I think, unfortunately, many opinion leaders in Germany - including government officials, politicians, social service bureaucrats and so forth - they are in the private system, and they get paid the private insurance by their employer. So for them this is the best of two worlds: They have some more expensive and privileged access, but they do not have to pay for it themselves. This is a system which is both inefficient and unfair at the same time, but it is defended by those who profit from this system, and this includes many opinion leaders and many politicians.

The German system is way less fair than it is expected to be, and the difference is becoming bigger. The private system, with its privilege to pay doctors and hospitals better, is basically putting the whole system at jeopardy, because many first-class hospitals and first-class physicians are wasting their time on trivial cases of privately insured and are no longer accessible for the difficult cases from the public system, despite [the fact] that the hospitals and also the education of those professionals is paid for by public money.

I think we have in Germany too many sickness funds. We started with more than 1,000 sickness funds. But the fewer sickness funds there are, the less bureaucracy and the easier the system is to operate. But it is important that the best sickness funds survive.

I think, unfortunately, many opinion leaders in Germany - including government officials, politicians, social service bureaucrats and so forth - they are in the private system, and they get paid the private insurance by their employer. So for them this is the best of two worlds: They have some more expensive and privileged access, but they do not have to pay for it themselves. This is a system which is both inefficient and unfair at the same time, but it is defended by those who profit from this system, and this includes many opinion leaders and many politicians.

In the '50s and in the '60s, the private insurance system originally was a benefit for the bureaucrats in Germany. And this system became ever bigger because the private insurance industry lobbied successfully for making this system bigger. In the '70s and in the '80s, they managed to find a system where they could take everyone beyond 40,000 euros income per year but didn't have to take everyone. So they only took those that had both high income and a secure job and who was not ill at that time.

The U.S. has a system that does have a poor cost-benefit ratio. I mean, 40 million people lack insurance; another 30 million or so are underinsured. The people who are insured do have to worry whether they are able to pay the bills. People become bankrupt because they cannot pay the medical bills, and there are vast differences in the quality of care depending on how much you are prepared and able to pay. I think the system is not working well.

In comparison to the U.S. health care system, the German system is clearly better, because the German health care system works for everyone who needs care, ... costs little money, and it's not a system about which you have to worry all the time. I think that for us the risk is that the private system undermines the solidarity principle. If that is fixed and we concentrate a little bit on better competition and more research, I think the German health care system is a nice third way between a for-profit system on the one hand and, let's say, a single-payer system on the other hand.