The same drugs are way cheaper in Germany than in America because, obviously, if all sickness funds negotiate with the drug companies for a single price, then the market power of the sickness funds is fully used. So therefore you would expect the prices to be lower for the drugs in Germany, and this is exactly what you see, at least for non-generic drugs.
Karl LauterbachThe 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.
Karl LauterbachIn 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.
Karl LauterbachIn Germany it's impossible to go bankrupt for medical bills, because even if you are bankrupt, ... the social solidarity system pays for your medical bills. The idea is, if you do have financial problems and a lot of worries for other reasons, you do not need to have another burden in not being able to pay medical bills.
Karl LauterbachI think the Scandinavian health systems are better when it comes to preventative care than the German system, because in the Scandinavian systems, the government is really more active in defining treatment, goals and defining health priorities. The German system is a competitive system with little government intervention. The price for this is that the government cannot set a health agenda. And the Scandinavian systems have little competition, so you often do have waiting lists. But on the other hand, you then have the government which can push for prevention.
Karl LauterbachI think from an economics point of view, it is important that the money that is spent for health care is well spent - what is the cost-effectiveness of the money that is used? - because if the money is well spent, many people benefit from the system, and it is also a good market for finding employment. I do not see a reason why we should limit ourselves when it comes to very qualified and humane employment opportunities if there is no waste and if there is medical need.
Karl LauterbachThe quality of health care in Germany is not as good as people sometimes believe it to be. We have problems with chronic diseases. The German system allows too many hospitals and specialists to treat chronic diseases. We do not have enough volume in many institutions to deliver good quality, and we do have fairly strict separations ... between primary physicians, office specialists and hospital specialists. But I think the quality problems can be solved in the next couple of years, and we have made major progress in diabetes, coronary artery disease and pulmonary disease care.
Karl Lauterbach