My patron Hauke suggested that I spend a video
talking about healthcare in Germany. Which, to me, didn’t sound like the kind of thing
you’d want to listen to for four or five minutes. But actually, there are some
important things to say about it. German health insurance goes back to the year 1883 and Chancellor Otto von Bismarck — you know, the hardline, strict, authoritarian,
warmongering politician who united most German-speaking territories
into a single nation state. He created a system whereby
factory workers earning less than a certain amount were able to get health insurance. At the time, that was about 10% of the population; but since then more and more
people have been included, and so here we are 130 years later. There are two types of health insurance: Which type of insurance you get will depend on the type of job you have
and some other complicated factors. If you are employed by a company —
that is, you are on their payroll — you may be eligible
for statutory health insurance. How much you pay depends on how much you earn. Your employer pays a share, and the rest is automatically deducted
from your wages or salary so you don’t have to do a thing. The insurance company, known as
“Krankenkasse” in Germany, issues you with a card. When you go to the doctor or dentist or hospital,
you present this card and that’s all you need to worry about: no fuss, you get your treatment
and your medication, and the insurance company pays for it. Some other groups of people also get
statutory health insurance: those registered as unemployed, for example. Their premiums are paid by
the relevant government agencies. Private insurance is for everybody else. It’s a normal insurance policy, so how much you pay will depend
on how much of a risk you are. The younger and fitter you are when you join,
the lower your premiums will be. If you need medical treatment, you state
that you are privately insured. You later get an invoice, which you pay, and then claim back from the insurance company. If it’s very expensive you can usually
arrange to pay in installments. If you know in advance that you’re
going to need expensive treatment, then your doctor or dentist can give you
a breakdown of all the expected costs, which you can send to the insurance company and they’ll tell you
what they’re prepared to cover. This whole system — the insurance companies,
the hospitals, the doctors, the nurses, the dentists and so on, is not run by the government. This avoids the pitfall of, for example,
the British National Health Service, which is a vast bureaucracy and swallows a massive 18%
of the government’s entire budget. Instead, it’s delegated to various
non-government associations and companies, but they are very carefully
regulated by government. The German constitution puts the federal
government in charge of the broad policies, but not the day-to-day running. This, then, avoids the pitfall
of, for example, the American system, where health insurance can be very expensive and you suddenly discover you’re not covered
for something very important and very expensive, and everything is run for profit. Health insurance in Germany is
a statutory requirement; which does make it sound as if not getting
health insurance will land you in jail, but that’s not the case. What it means is that
statutory health insurance companies must accept people
who can’t get private insurance. If you have no insurance,
you’re not breaking the law; but eventually you’ll be asked to pay all the
premiums you should have paid, but didn’t. Unfortunately, I’ve never been seriously ill… …which is a very weird sentence to be saying. Unfortunately, I’ve never been seriously ill, so I can’t give you the benefit
of any first-hand experience of German hospital care. But it does have a generally good reputation. And while it’s not perfect, it does normally
give you access to good quality healthcare. And whatever your income, you should
be able to easily afford it. I think that counts as a success. Thanks for watching. If you’d like to
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