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 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 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 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 LauterbachIn Germany there is ranking for contribution rate, so the cheaper sickness funds with good quality can both advertise their better quality plus their lower contribution rates and therefore be gaining members. We had about 240 sickness funds a couple of months ago; we are now down to 213, I think. In two or three years, only 50 or so will survive.
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 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 Lauterbach