What Health Care is like ~ from a conservative friend here in Germany

Here's this insider's view from behind German lines.

I don't know where to start.  The German health care system is so terrible compared to the US in service, prescriptions, things that make the customer feel comfortable, etc.  We've been over here for 5 years and feel so abused by the system at times.  It could just be our American intuitiveness to question the system vs. the German mentality to take what is handed you, but most Germans will say they love it but only to an extent, while we say we despise most of it.   It's "Zis is how we do singz arount hier" mentality based on regulations.  The one good thing is that it is *mandatory* to have insurance whether Public (socialized) or Private (like the US but still working in the socialized system).

What's bad for singers is the fact that when you have green snot and a head full of cold they send you home for 2-3 days to see if you can ride it out.  Then after suffering and it not getting better, they begin to reluctantly dole out medicine, that is after you wait each time in the doc's office for 3 hours next to coughing people in a room with no open windows, doors and no air conditioning.  (No one has AC- not even hospitals, because they feel that a draft will make you sick.)  After several nasal infections due to flying or being in closed spaces this type of thing gets really old.

You have to qualify for Private health insurance based solely on your income (a regulation) and if you accidentally have Public and want to switch to Private you have to pay at least 4 years into the Public system before you are allowed to switch (another regulation).  Private insurance varies but some benefits outweigh others.  Now that we qualify we might switch this year but haven't had the time to investigate it fully yet.  Germany's Public insurance in connection with the Travel Insurance only lets you be covered for 6 weeks out of the country at a time (another regulation).  Public doctors are only open from Monday - Thursday from 9 - 1 and 4 - 6 and Fridays from 10 - 1.  If you have Public Insurance and are sick on the weekend you have to wait till Monday morning, call the public doctor that makes house calls or go to the emergency room- so please plan to be sick during regular business hours.  Most people just wait till Monday because then they get to take off from work and stand a good chance of being written out sick for 3 days.

US medicine available is based on the free enterprise market of competing- like Claritin for example.  When it came out it was the best thing and it made it's company a lot of money.  Several years later there are knock-offs and you can buy many Claritin type drugs for cheap- but you can at least buy them.  In Germany, there is no thriving competition for your Euro because all pharmaceutical companies are government regulated.  No companies stand to profit from making a great nasal spray so no one tries and you end up with no meds available.  It took a stormy weekend (if you catch my drift) once upon a time to finally get some needed medicine and they promised it was the strongest stuff on the market.  A prescription and a pat on the back later we went to the pharmacy hoping to get this WunderMed.  It turned out to be simple Imodium tablets (regular strength) imported from the US.  You could imagine our disappointment.   They also don't have decongestants.  They don't believe in evil decongestants and you shouldn't take them because they are bad for you.  There is no German translation for the word 'decongestant'.  We have to smuggle all kinds of OTC drugs each time we make a trip.  Afrin, Robitussin, Mucinex, Zicam, (now Imodium too)- none of these exist here.  

Omeprazole however, is free with a prescription even though my doc says he doesn't believe in the American delusion of acid reflux.  He writes the prescription and shakes his head at me.

Birthing mothers with public insurance are in a room with 3 other moms (and their respective families)- and are given two whole extra strength tylenol for pain after child birth.  My wife gave birth here with a Cesarean Section and was given one day's worth of strong pain meds, then nothing but Ibuprofin.  More meds and we have to reconsider it after a couple of days.  Again with the needless suffering. :)  Then it's out on your ear after 3 days- no arguing. 5 days if you had your belly cut open. This type of regulation does not spring from good doctor patient communication. The one thing the German system does right is baby-birthing.  They have a negative birth rate so there are lots of docs/nurses/midwives and few mothers giving birth!

A friend of mine fell while drunk one night and ended up gashing his face with 7 or 8 horizontal lines from some escalator steps.  It was not pretty  He went home and slept it off and went to the emergency room the next morning.  Nope.  Can't give you the stitches (or stitch glue) because it's been more than 4 hours since it happened.  He had to **beg** and because it was his face, the doctors **reluctantly** glued his face back together.  If it were any other body part it would have been out of the question- regulations say that they shouldn't do it.  If this were the US, you would get a different doctor, tell your friends about the previous doc and run them out of business if you could.  Here, you don't get a say.  Take your one tylenol and call me on Friday.  Wait- Friday is a holiday so we might as well make it Monday.  Can't work on Saturday, you know.  And, well, Sunday is 'Sunday'- so your potential life threatening colon surgery will be put off because of the holiday schedule.  Don't worry, you just have to *not eat* for 3 extra days, but you can handle that.  (Again with the needless suffering)  That's who I visited in the hospital today.  My friend is holed up for 3 extra days just because of the holiday schedule.  He's already been in the hospital without food since Monday and will have to stay a week after the surgery, that is when ever they get around to it on Monday.  Ugh.

I know people who have had a tooth or two ruined by public insurance doctors but there is nothing you can do but go to a different public insurance dentist.  Crowns, braces, etc. I would consider too risky here and would want to get it done in the US.  

A friend had a boob job and was given 1 extra strength tylenol a day for 4 days.  (Needless suffering is the norm)

A friend had a colonoscopy and as she was getting dressed afterward she complained of a bloating feeling.  The doc pushed on her stomach and made her uncontrollably fart a large amount of air (from the procedure).  The doc and nurses all laughed and opened a window (at her expense).  She did nothing to bring on the joke and they made her feel so bad she won't go back in 5 years for the follow up.  She said she will wait 10 years before going there again.

Abortions are available on demand but not paid for except for low income or unemployed and are only legal under 12 weeks and after 3 days counseling and waiting period.   In 1992 it expanded to "on demand" from the previous clause of only in the case of serious health issues, rape or incest.

I hurt my back once and went to the hospital to beg for percoset or vicadin or something similar for the pain.  What they gave me was the equivalent to a mild muscle relaxer that didn't offer any relief.  I had to stick to the ibuprofin that we have on hand in our medicine box.

A friend has Poly Cystic Ovarian Syndrome:  The OBGYN doc said "If you are not planning on having children, why do you need a regular menstrual cycle?  Come back in 6 months or a year for the correct medicine that will give you a regular menstrual cycle after you tell me that you plan to start a family.  Otherwise, this will be needless medication and we don't hand out needless medication willy-nilly."  This is in spite of the fact that this doc is the leading endocrinologist in the area and that PCOS is linked to various health issues like large cysts, infertility, mood swings, acne, weight gain due to insulin resistance, to which the doc only answered "Eat less."  Google is your friend, and another doctor in the US helped our friend with her diagnosis via email and sent this new info to the supposed leading endocrinologist in Bavaria who perhaps learned from it.  Or perhaps she brushed it off as another self medicating American hell bent on finding silly 'facts' to support sound medical advice.

All that said, the one benefit that my welfare state minded colleagues take advantage of with the system is that they get "Nach Urlaub" or "After Vacation".  In other words, if you are sick during your 6 weeks of summer vacation and have a doctor's note that you were sick for 2 weeks- you get to take up to 2 weeks off during the work year at your employer's discretion (and go where ever you want- Italy, Paris, London, etc.)  It's everyone's right to have 6 full weeks of healthy vacation. So 4 healthy weeks and 2 sick weeks is not fair for the sick vacationer. While the rest of us work honestly, some of my colleagues get their doctor to "write them sick" just so they can take this extra two week vaca and milk the system a bit more.  Still others will be mysteriously "sick" for the maximum each year before they start loosing pay, which is about 6 additional weeks.  6 weeks in summer + 2 weeks Nach Urlaub + 6 weeks of general sickyness = 14 weeks of paid time off each year.  Since the government regulates all employers and won't let them fire people for being sick, many take full advantage without recompense.

I could do that too but like Russell Crowe in The Cinderella Man, I would feel to guilty taking the welfare money and want to give it back when I got back on my feet again.  :)

I have a lot more concrete examples of times that crap has happened due to the system here.  For me the bottom line after 5 years of dealing with it and seeing friends deal with it is that if you have a choice you need to fight to keep the government out of the health care system- except for the fact that they should make it mandatory for every person to have some sort of health care.  Once the regulations are in place, the only way to change the way big brother medicates you (or fails to medicate you) is to organize protests and hand out signature ballots- like in Germany.  I say let the private companies start competing for the best services they can offer and the customer has a choice.  There are *no* choices here.  There are many ways to attain "affordable health care for everyone" but only some of the ideas from socialized health care work for the benefit of the patient.

Heh.  If you aren't confused yet, at least you know that if you want to sing in Germany, you better bring some Tylenol, Imodium, Musinex, Afrin, sleeping pills, Claritin, Sudafed, and while I'm at it:  Splenda, Chocolate Chips, Cheerios, Cake and Cookie Mixes, English Keyboard Laptops, Men's Jackets that don't zip from the left side like Ladie's Jackets and your choice of personal lubricants- again with the needless suffering :)  

Hope it helps just a little.  If it does, feel free to pass it on.