What would a world without medical debt look like? In Germany's former coal-mining region medical debt is almost unknown, despite economic challenges and health problems. Here's why.
There is another important difference between this former coal territory and its Appalachian counterpart: West Virginia's economic struggles have been compounded by medical debt, a burden that affects about 100 million people in the U.S. — in no state more than West Virginia.
Rolshoven's patients pay nothing when they see him. That not only bolsters their health, he said. It helps maintain what Rolshoven called social peace."It's really important not to have to worry about these problems," he said. That, in turn, is driving medical debt. A quarter of West Virginians with a credit report have medical bills in collections, almost twice the national rate,
Along the Saar River in Germany, rusting steelworks and shuttered coal-fired power plants bear testament to the region's economic struggles. Many towns like Püttlingen carry on in the shadow of hulking mounds of debris —, as they are called — the detritus left behind as coal was separated from the rocky earth hauled up from underground.
In global Facebook groups with other parents who have children with disabilities, Wagner said she's amazed to see how much fundraising American parents do to pay family medical bills."I'm so glad we don't have to worry about that," she said."We have enough to do looking after Jonas."International surveys underscore the difference Wagner observed between her experiences and those of American families.
In the Netherlands, where patients enroll in private health plans as they do in Germany, insurers typically cover all medical expenses after patients pay a standard deductible of 385 euros, or about $400. Physician visits are fully covered. "It's better to have 20 unnecessary visits than to have one patient get harmed because they didn't come to the hospital because they were worried about how much it would cost," said Bolte, the chief medical officer."We don't want patients to worry about money. We want them to worry about getting better."
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