Germany, like the U.S., has a largely private health care system that relies on private doctors and private insurers. But unlike the U.S., Germany strictly limits how much patients have to pay out of their own pockets.
Dr. Eckart Rolshoven examines a patient at his clinic in Püttlingen, a small town in Germany’s Saarland region. Although Germany has a largely private health care system, patients pay nothing out-of-pocket when they come to see him.
The Saarland’s residents are sicker than elsewhere in Germany. And like West Virginia, the region faces economic hurdles. For decades, German politicians, business leaders and unions have labored to adjust to the mining industry’s slow demise. But Germany has long done something the U.S. does not: It strictly limits how much patients have to pay out of their own pockets for a trip to the doctor, the hospital or the pharmacy.
A decade ago, state leaders moved to expand the Medicaid insurance program through the Affordable Care Act. And as of last year, just 6% of state residents were uninsured,But growing numbers of West Virginians without government insurance are in private health plans with deductibles that require they pay thousands of dollars out of their own pockets before coverage kicks in.
“Access to medical care with minimal costs for patients has been essential,” said Armin Beck, regional director of the Knappschaft Bahn See, of KBS, a health insurance plan whose roots stretch back to the 13th century, when miners set up a mutual aid society to protect one another in case of injuries or accidents. “This has been a foundation of our community,” Beck said.
Andrea Fecht, 63, who has diabetes and came to see Rolshoven because recent tests revealed a concerning rise in her blood sugar, estimated she pays 120 euros a year, or about $125, to fill all six of her prescriptions, including her daily insulin.recent reportAndreas Mang, a former miner who left the industry 20 years ago after a series of accidents, would likely pay even more out-of-pocket for his family’s drugs.
Most wealthy countries in Western Europe, East Asia and elsewhere limit patients’ out-of-pocket costs. But when health plans tried implementing a copay of 10 euros for physician visits, it was quickly rolled back amid criticism from patients and frustration among doctors, who didn’t like chasing after their patients for bills.
Nationally, German patients are less likely than Americans to die from conditions that can be treated with good access to medical care, such as heart attacks, diabetes, pneumonia and some cancers, according toGermans are also less likely than Americans to say they had to wait to see a doctor,Lower-cost health care that protects workers from going into debt has meant fewer concerns for the Saarland’s policymakers, as well.
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