the pros and cons of your assigned country’s system.

Think about what it might be like to be a

citizen of your country as a healthcare consumer, and then compare this to the U.S. health care
system. Furthermore, consider what it would be like to be a physician practicing in your assigned
country, and compare that hypothetical experience to practicing in the U.S.

 15min presentation
 Which aspects should be implemented in the US
 Which health care model does your country represent (as discussed on pgs. 17-21 of The
Healing of America)?
 What are the main components of your country’s system?
 How does your country rate in terms of quality of healthcare provided?
 How does your country rate in terms of the cost of healthcare provided – both to
individuals in the system and to the country as a whole?
 How does your country rate in terms of the amount of choice provided to members of
country?
 Lastly, how fair is the healthcare system in your country? Fairness can be defined in
different ways, so I will encourage you to choose a definition and use it to assess your
country. This relates to how “just” a country’s system is.
 Do you prefer your country’s healthcare system to the US? Why or why not?

 Bismarck model: fee for service

 Guarantees healthcare to 82million Germans and guest workers (legal or not)
 Insurnace is purchased and paid for thru payroll deduction
 Government unemployment benefits automatically cover the insurance premium
 Can switch plans any time they want. Cannot be turned down for preexisting condition,
required package of benefits
 Covers doctor, dentist, chiropractor, PT, psychiatrist, hospital, optician, all prescriptions,
nursing homes, health club memberships
 No waiting time for emergency care or surgery: less time waiting than Americans
 Can choose any doctor or hospital and insurance must pay the bill
 Don’t have to pay copay each time
 200+ private insurance plans compete even though prices are fixed. “Krankenkassen”
sickness funds are nonprofits
o No incentive to cover or deny claims to pay dividends to shareholders like in the
US.
o 1/3 the administrative costs of American health insurance

 Very expensive: nearly 11% of GDP (yet less than US 17%)

 Controls payments to doctors and hospitals, lower administrative costs
 “digital health card” has eliminated paperwork and reduced administrative costs
 GOA is a document of what insurance will cover
 Shoulder replacement would be $30
 7% of population doesn’t join sickness fund can buy private insurance from profit-
making firms. Private hospitals cater to this segment and charge higher prices.
 Reduced pay for doctors