German Healthcare System - Good Bad Ugly

Well I'm back in the Fatherland continuing my quest for the ultimate socialist utopia. Yesterday I spent a night with our neighbor doctor and some great Grappa and got the update on the economics of German Health Care. So I guess between the Grappa and my fiscally conservative
leanings you may want to put a grain of salt on this. Gaby may comment and give more accurate info.

Lot has changed since Gaby was a kid, used to be everything was free for everyone, but reality has set in and this is what I heard is the current state of affairs.

German doctors make about 60K Euro per year (about $78K). There is this hierarchy of doctors, not the private practices that we are use to. THere are the big shots PHDs, then
under them are the underlings. I guess when you are in the hospital, there will be a hoard
of them following the PHD like little ducklings visiting each room. Gaby said it is an insult
to ask the PHD any questions because he/she is the all knowing deity and the unwashed
peasants aren't at the same karma level to interact.

There is 3 levels of doctor incomes:

1) None - for illegal immigrants, tourists, non-German types
2) Public - Anyone that had a job and paid into the system at one point. Works sort of
like our vaulted Social Security system. 80% of the people are Public in big cities.
3) Private - The chosen ones. 20% are private in big cities, 5% in rural.

#1) None Those unfortunate few that wander into the German hinterland, drink too much beer and get hit by 200mph BMW. They get into the emergency room and tossed out into the street until they get hit again by a BMW. Similar to 40% of the people in the USA.

#2) Public -Doctors get paid in quotas. Example they get $90K per year to treat 1000
patient 'treatments'. Patients show up in their office with ration cards. Patients can have
several 'treatments' per quarter. If they run out of ration cards, then the
doctor loses money on subsequest visits. So basically if you are a sickly type person and the doctor hates dealing
with you, then you go to the BACK of the line. WAY BACK. The doctor is now losing money
(not working for free, but losing money because you are taking up a paying slot) and if you have a bad attitude then it is their discretion to deal with you as they wish. So come back in 3 months
when the quarter starts again basically. You might have to come back in 3 months anyways, because some doctors close their offices and head to Greece when they fill their quotas for the quarter. COMMENTARY: I actually like this because if you don't take care of yourself then
no one else will. So the incentive to get in shape is higher in Germany than USA.

#3) Private - Anyone can buy private insurance and you will be treated like a Michelle Bachman at a Tea Party fund-raiser. The PHDs will shine your shoes. You go to the front of the line. This is where doctors actually make money to pay for their shiny equipment and Greek vacations. They WANT to treat you because they get paid a LOT per treatment. This is like the USA system that 60% of us are use to.

Sidenote (I didn't get this one): Hospitals get paid based on how many diagnosis you have. So if you have bad stomach and doctors think it could be cancer, or ecoli, or bad grapa then they get paid 3 times.

One note of sunshine for doctors. Malpractice suits are minimal. You can actually be a doctor here.

Doctor neighbor said in Germany you should go into medicine if you are passionate about it.
The money, fancy equipment, etc is just not there. Plumbers make more money for less
headaches. Sounds like doctors are more like USA teachers.

Soooooo the big question is how does Germany pay for all this? Well #1:
http://en.wikipedia.org/wiki/List_of_countries_by_military_expenditures
Germany military will have 163,000 members for a nation of 70 million by 2012. That's equivalent to a USA military of 600,000...we now have 1.5 million in our military and not counting all the contractors and cool equipment. Germans spend 1.4% of GDP (going down in 2012), we spend 4.7% of GDP. So basically Germany and the rest of NATO are no dummies, they will let Uncle Sam borrow money from the Chinese to pay for NATOs 'common defense framework', while they keep their aging electorate placated with cool social programs and humming industries fine-tuned with an educated workforce.

Oh yeah, they also pay lots of taxes.
http://en.wikipedia.org/wiki/Tax_rates_of_Europe
So assume you can bring home 50% of what the boss pays you (if you make it home, gas is $8/gallon). But remember you get basically free health care and grade 0 though University education, and nice fat social security checks.


Summary:
1) If you currently don't have health insurance: Don't move to Germany, vote Obamacare
2) If you are sickly: Don't move to Germany, vote BachmanCare
3) If you are healthy: You can move to Germany or USA. Uninformed opinion is USA has
better equipment, drugs, well-compensated talent.
4) If you are a doctor: Definitely don't move to Germany unless you like a lot of Greek vacations
5) If you are a lawyer: Stay in USA and continue to sue doctors for bad boob-jobs

Personal Opinion:

I'm healthy so I'd do OK in either system, but prefer USA. I'm thinking better facilities, options, talents, cool drugs, less restrictions. But if I'm wrong I'd switch in a heartbeat. One thing I really like about German healthcare is if you don't take care of yourself, the doctors have the option
of blowing you off. So there is an incentive to to cut your Marlboro and strudel intake. I wish
Obamacare would have a clause where you pay less and go to the front of the line if you take care of yourself.