Essay on Universal Healthcare in Germany

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Although the United States spends more money on health care per capita than any other country on the planet, this does not mean that it provides the best care available anywhere else. As a result, despite having the world’s most expensive healthcare system, which costs more than 16% of GDP, we also have one of, if not the least effective, healthcare systems among industrialized countries. They spend more than $10,000 per capita on health care, and not only is the quality of care poor, but we also lack proper coverage for all of our medical requirements. More than a quarter of insured people report financial issues paying for their treatment due to the high cost of therapy. 63 percent of respondents had to tap into their savings or take on a second job to fund medical bills, while 42 percent had to hunt for extra work. Pharmaceuticals that save lives are sometimes ten times more expensive in the United States than in other countries. Consider the following example: a vial of insulin costs $32 in Canada, while the same drug manufactured by the same company costs $300 in the United States, and this isn’t even an extreme case. Consider the HIV medicine Truvada, which costs $8 in Australia but $2,000 in the United States, even though it was developed with taxpayer money. In a country where 40% of the population cannot afford a meal, almost 500,000 people go bankrupt every year while seeking to pay their medical costs. A $400 ambulance ride to the hospital will set you back more than double that amount, and this is in the world’s richest country. The United States, unlike the majority of other industrialized countries, does not have a universal healthcare system. In terms of health outcomes, rising economic inequality in the United States has been paralleled by rising disparities in health outcomes. The wealthiest Americans live 10–15 years longer than the poorest Americans. Many studies have examined how, rather than alleviating income-based health inequities, the healthcare system frequently contributes to their exacerbation. The many types of organizations that provide health care in the United States include insurance companies, healthcare providers, hospital systems, and independently operated providers. The income disparities in the United States are the greatest in the world. When income inequality is measured before taxes and transfers, it is comparable to that of other industrialized countries, but after taxes and transfers, it is among the highest, meaning that the US transfers less income from higher-income households to lower-income households. The lowest quintile had a market income of $15,600 in 2016, while the richest quintile had a market income of $280,300. (Source: Bureau of Labor Statistics, n.d.) The top 1% of the population collected $1.8 million, which is more than 30 times the median income of the middle quintile ($59,300). If there is income inequality in the country, universal healthcare should be provided for free as a basic standard.

The United States stands out as the country with the highest per capita expenditure on healthcare services. Per capita expenditures appear to be lower in systems that ration care through the provision of government-sponsored insurance or other means. However, waiting times in the predominantly private system in the United States are generally shorter than in rationed systems, which is a conclusion that can be drawn both from theory and observation (Sociomed 1). Americans have shown greater dissatisfaction with their healthcare system than their counterparts in Canada and Germany. Many people believe that the uninsured population in the United States, which totals more than 40 million people, is the most serious defect in the American system. While this does not indicate that they are completely without medical treatment, uninsured persons utilize half the amount of health care that insured people do every month. The United States is by far the greatest of the three countries in terms of absolute per capita expenditure. In addition, it is the largest consumer of goods and services as a percentage of its gross domestic product. A healthcare system in Germany provides universal health insurance while avoiding the enormous queues that beset government-run systems elsewhere in the world. However, costs per capita have been increasing at a higher rate than earnings per capita, a problem that drove drastic reforms in the 1990s to be implemented. Several hundred thousand Americans believe that Canada has established a comprehensive and universal national health insurance system that is both economical and widely accepted. The Canadian system is more affordable, offers more services, provides universal access to health care without financial barriers, and has a better overall health status than the United States’ system (Sociomed 1). Canadians and Germans have longer life expectancies and lower infant mortality rates than Americans, according to the World Health Organization. One possible explanation for the difference in health-care costs between the United States and Canada is the failure to account for Canadian hospital capital expenses, a higher proportion of elderly people in the United States, and a higher level of research and development investment in the United States, among other factors (Sociomed 1). Unlike the United States, where a considerable section of the population believes that major and fundamental changes are required in healthcare systems, most Canadians and Germans believe that only minor to moderate adjustments are required in their respective healthcare systems. Germany has a healthcare system that is akin to the United States in that everyone purchases health insurance from a commercial corporation, and doctors, hospitals, and labs are nearly entirely owned and operated by private companies. Considering that the government dictates who they can accept as clients, they’re effectively just following orders. They’re essentially non-profit organizations in their basic form. They are not in the business of making money for their shareholders in the sense that American health insurance companies are in the business of. They are there to ensure that people maintain their health. That’s exactly why they’re there in the first place. They adhere to a set of regulations that would never be accepted by American insurance firms. This system is supported by mandatory contributions based on a percentage of employees’ earnings, with employers bearing a portion of the costs. In addition, safety netting has been constructed. The government will make a payment to S.H.I. on behalf of persons who have been out of work for an extended period. Sickness funds compete for clients even though they are non-profit organizations by offering particular coverage and incentives to attract new customers. In tandem with the expansion of the system to provide additional options to individuals, the nature of this competition has changed. There are approximately 100 statutory health insurance firms in the United States as of 2019, but there used to be many more.

In Germany, it is mandatory to have health insurance. Approximately 86 percent of the population is covered by statutory health insurance, which includes coverage for inpatient and outpatient care, as well as mental health and prescription drug coverage, among other things (Tikkanen 1). The administration is handled by sickness funds, which are private insurers that are not affiliated with the government. The federal government has a minimal role in the provision of direct healthcare services to patients. A mix of normal wage payments (14.6 percent of usual incomes) and a specific, supplementary contribution (1 percent of typical salaries) are used to finance sickness funds, which are distributed between employers and employees. Inpatient services and medications are subject to copayments, and sickness funds are subject to a variety of deductibles. Germans earning more than $68,000 per year have the option of opting out of SHI and instead purchasing private health insurance. The federal government does not subsidize private health insurance. Statutory health insurance (SHI), which is composed of competitive, non-profit, non-governmental health insurance plans known as sickness funds and private health insurance, are the two forms of coverage available: statutory health insurance (SHI) and private health insurance. In Germany, long-term care insurance is required by law and covers each individual who requires long-term care services (LTCI). In contrast to many other countries, in the United States, sickness funds, commercial health insurers, and long-term care insurance all use the same providers. In other words, hospitals and physicians provide care to all patients, regardless of whether they have SHI or private insurance. The Role of the Government: The German health-care system is well-known for the split of decision-making powers between the federal and state governments, as well as between self-regulatory payer and provider groups, among other characteristics (see exhibit). The following are the responsibilities of public health insurance: Health expenditures accounted for 11.5 percent of GDP in 2017, according to the World Health Organization (GDP). Health expenditures were covered by the government in 74% of cases, with SHI accounting for the vast majority of these expenditures (57 percent of total spending). Approximately 88 percent of the population is covered by sickness funds, with private insurance covering the remaining 11 percent. There were 109 sickness funds in operation as of January 2019. The following are the functions of private health insurance: 2017 had an 8.4 percent increase in overall health spending, which was driven primarily by private health insurance. 5 There are two types of coverage available: supplementary plans purchased by sickness fund subscribers and substitutive coverage purchased by those who are exempt from or have the option to opt out of SHI (such as higher-income individuals). Out-of-pocket expenses and cost-sharing arrangements: The amount of money spent out of pocket by individuals in 2017 amounted to 13.5 percent of total health expenditures. Nursing homes, pharmaceuticals, and medical assistance accounted for the vast bulk of personal expenditures. Protection nets: Unemployed people contribute to the SHI in proportion to the amount of unemployment benefits they receive. The government contributes on behalf of long-term unemployed individuals. Aside from that, Germans can reduce their out-of-pocket expenses by taking advantage of copayment restrictions and exclusions.

Covered services include: The following are covered by SHI:

    • Regular dental checkups, kid checks, basic vaccines, chronic illness checkups, and cancer tests at various ages are all examples of preventive treatments.
    • Hospital treatment, both inpatient and outpatient
    • Services provided by physicians
    • Mental health treatment
    • Dental care is important.
    • Optometry
    • Physical therapy is a type of treatment that is used
    • Prescription medications, except those that are expressly prohibited by law (most notably, so-called lifestyle pharmaceuticals such as appetite suppressants) and those that are prohibited due to an unfavorable benefit-risk evaluation.
    • Medical equipment
    • Rehabilitation
    • Palliative and hospice care
    • Prenatal and postnatal care
    • Compensation for sick time.

Female-dominated occupations, such as childcare and restaurant service, remain at the bottom of the American wage scale. According to the Bureau of Labor Statistics, women make up 67 percent of workers earning the federal minimum wage, which has remained at $7.25 since 2009. Women, on the other hand, account for only 8% of Fortune 500 CEOs. In 2020, CEOs earned an average of $15.5 million. Even though women now make up nearly half of the workforce in the United States, men still account for the vast majority of top incomes. Women make up only 27% of the top 10% of earners, and their proportion of higher income groups is much lower. Women account for slightly less than 17 percent of workers in the top 1%, whereas they account for only 11 percent in the top 0.1 percent. Women continue to be grossly underpaid in the American workforce. In 2016, women earned less than 81 cents for every dollar earned by males among full-time workers. Women are more likely to work reduced hours to manage childrearing and other caregiving responsibilities, thus the disparity would be considerably higher if part-time workers were included. In all industries, American women earn less than males on average. The biggest pay disparities are in management roles, where men earned an average of $88,000 in 2016 compared to just $55,000 for women. The construction business has the smallest gender disparity, with women accounting for only 9% of workers (Equitable Growth 1).

The health-care systems in Canada, Germany, and the United States were studied in this article. Finance, payment arrangements with providers, and government engagement, including centralization, all differ. The United States is the country with the highest healthcare costs. Per capita expenditures appear to be lower in systems that ration care through government distribution or insurance. According to both theory and observation, waiting times are shorter in the US privatized system than in rationed systems. In comparison to Canadians and Germans, Americans are less satisfied with their healthcare system. The uninsured – about 40 million people – are often regarded as the most serious shortcoming in the American system. While uninsured people do not go without medical treatment, they utilize half as much as insured persons. Of the three countries, the United States spends the most per capita. It is also the largest GDP consumer. Germany’s healthcare system provides universal coverage without the long lines that beset government-run healthcare systems. In the 1990s, however, growing prices per capita exceeded rising income per capita, necessitating significant reforms. Finally, the majority of Canadians and Germans believe that minor to moderate changes are required in their healthcare systems, but many Americans say that substantial and fundamental changes are required. Each of the three healthcare systems discussed above is constantly evolving and improving, all while maintaining and growing healthcare access. They can only aspire to come close to achieving this goal. In these three countries, health care consumes a big portion of the economic pie, and this is anticipated to expand in the future. As a result, future developments and improvements in the healthcare systems of Canada, Germany, and the United States will be fascinating to follow. It can be improved through universal health care as Health care for all is a term that can refer to any action made by a government to guarantee that the greatest number of individuals as possible have access to healthcare services. Governments can accomplish this by establishing minimum standards and rules, while other governments can accomplish this by implementing projects that benefit the entire community. The ultimate goal, on the other hand, is to provide universal health coverage to all citizens. Having universal health coverage means that everyone has access to the health-care services they require, when and where they require them, without having to spend a disproportionate amount of money. Prevention, treatment, rehabilitation, and palliative care are all included in the scope of basic health services, as is the provision of medical equipment. Primary health care that is strong and focused on the needs of the individual should be the foundation of universal health coverage. Effective healthcare systems are those that are rooted in the communities that they serve. The prevention and treatment of disease and illness, as well as the enhancement of well-being and quality of life, are all important concerns for them.

Advantages of Universal Healthcare

Most obviously, universal health care ensures that all people have equal access to health insurance and medical services, as well as the fact that no one becomes bankrupt as a result of medical costs. (MasterClass staff 1)

Because the government sets the prices for drugs and services, universal healthcare lowers healthcare costs for the entire economy at the federal level, which benefits the entire economy. In part, because they are no longer obligated to interface with a large number of healthcare enterprises, doctors have been able to reduce administrative costs while also recruiting fewer staff as a result of simplifying. (MasterClass staff 1)

Universal health care also equalizes service because it eliminates the ability of doctors and hospitals to seek and cater to a wealthier clientele. As a result, everyone receives the same level of care, resulting in a more productive workforce and a higher life expectancy overall. (MasterClass staff 1)

When a person has access to universal health care from birth, it can also lead to a longer and healthier life, as well as a reduction in societal inequality. (MasterClass staff 1)

Disadvantages of Universal health care:

Patients in certain nations with universal health care face extensive wait times or even months before being treated. Governments may overlook rare diseases or elective procedures in their focus on delivering vital and life-saving health care. (MasterClass staff 1)

It is prohibitively expensive to provide universal health care. If a government is having financial difficulties, it may discover that health care is diverting funds from other critical initiatives.

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