Germany
In Germany, the health care system is universal. There are two types of medical insurance coverage available: law-enforced and private. Law-enforced, obligatory insurance plans are only available to those whose income falls below a certain level. These plans are offered by private not-for-profit “sickness funds” and persons cannot be refused coverage. Both employers and employees pay into them. For those individuals whose income falls above the identified level, private coverage is an available option. However, they may also opt-in to the obligatory insurance system, which most do. Private plans may be used to supplement, in these cases.
Healthcare Spending
In Germany, healthcare spending is moderately high compared to the rest of the world. The World Health Organization (WHO) indicates that Germany spends 11.3% of the national GDP on healthcare. In 2012, that percentage amounted to $4,617 USD per capita, a figure that is more than double the average spending per capita across the European region. The CIA World Factbook ranked Germany fourteenth in the world with respect to the percentage of the GDP that went to healthcare costs.
Availability of Care
It is easy to access healthcare in Germany. There are 3.81 physicians per one thousand people, a figure that is higher than most other high-income countries, such as the United Kingdom and the United States. Across the European region, the average number of physicians per one thousand people is 3.31. Nurses and midwives are also plentiful in Germany, with 11.49 nurses and midwives per one thousand people. This figure is also higher than the regional average of 8.05 nurses and midwives for every one thousand persons across Europe. Finally, Germany has one of the highest hospital bed-to-person ratios in the world, with approximately one bed for every 120 people.
Life Expectancy & Mortality
On measures of longevity, Germans are among the longest living. The current average life expectancy is 80.44 years, which is the 28th highest in the world. Neighboring countries, including the United Kingdom, Ireland, Austria, and Greece all have life expectancies between 80 and 81 years. For German males, the average is slightly below 80, at 78.15 years, whereas for German females the average is slightly above 80, at 82.86 years.
Other Issues
Germany faces relatively few healthcare issues. However, several features of the system have been criticized, including coordinating care, access, efficiency, and equity. Those who provide healthcare are divided according to specialty, which can lead to difficulty maintaining patient records. In spite of Germany’s numerous health professionals, wait times for care can be long. The reason for this is that many healthcare professionals are specialized, making the time it takes to see a primary care physician on par with the amount of time it takes to see a specialist. Germany will also face difficulties limiting the cost of healthcare in the country given its aging population. Finally, inequities in access to healthcare do exist in Germany, although they are not as great as in other countries, such as the United States. Obligatory health insurance does not cover all costs in every case; therefore, those that cannot afford to purchase supplemental private insurance may not have equal access to care.