Universal Healthcare: USA, Canada and Germany
Few would disagree that EVERYONE should have access to healthcare. And, yes, that includes me.
The question is WHAT healthcare everyone gets and at what COST to them.
Cost?
Yes, cost.
Let's first look at our universal healthcare here in the US for those 65 and older, ie Medicare:
And the Germans? Well, they don't have a healthcare plan either. They have a universal healthcare insurance plan or, more specifically (and with the typical German propensity to complicate things), 160 "sickness funds" in the country, to one of which you must subscribe (or take private insurance instead). All Germans with incomes under €46,300 are required to enroll in one of the sickness funds for which premiums come to about 15% of income. Workers pay half the cost of their sickness fund insurance (about 15% of their income), and employers pay an equal amount. The German government foots the bill for the unemployed and for children. There are also limits on out-of-pocket medical expenses. The sickness funds are mandated to cover a standard set of benefits set by the Federal Ministry of Health based on the German Social Law (Sozialgesetzbuch – SGB), which limits those services to "economically viable, sufficient, necessary and meaningful services" ... whatever that means by whoever decides what they are. Copays are generally very modest, typically about 10 Euros. Additionally, wage-earners pay about 2% income for long-term care insurance.
Universal healthcare is NOT free healthcare.
The question is WHAT healthcare everyone gets and at what COST to them.
Cost?
Yes, cost.
Let's first look at our universal healthcare here in the US for those 65 and older, ie Medicare:
- Premiums. None if you paid Medicare taxes for 40 or more quarters (10 years) but $227 monthly if you paid Medicare taxes for 30 to 39 quarters or $413 monthly if you paid quarters Medicare taxes for less than 30 quarters.
- Hospitalization and Coinsurance. A $1,316 deductible for each benefit period then $0 coinsurance for 1-60 days, then $329 coinsurance per day for days 61-90 days, then $658 coinsurance per each "lifetime reserve day" after day 90 (up to 60 days over your lifetime), then $0 coinsurance after the "lifetime reserve days" are used.
- Part B. For those who elect to buy Part B insurance for $143 or more per month, Medicare pays for 80% of your healthcare AFTER premiums are paid and the $183 deductible is met.
And the Germans? Well, they don't have a healthcare plan either. They have a universal healthcare insurance plan or, more specifically (and with the typical German propensity to complicate things), 160 "sickness funds" in the country, to one of which you must subscribe (or take private insurance instead). All Germans with incomes under €46,300 are required to enroll in one of the sickness funds for which premiums come to about 15% of income. Workers pay half the cost of their sickness fund insurance (about 15% of their income), and employers pay an equal amount. The German government foots the bill for the unemployed and for children. There are also limits on out-of-pocket medical expenses. The sickness funds are mandated to cover a standard set of benefits set by the Federal Ministry of Health based on the German Social Law (Sozialgesetzbuch – SGB), which limits those services to "economically viable, sufficient, necessary and meaningful services" ... whatever that means by whoever decides what they are. Copays are generally very modest, typically about 10 Euros. Additionally, wage-earners pay about 2% income for long-term care insurance.
Universal healthcare is NOT free healthcare.
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