Healthcare in Germany has a two tier system, even when the official government position denies this fact. The first tier is the government mandated health insurance that all workers paricipate in.  The second tier and most prized by those who can afford to buy it and by the doctors, is the private insurance.  Those who can afford it, buy a policy that upgrades their government insurance to the private insurance level, have a better chance at receiving better treatment and respectful treatment.  People with "private" insurance get appointments faster, often on the same day or within a week at the most.  Their poorer cousins however, have to wait sometimes months or even years for appointments.  This is due to the fact that the private insurance reimburses the doctors at a higher rate than what they would receive from the government program.  As a result those who are not privately insured suffer longer and receive second class care all around.  As a foreigner who is employed, I have the government insurance.  So far, I have had to wait for over two years to get the proper evaluation and treatment of an unstable spine problem in my neck, that was eventually corrected with a titanium plate and screws. 

Rather than do the surgery early, I was placed on long acting morphine tablets and placed on a long waiting list.  When my appointment date finally came up, I was told on the day before that there was an emergency that came to the hospital and I would have to go to the back of the list again, for my problem wasn't acute enough, even though I could hardly walk and had electric shock like feelings in my body and had lost the feeling in my arms and hands.  Luckily, I had a contact at a different hospital who arranged a visit with their neurosurgeons and within two weeks was evaluated and placed on the surgery schedule for the following Monday.  I have been left with a permanent feeling of tingling in my fingertips and a feeling of weakness in my arms as well as chronic neck pain.

 

I also suffer from a rare disease called Porphyria.  The surgery for my neck caused an acute attack of this disease which required hospital treatment.  The treatment plan is rather simple for this very rare disease.  I needed either a 10% or 20% solution of glucose by IV and pain medicine, nausea medicine and within 48 hours, treatment with a blood product know as "heme".  The doctors who took care of me decided to wait three weeks before ordering the heme because of the cost.  They said "the cost would be around 7,500 Euros for four 250 ml bottles".  This attack was the worst attack I have ever had.  I did not eat or drink anything for 21 days which only made things worse.  They finally started the "heme" and I started to respond a little by the third dose.  As a result of delaying treatment, I now have chronic, severe pain in my stomach, the food I eat doesn't digest well and I have severe diarrhea and gas.

 

These two examples of how the German medical system worked for me, and demonstrates how any government mandated health system works.  You might say, Why don't you buy the private insurance?, my answer is I can't buy the insurance because I have an inherited disease and the spine problem, both of which are pre-existing conditions that disqualify me from any private insurance coverage.  I can't buy the insurance at any price. 

 

Prior to moving to Germany, I worked as a Physician Assistant with experience in Family Medicine, Orthopedic and Neurosurgery.  In my experience, not one person was ever turned away from the practices I worked at because of a lack of insurance.  Their evaluation and treatment didn't depend on what kind of insurance they had, every person received the same level and expertise in their treatment plan.  For two years, I worked and ran a clinic for the homeless, nobody was turned away for care, I was able to arrange specialist appointments for my patients as well without cost to them and arranged for medication from the the local pharmacies and pharmaceutical companies again at no cost or very low cost.   I prefer the system as it is in the United States far more than that here in Germany.  I have had family and friends in the US say to me, well at least it is free for you.  I hate to burst your bubble I said to them, but despite what you hear from those politicians who want a European style healthcare system and they often quote it as a free system for all Europeans, this is not true.  Between what I pay and my employer, the cost is over 500 Euros per month just for me.  My wife has her own insurance, there really are not any family plans like in the US.  Each individual has his or her own policy and it is never free for anyone who works.  For those people who are unemployed they may qualify for insurance and in some cases it is very low cost or free sometimes based on ability to pay.  For some people I know here, they have no health insurance at all and can't get any.  So the myth of free universal health coverage in Europe is just that, a myth.

 

I hope and pray that the good people of the United States never fall victim to a healthcare delivery system such as I have to suffer with.  The system in the USA is far from being the perfect system, but the systems in Europe are much worse in so many ways. Perhaps someday I can return to the USA and not have to fear for my life when it comes to healthcare.  The doctors in Germany are not aw well trained as those in the USA and from my experience here, they don't really give damn about their patients even if they have the Gold Card or private insurance.  That I will leave to another post regarding the doctors in Germany.