
- Uninsured people
- People that don't call the ambulance to avoid 2000$ bill (up to 5000$ depending on the distance and hour of night)
- People that reach the hospital too late because the ambulance has to bring them to an hospital that is served by the insurances they have (while in other countries the ambulance simply bring you to the nearest one because insurances cover EVERY HOSPITAL in the same way)
In our systems every doctor and every hospital is covered in the same way. In your system every insurance company has its own "network" of doctors and hospitals covered, so you can end up to be 1 hour away from an hospital that accept your insurance. This can make the difference between life and death
Just some examples of why your infant mortality rate is higher than any other OECD nation
cost of an ambulance sounds so silly to a german^^ if you are in need you do not to pay anything for an ambulance. even if they say that it is not a wild thing you can go to the doctor tomorrow you won't pay a cent
Infant and maternal deaths are higher in the US largely in part due to the fact, pregnant woman are not getting the very important prenatal care they need to ensure their health and that of their fetus. This is because they cannot afford it due to the American system of healthcare. All countries that have universal healthcare have excellent prenatal programs at no cost to the patient.
I live in Germany. The system works.
the story behind "long waiting times" needs an explanation: if you are familiar with triage it makes sense and healthcare had priorities from life threatening to "I have pain" (like a knee operation).
The waiting time is for routine checkups. In emergencies the answer at the reception mostly is "stay here, can you wait for a while?"
Different goals. In Germany and many parts of Europe it’s about making sure everybody is insured and gets the treatment necessary while american health care companies are aiming for as much profit they can make. Preemptive measures e.g. are a lot cheaper (still charging a couple of hundred bucks->avoid the doctor)but are not in the interest of American companies because they can charge more for surgeries, ER visits etc.
Getting a child does not start at date of birth. Monitoring the mother and child during pregnancy, providing aid for both of them afterwards plays a major role as well. In the US mothers will be discharged hospital after a few hours.
4.20 that is very easy to explain! RUclipsr Ashton (the Black Forest Family) made a very good video about the costs of giving birth in a hospital in both Germany and the US.
Because it is so expensive, many women in the USA chose to give birth by themselves at home, maybe with a midwife. In Germany it’s basically free to deliver in a hospital. And that’s so much safer. Have you heard about the Nebraska midwife trial? A child died because a family chose to have their baby born at home, with assistance by a midwife. This midwife wasn’t really qualified (hence cheaper) and made awful decisions. The death of the baby was nearly 100% preventable.
Minute 22:48 - This is a very important point and you should look at it closely, multiple times. Every cost is PREDICTABLE, both the final cost and the amount of coverage. That's something is completely non existent in US and probably one of the first things you should work on
In US if you go for a surgery, you really cannot predict anything, because the bills are so complicated, with vague and obscure voices and you get that bill at home after days or weeks, with the insurance coverage that is nearly unpredictable. This is a nightmare for a family that is struggling to keep all going on
Minute 10:02 - No. They can charge you no more than 840$ per month. It's not what's covered, it's what you spend
Minute 14:06 - "you want to smoke yourself to death? you want to eat yourself to death? go ahead"
I don't know how you call that. We call that being selfish
As a german, who lived in the US for 15 years, and had 3 kids in Germany and 1 kid in the US, i can definitely say, that prenatal and post natal care in Germany was 100% better in Germany, then in the US ( we had free medical care through the US Army in the States), especially if you have a complicated pregnancy.
Due to poor prenatal care and pediatric care, infant mortality in the US is higher.
For infant mortallity rate i think i have a really simple explanation: In Germany, if you are pregnat, the next hospital is maximum about 15 Miles away. In the US, it may be 100 Miles. Germany is a bit small compared to the US so.... It would make sense.
In the US healthcare is handled more like a pure profit-money system - as everybody is dependent on health everybody is dependent on spending money on it resulting in a big market to make money.
In Europe this aspects exist to but the system overall is seen more like some basic-need system which isnt designed to only make profit but keep the population healthy (even if it not is generating profit) so the population longterm can make more profit in other branches (for example healthy construction workers who can work some years more efficient)
In many cases avoidable deaths, infant mortality, etc it's not that people don't WANT to foot the bill; it's that they CAN'T foot the bill.
When a birth can cost anywhere from 3000 up to 30000 dollars in complicated cases with extended labor, C-section, post-partem complications, etc. If you have to decide if you might need to shell out another 2.5k for even a single additional day of extended observation of your newborn's condition or taking the risk of going home early with your child and not paying, many people simply can't afford to pay in the USA.
In Germany you don't have to think about payments; you focus on getting the necessary treatment at the time you need it. Because your insurance will, 100%, cover it. If that means even a week or more in hospital after complications, so be it. Your job is safe, you're not loosing PTO, your wages/salary is going to come in normally, yada yada yada. That safety of mind is invaluable in helping you recover.
Edit: the original video made some small but fairly consequential mistakes. You CAN transfer to PHI whenever you want to, but you have to be able to pay their fees from then on out. Once you're in PHI there's no simple way back into SHI again. PHI is MUCH more expensive in fees, and these increase the older you get, and the more existing conditions you have; just like in the USA. You do however get preferential treatment from most doctors as they are legally allowed to charge you up to three times the fees fixed in a nation-wide price listing for all treatments and check-ups that they can charge an SHI patient.
However more than 80% of all people in Germany are covered by SHI because the outcome varies soo little from PHI. If you want more info, check out Healthcare Triage and their video on the German healthcare system.
I can remember in the 50s or 60s my Canadian uncle being most impressed with the NHS but now it seems Canada has its own Universal Healthcare.
Infant Mortality: There are no additional costs when it comes to children's Medical bills and even Medicine bills as those are free.
Also, there is paid time off a Mother take before and after birth,;
and then there are 3 years of Parenting time that be split between the parents, those can be be used in incriments, if preferred, up until the child is age 12.
All with a guarantee to be having the same job at the end of the 1st year and a similar and similarly paid job after taking all of that time in one go.
Then there is low cost child care or no cost for those receiving government assistance in any shape or form.
There is assistance for school supplies and school trips available to low income families etc etc
Surely the infant mortality rate is high, because people try to have children at home, instead of a hospital, because of the crazy fees they charge.
Note: because the British health system is currently collapsing, many British come to Germany to be treated or operated on
Infant mortality is higher because of less care during pregnancy (too expensive), too much stress, and the bad food! The stress comes from working too much, the anxiety to lose the job, and because of this losing insurance, the fear of the upcoming costs!
10:00 no that means that they have to pay a maximum of 840€.
Yes, to see a certain specialist in Germany sometimes you have to wait 2-4 month to get an appointment. But this is only in case of a check up, not in case on an emergency. If you are in acout pain you mostly can see a doctor the same day or you go to the emergency at an klinic. There you have to wait maybe a few hours but you will be treated and will not pay extra for this.
You said "good job" to the NHS. But the NHS has a lot of problems to. A know that German dentist often use the vacation to work 4 weeks for the NHS for a hugh sum of money to go in a rual region to look after people teeth and will see cases of 23rd world teeth problems" because there had been not dentist for years in the region... And after Brexit the NHS lacks thousands of nurses and doctors.
Why is mortality rate at birth higher in the US? Because the high costs of giving birth sometimes give death. "Should we have a C-section?" - "I'd rather not, I can't pay for it."
10.01 noooooo!!
Costs of life-dependent treatment are fully covered, even if that means that the hospital bill is hundreds of thousands of dollars.
These 840 Euros are about the maximum monthly costs of health insurance. It doesn’t get more expensive.
For SHI, the monthly cost of health insurance is around 14-15% of your monthly income. (You pay 50% of this and your employer 50%). But if you earn a million bucks per months, the health insurance costs still no more than 840 Euro.
The infant mortality rate in the US is probably higher because there are people who can't afford proper healthcare for their children. There is no such thing in Germany. If you need medical help, you will get it, that's guaranteed by law.
No your monthly fee for your health insurance is capped at 840€. Most people pay way less. The cost for your health insurance is a percentage of your salary. The more you earn, the more you pay into the system
the term "medical debt" has no proper translation into german. in Germany, there is no such thing. I live on government benefits and I had a pulmonary embolism in 2022. So I went to a hospital, spent two weeks there, received medication and a ct and was on intensive care for some days. I paid 140 € copay total, 10€ per day. The blood thinners for half a year cost 7.5€. that's it. And I was treated by the senior physician, not some student.
if you live in Germany and earn less than 60.000, you pay roughly 10% of your income into the public health fund, capped by 840€ per month. The health insurance pays for any health costs you need without limit. Copays are very low. You can go to any doctor and receive any treatment your doctor deems fit.
It’s not the quantity to make money…it’s the Quality of Health care..
In America as always it’s about making a profit…and they don’t care where they get it from…
The diffference between the US and Europe, in general is that Europea decided 75 years ago to make healthcare a 'societal' issue and not a volatile political one ...Everything in the US is politicised and people find that normal, somehow. For profit healthcare does not work anywhere...and the US is a good example. And I think the stats about the US uninsured is more like 70-80 million. That's 20% of the US population...People need to stand up and ask for something better, period !
Not only are u less likely to get longer care after a child incase something happens that needs a Dr after birth but the care during pregnancy in Europe is much higher n everyone goes because its affordable
You misunderstood the €840/month. This is the maximum you pay in a month. This gets you fully covered.
Infant mortality has a lot yo do with Pre-Care check-ups and giving birth at home. This does not cost in Canada so most people get them and find issues (ie high risk are taken off work and paid for the time off). In Canada there are still some crazy homeopaths that believe in home births so that increases infant and maternal mortality. But even so, tjis only makes up a small petcentage of that statistic.
Home birth is pretty popular in Germany. We have a midwife system.
Home birth in itself is not the problem, I promise you.
There are just huge swath of rural areas in the US - especially in the south - without a single gynecologist in sight. Planned parenthood, after all, provided more than just abortions.
Most children in the Netherlands are born as home as far as I remember, accompanied by very well trained midwives. Any pregnancy with a higher risk than normal is routed to as hospital (just like I have learned from my midwife in Germany „homebirths are for low risk pregnancies with short distance to the next hospital, but still one birth is covered by two well trained midwives“ - that’s a translation of what she told me).
United Nations data published every year
Considering only all EU countries, Canada and US (those considered western wealthy counrtries), these are US data
- Life expentancy at birth: LAST
- Number of hospital bed per capita: LAST
- Child mortality rate at birth: 1st
- Maternal mortality rate giving birth: 1st
- Health care cost per capita: 1st
All this end up giving the so called "Health care international score ranking" in LAST position (69th in the world)
It's not the worst of the world (69th), but surely the worst between western wealthy countries
US insurance/ hospitals sends you home really quickly to keep beds full and charge 2 for 1. With regards for maternal mortality US the richest country is on par with Africa, India, South America and South Pacific islands.
Minute 19:17 - You say "good job UK" but UK system is 100% public and 100% tax based. That means it do exactly what you don't like: everyone pay taxes based on annual income and everyone get THE SAME free treatments no matter what (smoke, obese, drug addicted)
We have that in Italy too. And we like that, because as I wrote in another message, we consider health care a basic human right and we are happy to have basic human rights spread more and more
If I could choose I will probably go for the French method instead of Italian one, but anyway our system is not that bad. I had two daughters. Starting from 3rd pregnancy month we had 1 free visit at the hospital each month with ultrasound included. My wife gave both birth at the hospital, statying 5 nights both time and spending ZERO, thus I cannot blame or whine
You should change the sentence you said from:"Are those the people who don't want to pay the hospital bills?" to: "Are those the people who can't pay the hospital bills." while remembering the 8.8% uninsured people and the underinsured ones. It's not that they wouldn't - they cant!
As far as I understand the US System, not the salery of doctors is the problem, more so that it is a for profit system, a lot of the money goes to the shareholders of insurances and hospital companies.
It's no surprise you had questions after watching the CNBC video. Some issues are not explained really clearly. A different video on German healthcare which is better to understand for someone who is not from Germany (in my opinion) is this one: ruclips.net/video/NdarqEbDeV0/видео.html
In Luxembourg I paid €110/per month from my minimum wage of €2600/month. It is now €3000/month but I am retired and get a pension of €2900/month after tax and health charges.
There is No state in Europe having No SHI. We all have a system of health care based on solidarity
You answered your own question regarding infant mortality - if pregnant women have proper maternity care any problems are picked asap - and the cost of that should not be an issue - it isn't in the free world
I don't understand why Americans can't grasp that healthcare should be accessible to all and paid via their taxes just like schools police fire service etc???
And if people had easier access to healthcare maybe they'd get help to be able to manage their diets and get help to stop smoking etc like they do here
At the very LEAST a visit to see a doctor should be FREE
You have to have a strong stomach and be very intelligent to become a doctor/surgeon I doubt the pay is the incentive at the start of their training
Minutr 21:13 - Yes, you're completely wrong. There isn't any quality issue in the universal health care because of the wages. The statistics demonstrates it very well. Life expectancy, child and maternity mortality rate, avoidable deaths rate. We all have very good values (better than US) in these metrics, thus the universal health care works, end of story. The
our clinics are very careful about their costs. For example, there is the "flat rate per case", which specifies how long you stay in the hospital for the illness until you are discharged.
I had a complicated broken leg (upper and lower leg) that was fixed with a plate and 13 screws. Already after 1 week I was released to go home to bed (with a plaster cast from upper to ankle). I lay there for 6 weeks, cared for by a nursing service that I didn't need before the accident.
A child is a health risk by itself. If there is a possible danger Insolvenz the health csre Providers go to Red alert and not really the Patient themselves decide. In the US the dangers are often enough overlooked, while in Germany they call expets at once. And then the whole case is marked as risky. It might be unnecessar, but if it isn't necessary it is much cheaper and sauer to scale back. While in the US no one wants to talk about the risk since it is so expensove. While in Germany you simpl, try to stop thonking and wait for the outcome.If doctors find anything suspicious, the dovtors take care that it isn't anything dangerpus, only after they have eliminated possible dangers, they are allowed to scale down. You might loose a few days at work but the insurrance pays everything and after that they have pretty good Indikation what is Happening. While in the US the do Torsten have to take a Look at the costs.
In the US they sell junk food (food and ingredients thats banned elsewhere) to make people sick so they can earn money on peoples health...sadly it goes hand in hand🧐
Research indicates that socioeconomic inequality in the United States is likely a primary contributor to its higher infant mortality rate. Maternal risk factors for infant mortality include maternal obesity (BMI≥30) and use of alcohol or tobacco during pregnancy.
+ work work work
There are several factors that contribute to the difference in infant mortality rates between the United States and Germany.
One factor is differences in healthcare systems and access to healthcare. In Germany, healthcare is provided through a system of public and private health insurance that covers all residents. The system is designed to provide comprehensive, preventive care and includes regular check-ups for pregnant women and newborns. In contrast, the healthcare system in the United States is more complex, with a mix of public and private insurance programs that can be expensive and may not provide coverage for all individuals. As a result, many people in the US may have limited access to healthcare, including prenatal and postnatal care, which can affect infant health outcomes.
Another factor is differences in lifestyle and environmental factors. For example, in the United States, there are higher rates of poverty, which can lead to poor nutrition, exposure to environmental toxins, and inadequate access to healthcare. Additionally, there are higher rates of smoking, drug use, and obesity in the US, which can all have negative effects on infant health.
Lastly, differences in cultural attitudes and practices may also contribute to differences in infant mortality rates. For example, in the US, there is a higher rate of premature births and elective C-sections, which can increase the risk of infant mortality. In Germany, there is a greater emphasis on natural childbirth and midwifery, which may result in lower rates of premature births and other complications.
Overall, the difference in infant mortality rates between the United States and Germany is likely due to a complex interplay of multiple factors, including differences in healthcare systems, lifestyle and environmental factors, and cultural attitudes and practices.
Thanks Connor. Enjoy your videos and you are open minded
Not only in Germany this system, throughout Europe
Hi, Connor....Perhaps it might be useful to explore more closely the American health system from an internal unbiased (if possible!) perspective. Groundwork, if you will, so as to then offer a more informed view - about infant mortality, for example - when comparing US healthcare with other nations. Robert, UK.
I worked inside US socialist health care ... US military ... For 22 years. Regardless of the endless lies that is the US there is no citizenship without service. If you aren't getting "free" healthcare, you aren't a citizen. I served as a civilian, didn't get military healthcare, but my taxpayer paid corporate health insurance worked well enough.
4:30 why the infant mortality rate is higher? Because a lot of people don't have 10.000 dollars to give birth in a hospital...
@10:00 no, that means you will never _PAY_ more than 840€ per month.
Resentment for a few people shudnt mean children don't get looked after or an old guy who's worked in a low wage there life die younger coz there poorer
we have something similar but the point is, that what u say that someone is obese or smokes or whatever and develops a sickness because of that they are covered, they have things covered, everybody pays monthly fees, a certain amount (where i live is around 500€ or so yearly, but pay montly that amount hope its clear) and u can be sick as u want if u have a good insurance tha tu choose u can go and have whatever medical thing, probably u wont pay anything, mostly. There are probably medical procedures that ull need to pay something, but like for here u wont pay for perscription medicaments many times, some drugs arent covered etc. Visiting a doctor for me is free and its a specialist etc. So USA should ahve that, not see that if its fair for some and not for others, everyone receives great care no matter how wealthy or poor someone is. Fair for everybody, Health Care thriving. In USA is good healthcare affordable only for i guess certain demography, those that are poorest heavy it the hardest, many time not by they doing and receive bad healthcare. While in most EU is so much better. Thats why this videos pop up, has a reason, to point out how USA medical care is so unefective. U have the doctors the personal the hardware but used very inefective and this is why that movie with Denzel, where he does anything just so they save his son. Desperation leads, might lead to deeds that well are desperate. Probably didnt make it clearer. But the point is EU is mostly free, USA is not and as u said USA business and EU is for people.
My country, Italy, is second in the world for healthcare even if public investments are slowly decreasing in favour of a more integrated private/public system. Waiting lists are becoming longer and more people are now turning to private hospitals since they cannot wait. The State will still cover most of the costs but politics are ruining the second best healthcare system in the world because of costs. What is more important than people's health? Nothing is, that's why free universal healthcare is in our Constitution.
Hi, in Canada we have universal healthcare - everyone is covered for everything from seeing doctors to specialists, to surgery, pre and post operation care as well as hospital stays, ambulance and any medical tests/procedures you need - we pay no extra for these services ( I've had three CT scans and 1 MRI for $0.). The cost of our healthcare system for people making over $20,000.00 is about 11% of our wages. We do pay for some prescriptions (that are purchased from pharmacies) but these are A LOT LESS than in the US - which ironically IS where most of our pharmacuticals come from! Our government regulates the cost of them, which your US companies comply with - so they can sell in the Canadian market! and still make a profit.
We do have waitlists for elective procedures, but the more dire the condition or health issue, the shorter the wait. Emergent care is triaged, most severe immediate (ie heart attack, stroke, broken limbs...) and least severe will be last. So yes, for a bad cold you may wait for a couple hours in ER - but you shouldn't go to the ER for a cold - wait and go to a walk-in-clinic the next day to see a doctor for FREE.
You want to know why the infant mortality rate is so high? Because nobody can afford to go to a doctor.
a common sport in the US to avoid the doctor as long as you can and for little children's, infants, this is far too late, if they have major issues.
I know you posted this months ago but I think the video you watched didn't explain the system very well.
The SHI is the type of insurance that applies and is mandatory to all Germans who earn less than 60K a year. The insurance premium is a certain percentage of your salary where half of that percentage is paid by the employer and half is paid by the employee. The payment is directly deducted from your gross salary. If you are out of a job, the government agency for unemployment is paying into the SHI for you.
The SHI is not one big government organisation, though. Instead, as said in the video, it consists of hundreds of private nonprofit sickness funds that you can choose from, depending on small differences in perks and procedures covered.
As a child you are usually insured through your parents. Once you get your first paid job, you'll have to choose a sickness fund. You simply apply for the fund you want and let your employer know which one it is (if I remember correctly). The fund cannot reject you. After that you are covered for all major treatments, doctor visits, prescription drugs (except for a small fee of I think 5 Euros) etc. That's how it works and I love the system.
I moved to a different country a few years ago and one thing I dearly miss is the German healthcare system.
The percentage is 7.5% so in Germany I would have to pay over $10,000 per year for "free" healthcare. In the US I pay $200 per month. There is no free healthcare it is always paid from someone else's money and the only people that complain about any kind of costs are those that can't afford it and want freebies.
@@royharper2003 As far as I remember, I never said it was free. It is called free healthcare because at the moment when you actually are in need of care, you usually don't have to pay anything.
As for people just wanting freebies and you saying that "only" those are affected who can't afford it: that is an opinion and I have a different view. Seeing as so many bankruptcies and go fund me campaigns in the US are due to health care debts, I would say it is a pretty big "only" who can't afford the US healthcare system.
And even if I pay quite a bit to start with, I am happily paying for the knowledge that I'll never ever be denied a procedure I need just because my bank account isn't big enough. AND I am also happily paying for the knowledge that none of my neighbours and fellow Germans need to die an avoidable death. I have empathy for my fellow humans and I think that is one big cultural difference for many US Americans who are scared more of getting less or paying more than the fellow men than they are of seeing them suffer or die.
As for freebies as you call them: to me health is not a good, it is a human right. Of course there are people who abuse the system. That's on them and stupid enough to begin with. But it's not the majority.
So, on the opinion part, let's agree to disagree.
On the facts part, I am happy to pay into my insurance because it will not come back to bite me when I am actually in need of help. And you should check how big of an "only" you are referring to that can't afford healthcare in the US. Otherwise that is an argument that doesn't speak in your favor.
@@nfreye8828 I stand by my original comment.
If you think higher salaries for Doctors and professionals always lead to better healthcare, I would suggest looking at clips for Americas Frontline Doctors, Fentanyl Crises, dental scams, any program featuring Doctor Oz.
im assuming that the infant mortality rate is largely due to cost. I have seen multiple sources that vary costs from between $10,000 to $25,000 - so those millions of uninsured people could be trying the diy method. i have also heard that in the usa it is basically a quick in and out- maybe 2 days in the hospital - whereas other countries might give a week or two stay for the mother to recover
This is what Obamacare could be like if it was well regulated
Also a lil social responsibility for health is not a bad thing
The NHS is totally screwed.
6 million on the waiting list and counting.
Waiting times for some routine surgery up to 2 years and counting.
The NHS costs little, but also performs little compared to many other countries.
That's because the Tories broke it. It used to work just fine.
Happens when you cut costs everywhere.
I really wonder why the Brits keep voting for these people...
Your conclusion was on point. It is also a lot about peace of mind that helps you to live a healthier life.
The video you watched was by MSNBC, trying to explain the German Health System by using American terms. There are better explanations by other YT, like "TheBlackForestFamily".
13:40 I don't get this concern. It's not like the universal health systems are a new thing, you can see examples of countries that have this systems and have had them for decades. Do Canadians have more issues with fat shaming than the US, for example?
20:49 If money and prestige was the principal factor for health care workers, you guys wouldn't have good nurses. If someone becomes a doctor sorely for the money and prestige, then yeah, salary is super important. But some do it for vocation, because they enjoy it, just like any other work. Maybe they like helping people, maybe they like the intellectual part, the adrenaline, the power, etc. Also, you might be forgetting that doctors in other countries don't have the huge student debts many American doctors do, so less of their salary goes into paying that. (In the US some people become doctors motivated by money, for those people their salary is important. In other places doctors don't expect to get so much money, so people that become doctors do it motivated by other reasons.)
4:22min ... probably also because of the food
It's quite funny from Polish perspective to find out some wealthy western countries have worse problems with the healthcare system than we have. In Poland, when working full-time job you pay 9% of your income to the specific goverment entity called NFZ (National Health Fund) no matter of your income and it's mandatory - please keep in mind that average wage in Poland is 1700$. This gives you access to unlimited doctors' visits, any surgery or treatment available in Poland and contracted by NFZ. There is no subpayment of any kind, except not all drugs prescribed are free. In practice there are three major flaws of our system: usually long waiting for serious, common treatments , lack of dental care (almost all private), hospital food and accomodation is not comparable to western standards. Private healthcare is on the rise, but it's still quite affordable - a doctor's visit costs 35-55$.
The use of the word "free" so often is not just misleading but simply wrong and that is the problem Americans have when trying to understand health systems like in Germany.
WOW does public health result in less skilled doctors .
Whether doctors go into private or public practice is irrelevant, they all attend the same medical schools and have to pass the same tests and training. So you’re not being treated by less qualified doctors because of public healthcare. What’s more unlike private insurance where your provider may not cover certain conditions, procedures or doctors you are entitled to be treated & covered for any doctor of your choosing.
Heaven forfend a country looks after its citizens !!