In 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 LauterbachHealth insurance in Germany continues with no change if you lose a job. We do know very well that people who become unemployed are at an increased risk of becoming ill, and therefore becoming unemployed is about the worst time to lose health insurance. So therefore, everyone who loses a job remains in exactly the same insurance system he is in.
Karl LauterbachI 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.
Karl LauterbachI 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.
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 LauterbachIn 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.
Karl LauterbachThe 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 Lauterbach