|American expatriates cherish the health care they receive in the German system — and look at their own country with disbelief.
Luisa Weiss is a German-American writer about food and culture who lives in Berlin and has a cult following for her recipes for bagels, cinnamon buns and chocolate-chip cookies, which usually combine her American, Italian and German heritage. Earlier this year she had a baby by caesarean section. First the baby arrived, then the bill — and she was shocked, in a good way.
In the United States the procedure would have cost insurers $50,000; in Germany, it cost $3,000. “There’s nothing like major surgery and a week of recovery in the hospital to reinforce how lucky I feel to live in a country where affordable and good-quality health care for all is a given,” she wrote in a blog post that earned a torrent of ‘likes’.
Ms. Weiss’ comments — she also posted a photo of the hospital bill on Instagram — added fuel to the never-ending debate about health care on either side of the Atlantic. US-based mothers responded, one writing that she had been discharged from hospital two days after having a C-section. “It was brutal coming home and not having the nursing care. Germany has got it right when it comes to maternity health care,” another mom said.
In Germany, health-care coverage is mandatory, based on an insurance system that is founded on solidarity and mutual support. Premiums are deducted from workers’ paychecks, and if people want more options, they can opt for more expensive private coverage. The insurance system is available to all and in 2015, only 0.1 percent of Germans did not have health-care coverage. A recent poll found that 87 percent of Germans are happy with their coverage.
It’s a major contrast for Justin Evans, a musician from southern California who lives in Berlin and is a fan of the cheaper health insurance available to artists and musicians. Most of his friends in the US who work in the service sector or the arts do not have health insurance at all, he said.
His comments echoed those of Ms. Weiss, who said that when she first started out working in publishing in New York, she had to borrow money for dental care from her father. “What 25-year-old has a couple of thousand dollars to spare?” she said. The worst case she recalled was that of a couple of friends who fled the US when they had twins at a hospital in California and could not afford to make the co-payments. “The American health-care system is totally broken,” Ms. Weiss said.
That chimes with the conclusion of a recent study of the national health-care systems in 11 countries, rating them on the care process, access to health care, efficiency, equity and health outcomes. The researchers, from the Commonwealth Fund based in New York, ranked Germany eighth; the US came in last, due to its poor performance on everything from infant mortality to life expectancy. “The US has the highest rate of mortality amenable to health care and has experienced the smallest reduction in that measure during the past decade,” the researchers wrote, concluding that “despite spending nearly twice as much as several other countries, the country’s performance is lackluster.”
Clifford Kimchen, an American from Florida who now lives in Berlin and works as a tour guide, feels well-placed to compare the health-care systems he has experienced in the US, the UK and Germany. As a child, he was raised by a single mom in Miami and was uninsured for most of his life in the US. He recalls the time he broke a finger playing basketball. His mother struggled to pay the $2,000 it cost to have his finger reset. Thinking about it still makes him “angry and pissed off,” he said.
Later, cycling in London as a student, Mr. Kimchen was “car-doored” and knocked off his bike. He needed stitches which he received free of charge. “It was nice to get the care I needed without shelling out everything I had in order to stay healthy,” he said. He decided to write his Master’s thesis on Britain’s National Health Service.
As a tour guide in Germany, he now pays the equivalent of $40 a month to go to pretty much any doctor he wants whenever he needs to. The quality of care is much higher than in the US, he said. Many American expats based in Germany say the same. “I don’t know any one of my American friends who say the US system is better,” one commented.