Communal Responsibility for Health Care — The Example of Benefit Assessment in Germany

Here’s a worthwhile intervention – from abroad! – in the U.S. health care debate, published in the New England Journal of Medicine. Here’s an excerpt of "Communal Responsibility for Health Care – The Example of Benefit Assessment in Germany" by Peter T. Sawicki":

"Many German observers are bewildered over the U.S. health care reform debate. Most Europeans see affordable health insurance for everyone as a fundamental element of a stable and prosperous society – an element founded on the principle of communal responsibility. Like the United States, Germany is a wealthy, democratic society with strong nongovernmental community institutions. In Germany, 90% of the population pays affordable contributions into the community-based system of statutory health insurance funds, which is supplemented by employer contributions and some taxes.

The remaining 10% of citizens, most of whom have above-average incomes, pay into private insurance schemes. For the small group of people who receive state income support or have no income, contributions are financed from taxes. Most people in Europe believe that a strong community is a central driving force for both a good health care system and a prosperous society. Adequate medical care can be so expensive that few can afford it on their own. But if the risks are divided among us, optimal medical care can be offered to all. Communal responsibility is not an unrealistic ideal. Healthy people’s communal support of the sick is in their own interest, since one day they may need an expensive treatment for which they will have to rely on the working healthy – and if not, at least they are spared the worry that they will be on their own at a time of need. Such an approach is not communism or socialism but simply common sense. Indeed, this system was introduced 125 years ago by the conservative German politician Otto von Bismarck."

To read the rest of the article, click here.