as of 2017 roughly 87 of germans received their primary coverage through shi and 11 of the
population through phi the remaining populations such as soldiers police officers and refugees
receive health insurance through specific government programs how much does a phi charge
is because i i think she said the shi was like 870 somewhere around 800 right um it's not cheap
i can't lie to you but they said that the um dependents or actually they don't you don't
have to get a separate thing for the dependents which is really good um meaning kids and autumn
type folk stuff you know but it's not cheap but i mean i think everybody if i'm understanding
correctly it's not cheap based off of the 850 dollar i'm going to go 850 right it's not cheap
but when you think about all the possibilities right that 850 works in really really good so
y'all let me know because they they said this is a you have to have it like you have to you have to
so if you guys are germans you got to let me know hey guys welcome back to foreign reacts today
we're going to be doing a very interesting video we're continuing the series here at uh foreign
reacts where we're doing videos all related to germany so this one is gonna be how germany is
a universal healthcare system works so we're gonna get right into this video but before we do
i don't even like to say if you are not subscribed and you are new to four and reacts welcome to
foreign reactors this is a channel where we do reactions that are foreign to the reactor
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reacts and subscribed but either ways guys we're going to get right into this reaction video so if
you're from germany wrap your country and if you guys want to share any information
regarding anything uh about germany feel free to do that and also if you guys want to share
information about any other country you guys can do that as well if you have any suggestions
of uh a particular country your country preferably uh leave those in the comment section down below
we'll get to uh those comments eventually but either ways guys let's get right into
the reaction video 70 of americans say the u.s healthcare system is in a state of crisis or that
it has major problems that's why we're hearing a lot about medicare for all including some plans
going as far as banning private health insurance companies all together on page eight of the bill
it says that we will no longer have private insurance as we know it and that means that 149
million americans will no longer be able to have their current insurance that's in four years
i don't think that's a bold idea i think it's a bad idea problem senator sanders with that damn
bill that you wrote and that senator warren backs is that it doesn't trust the american
people i trust you to choose what makes the most sense for you not my way or the highway
one country found a way to provide universal health care coverage while maintaining a
competitive insurance market that offers citizens more choices germany here's how they did it
in 2017 us healthcare spending came to around 10 200 u.s dollars per capita in
germany it was a little under six thousand dollars overall germany spent about 11.2
percent of its gdp on healthcare while the u.s spent 17.1 percent germany manages to cover 100
of its population in the united states about 8.8 percent of the population remains uninsured
that comes to about 28 million people with even more people underinsured despite spending less
germany has better or comparable health outcomes to the united states studies show that in germany
there were fewer deaths that could have been prevented with proper access to care in 2013 there
were 83 avoidable deaths out of every 100 000 people in germany while the united states had 112.
life expectancy in germany is 2.5 years higher than the united states and the infant mortality
rate is lower in germany with 3.3 deaths per 1000 live births as opposed to 5.8 deaths in the united
states additionally the maternal mortality rate in the united states is more than two times higher
than in germany so how does germany manage to have better health outcomes while spending nearly half
as much as the united states germany is a system that would look familiar to americans in that
everybody buys health insurance from a private company and then the doctors and the hospitals
and the labs are almost all private that's t.r reid author of the book the healing of america
he traveled the world exploring different health care systems and how well they worked
but it works better in germany for a couple reasons one is everybody is covered everybody
is required to have insurance everybody's in the system the insurance companies can turn you down
because you had cancer last year or something they have to take you they have to cover you everybody
has access to the same treatment and this all the doctors you can go to any doctor without
without any limit set by the insurance company in germany health insurance is mandatory for
all citizens and permanent residents there are two different systems that residents can turn to
for insurance shi which stands for statutory how much does it cost though health insurance and phi
or private health insurance german citizens are eligible for phi if they make more than
roughly 60 000 us dollars per year or if they are self-employed citizens making under that threshold
must pay into shi shi is made up of a network of competing not-for-profit private health insurance
funds known as sickness funds in shi dependents are covered free of charge and monthly costs
are capped around 840 euro per month even though shi sickness funds are not government agencies
many germans think of them as part of a public system because of heavy regulation
keith tanner helps expats navigate the german health care system and he considers s-h-i sickness
funds quasi public organizations basically they have to do what they're told they are told by
the government what in what range they can charge they're told what health procedures they can fund
and they are told by the government who they can accept as clients so they're really just carrying
out orders they're basically charities they don't exist to make a profit for investors like american
health insurance companies they're there to keep people healthy that's what they're there for they
follow all sorts of rules that american insurance companies wouldn't dream of the system is funded
through compulsory contributions based on a percentage of citizen salaries with
employers sharing the costs there are also built-in safety nets the government will pay
into shi on behalf of the long-term unemployed despite being non-profit organizations sickness
funds compete for customers by offering specific coverage in perks this competition has changed
over the years as the system has allowed citizens more choice as of 2019 there are about a hundred
statutory health insurance companies but there used to be many more when germany's system was
first established in the late 1800s sickness funds were linked to a person's profession it
used to be that people were assigned to a specific sickness fund based on their occupational region
now germans can choose where they enroll and they can change funds on a yearly basis as a result
sickness funds began marketing themselves in order to retain customers and attract new ones this also
led to the funds merging so they could become more competitive some of the sickness funds offer perks
that might seem similar to credit card rewards you still can get a bonus for going to the gym the
bonus having a checkup this isn't a public system and if you get certain number of bonus points then
you get a voucher but kind of trivial stuff like 200 a year or something like that um trivial
200 euros right which is particularly relevant to the person who's paying
their 840 a month as of 2017 roughly 87 of germans received their primary coverage through shi
and eleven percent of the population through phi the remaining populations such as soldiers
police officers and refugees receive health insurance through specific government programs
how much does a phi charge is because i i think she said the shi uh was like 870 somewhere around
800 right um it's not cheap i can't lie to you but they said that the um dependents or actually
they don't you don't have to get a separate thing for the dependents which is really good
uh meaning kids and autumn type folk stuff you know but it's not cheap but i mean
i think everybody if i'm understanding correctly it's not cheap based off of the 850 dollar i'm
going to go 850 right it's not cheap but when you think about all the possibilities right that 850
dollars works in really really good so y'all let me know because they they said this is uh uh you
have to have it like you have to you have to so if you guys are germans you got to let me know all
individuals insured through phi pay a risk-related premium with separate premiums for each dependent
these risk-based premiums mean that costs will increase as the insured gets older
as a result the government regulates phi so people don't become overburdened by premiums as they age
the biggest issue with private health insurance if you opt out of a public system is affordability
in old age if you don't impose these financial constraints on the insurers then the government
will be lumbered but a whole lot of old people who reach 85 90 95 and are gonna be totally unable to
pay for their health insurance so it'll all fall back on the government once someone switches
to phi they cannot switch back to shi in the future but tanner says there are ways around
that if you're a freelancer in the private system you're just going to get a job paying
less there's a threshold any employee earning under about 5000 a month is required to have
public if they earn more than that they can opt out so if you are a freelancer you want to go
back into the public system for some reason then you get a part-time job with a friend
pays you 500 a month for a few few months and then you're back in the public system so there
are ways to do it the only reason you probably want to do that though is if you have lots of
children because children can be covered free in the public system and the practices we have to pay
separately for each child germans can also buy supplemental private insurance while staying
in shi for example many germans by supplemental dental insurance the public system pays like for
major dental work about half the cost and then you get supplementary to take it up to 89 of the cost
germany's system is not perfect with so many different insurance companies there's a lot of
bureaucracy that contributes to costs one of the financial things thinking of the public system
administered by more than 100 organizations called cranking castle each of those has a
head office and a president and a vice president and a financial officer a whole lot of unnecessary
bureaucracy this may be one of the reasons that the german system is not as cost effective as
other european countries more than 30 percent of both germans and americans felt bureaucracy
was a major issue in their country system wait times can also be an issue for people in shi
37 percent of germans cite wait times as one of the biggest problems within their system while
22 percent of americans feel the same generally i think people are quite happy with the public
system it works reasonably well the major issue in big cities i'm in berlin munich dusseldorf hamburg
it can take quite a while to get an appointment with a specialist it is the case that the doctors
prefer the private patients because they earn up to three times more if they see a private patient
so what can the united states learn from the german system germany has managed to balance
cost controls and universal coverage while also maintaining competition and germans generally like
their system in one survey not a single german said they had to wait more than four months for
an elective surgery while four percent of americans said that they had to wait that
long for the same kinds of procedures and only seven percent of germans said they experienced
a barrier to care because of cost in the past year compared to 33 percent of americans the citizens
really like it they like the fact that everybody is covered they like the fact that the costs are
totally predictable you know what it's going to cost you and how much your insurance company
is going to pay you before you walk in unlike the united states they think it's normal that
the insurance company pays every claim they can't believe that insurance company might deny a claim
and they think it's normal that they get to choose the doctor they don't understand
america where the insurance company says we won't cover dr jones you have to go to dr smith instead
so the main thing i learned in going around the world is you have to make the commitment
to provide health care for everybody that's the destination it turns out there are many different
routes to that destination i found you know the canadian model the french model the british
model the german model they all get get to this goal in different ways and different models so i
i don't care what the model is i think it's important that you make the commitment to
cover everybody and this is something the world's richest country has never done
yeah makes sense bro makes sense that makes a lot of sense i know a lot of you guys
you know that makes a lot of sense um it's really unfortunate when you think about it um
you know the health care system it is expensive in germany right with that 850 i think but having
to pay 850 i think a lot of people would be way more appreciative of paying 850 rather than to not
be able to you know even have anything but the weird part is that it's compulsory it's a must
you have to and it's very interesting you know so um you guys can go in depth and like tell
me about like what if you don't have a job you know what if you don't have a job what what how
do you how do you get by or is it possible that everybody has a job y'all can let me know because
there are some things that were not very clear and big use and all that kind of stuff you know
so um yeah i can you know clarify a little bit of things view if you guys want to write some stuff
you know just leave those in the comment section i really am interested in interesting interested
in knowing more about this particular health care system but either ways guys i'm out of here peace