Germany has 80 million people and they manage. They also manage to have one of the strongest economies in the world.
http://www.miller-mccune.com/health/warning-signs-from-europe-3470/National health care schemes in Germany and Switzerland (and many other countries) rely on the government’s power to cut deals with major industry groups, including doctors, to keep expenses down. European doctors who work in the statutory insurance market earn scaled salaries set in agreements with the government.
The result is a class of doctors that feels increasingly underpaid and overworked. German hospital doctors earn about
one-fifth of their American counterparts — an average of $56,000 per year, as opposed to $268,000 in the states. When negotiations with the government fall short, the doctors behave like any other group of workers in Europe: They take to the streets.
The marches in 2006 were the largest in German history, triggered by government reforms aimed at controlling costs in the national health care system.
Only part of the problem was pay. Another problem, from the doctors’ point of view, were the so-called bonus-malus laws, which punished them for prescribing expensive drugs and rewarded them for prescribing generics. The idea was to keep down pharmaceuticals prices, but the doctors felt the hot breath of government on their necks. “This ethically objectionable bonus-malus legal gimmickry —
akin to bribing physicians not to treat to the best of their ability — was one of the sparks of the doctor protest movement,” wrote Alphonse Crespo, a libertarian-minded Swiss orthopedic surgeon.
The reforms finally pushed through by Angela Merkel’s government gave Germany its current system, which uses a central fund to compensate insurance companies for patients according to the patients’ risk. The government dropped its bonus-malus rules in 2008. But Germany’s specific problems with its health care system are less relevant than their cause, which is the same as the cause of America’s crisis:
ballooning costs. Doctor salaries are the least of it. The German system is full of
administrative corruption within the nation’s many
insurance companies.
So is insurance itself the problem?
Maybe.