Wednesday, February 02, 2005

Good Old Fashioned German Values

Last night in my Healthcare Public Policy class, we discussed the German healthcare system. I won't go into all the details, but the basics are as follows:

Everyone covered (including unemployed, poor, old).
Paid for by employees & employees as % of wages much like US social security.
Ability to go to any hospital or physician.
No long waits.

They use sickness funds which are similar to healthcare insurance companies except they are nonprofit and have strict rules from the government as to benefits and copayments. As for the negatives of this system, it is basically this:

The employee/employer tax contributions aren't able to support the expense.

This is because they have high unemployment (10%) and an older society with more people over 60 and very low birth rate. I don't know if this is true, but my professor said that Germany was considering charging couples with no children a higher rate than couples with children since they weren't supplying the future taxable workers. (Funny, my face looked just like that when she said it.) Of course not everyone child-free in Germany is infertile, but for those who are, this would be another slap on the face.

We had a very lively discussion in which we compared the German values and American values with regards to healthcare. Germany has a historically strong feeling of solidarity in which they want everyone to be covered regardless of their ability to pay. Maybe paternalistic or perhaps brotherly, but it is quite the opposite of the American system where we find healthcare to be a priviledge and not a right. While we care about those who are sick, god forbid we give everyone coverage because then our hospitals would fill up and we couldn't get in. Or, there would be a flood of immigrants to our country who would drain the system and then we couldn't get in.

German people also want to keep profit seeking out of healthcare. They even limit how much physicians can make. For the U.S., it's all about profit baby! There's the insurance company sitting between the hospitals and the patients, trying to collect more from the patient/employees and pay less to the hospitals all so that they can pay their top executives a multi-million dollar salary and show a great earnings-per-share to Wall Street. There's the pharmaceutical companies who in a race to get their product to market to make up for the high cost of research and start raking in dollars for their stockholders, gets a product like Vioxx to patients without knowing all the long term effects. And when they do find them out, they don't pull the product right away. And forget low prices or free drugs for the poor, it's all about profit.

As for infertility coverage, considering what we value in the U.S., it's not surprising that it's not covered. We call it a priviledge to become parents, not a right, even though everyone else can just do it on accident or with one good bottle of wine. Sometimes religion or ethics are thrown about as if they were major underlying reasons for denying coverage, and although I think that it plays a role, I don't think it's nearly as important as profit. Yep, money. It's our capitalist system at work again. What if it were covered? Then the RE's would have to be paid some lower percent of charges by insurance companies instead of the full fees they dreamed up and printed in their brochure. The infertility financing companies would have to crawl back into the hole they came out of, dreaming of a new way to make money off of the desperate. The insurance companies would have to pay out for yet another benefit, taking away money they could have spent on new marble bathrooms for their executive team. And our fellow employees may have to pay an twelve cents a month (as was calculated under Massachusettes program) for us to be able to have our selfish way.

So why is it that erectile disfunction is a covered benefit but infertility is not? Well, let's look for a minute at the board of directors and executive team of any of the major insurance companies. See any women of childbearing age? Actually see any women at all? What you will find is a lot of older men in suits who appreciate this coverage and whose baby making days are over. They are old school, with no paternalistic feelings for solidarity with their fellow Americans. They want positive analyst predictions, a strong bottom line and a bonus big enough to pay for their second home.

So I guess it comes down to values and in the U.S., we've decided to turn a blind eye towards our fellow citizens so that we could continue to enjoy our healthcare system as is. Unfortunately, we become one of the forgotten the day we are given our infertility diagnosis, but then it is too late.

I don't need infertility coverage anymore, but I will continue to fight for it. I see its chances of spontaneously happening as much as I see universal healthcare being adopted in this country as the right thing to do. I wish there were more spokespersons willing to speak out about it, although that is difficult considering the sensitivity of the subject. Yet, I can't help but wonder, if Bob Dole was willing to stand up for Viagra (paid is fine), then why wouldn't Julia Roberts be willing to stand up for infertility coverage? Maybe because she hasn't had to sit in the waiting room looking around at all our scared faces and bruised arms. Maybe because she didn't need infertility coverage but could afford the best money could buy. Maybe because she was able to get through all this without forming bonds with other infertile women, unable to see how the situation could be different without millions in the bank. She doesn't feel the solidarity that we need to make our voices heard. We have to stand together, and if we get pregnant, never forget and never stop fighting for our fellow sisters.

Now let's all clench our hands together and give them hell.


Blogger DeadBug said...

Well said, sister!

Thanks for that very instructive post. Jaw still on floor about the proposal to charge childless Germans more. Utter lunacy.

I'm one of the fortunate few whose infertility coverage is just as comprehensive as it would be for any other physical ailment (all drugs, procedures and care covered with minimal co-pay), and I am realizing more and more how much harder this process would be without it. Everyone facing infertility deserves it.


11:28 AM  
Blogger Jen P said...

I really enjoyed this because I actually miss the American system. Here, in NZ, we are told to take out insurance so that we can be seen by private doctors and clinics and yet they push and push and push the merit of the free for all healthcare system, even those the waits are tedious, the doctors so overworked and underpaid they make mistakes and staff go on strikes regularly.

When I lived in a larger area, I would use my health insurance like a golden ticket and I could be seen by anyone, but without that option of private anything, it really, really sucks. REALLY SUCKS.

Siiiiiiiiigh. What I take issue with most is how standarized medicine must pay for everyone, including those who get unemployment checks or spent 45 years smoking and now require $80,000 sugery or chemo or the like. It's disgusting and it ticks me off.

Why not charge more for those who lead a negligent lifestyle than those who have a physical problem producing the next generation of tax payers? Gah. Sheesh.

4:26 PM  
Blogger DeadBug said...

Pazel, I tried to email you but it bounced and said the address was no longer in use. Just wanted to let you know how much I appreciated the Helen Reddy--in fact, the friend with whom I hid out after Vile used to sing it in tandem with her mother, dancing around their living room. Always wanted someone to sing it with myself--now I'll imagine a big chorus of it with my friends in the computer.


8:00 PM  
Blogger amyesq said...

I have to say that I thank God for the German healthcare system - it really is good except for the high tax rate. My MIL is quite elderly and lives there and if it weren't for that system, our bank accounts would pretty much be empty from paying for all the treatment she has had. That's all we would need after shelling out 8 zillion dollars on infertility last year.

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Blogger Belinda Gwen said...

Pazel! May you be happy and wealthy always! I can't thank you enough for your post on home healthcare products! Really gave me a lot of insights!

1:48 AM  

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