How Germany's Universal Health-Care System Works || FOREIGN REACTS

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Intro 00:00
Reaction 02:05
How Germany’s Universal Health-Care System Works


Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information.

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  1. Think of it this way: Say you have medium monthly salary of 3500€, two kids and a stay at home wife. you pay 7% every month (245€) and your hole family is covered. if you earn more, you pay more, but still 7%. The other half is payed by the employer. and its mandatory to every job. if you are jobless, healthcare is paid by social security with the same quality of service. the 840€ is the absolute maximum, so it is capped to keep it fair.

  2. Employees pay 7% and the employer 7% of the salary, but a max of 840€ to keep it fair and competable to private insurance.
    Typical first US question 'But what does it cost' lol. I never pay this it is taken from my salary before I get payed, same with taxes

  3. I live in Germany and earn €44,000 + 13. Monthly salary and shareholdings. Of these, I pay 4000€ pension insurance, 500€ unemployment insurance, 3500€ health insurance, 800€ long-term care insurance and 6500€ payroll tax. My employer pays another 8500€ into these insurances.

    For this I receive completely free education, relatively good public transport, 33 days of paid vacation, free health care, paid sick days, parental leave and so on. I think that’s a good deal 😃

  4. The difference in a nutshell: Not-for-profit.
    Mind you, nobody HAS to take out PHI. Regardless of how much you earn you can always stay in SHI and I know a lot of really rich people who do stay in SHI.
    The 800something Euros a month is probably the maximum private insurance companies are allowed to charge.

  5. Don´t know if this has been mentioned already but all basic dental work, psychotherapy, physical therapy, every type of rehab, further treatments and life long (neccessary) meds are part of healthcare too. Receiving 90 % salary (before tax) after 6 weeks continous sickness (while your employer pays in full) for a maximum of almost 1,5 years can´t be ignored as well, right ?

    BTW…your share of the max. 900,- € is only 50 %. So in public HC your share is capped at 460,- € (at about 58k € annually ), no matter how much more money you earn above that as an employee. If you make small money like 20K €/year you will get away with a share of 125,- € still getting the same treatment as top earners. Less than 11k (I guess) or having no job for whatever reason, being a kid or non working spouse grants you the full spectrum for free.

    Just swipe your "health card" wherever you land and let go of thoughts regarding money…it´s as simple as that. You may buy additional upgrade insurance to VIP treatment for all kinds of stuff (like single room in hospitals or top notch dental work) for ~ 40 € each/month . Of course all aesthetic and cosmetic surgery (unless accidents, etc.) are not included..;-)

    Private insurance is imho an expansive trap you might regret later on in your life (because you cannot switch back to public) and grants you too little benefits. Upgrade deals in addition to public HC make much more sense and can at least be cancelled in times of "trouble".

  6. If you are employe, your boss payes it for you. If you have no job, the gov. payes it for you. If you have your own company, than you pay for it and the 840€ is the highest price and you wont pay that if u don'T make like 150.000€ a year 😀

  7. Don't be so hung up on that 840€, that is the absolut maximum you have to pay for SHC.
    Currently the maximum you would have to pay is 764,33€ and it only applies if you earn more than 4.840€ per month. Also, you only have to pay half of that ammount, the other half pays your employer. So you would pay 382,17€ out of your 4.8k+ paycheck. If you earn less, than you pay 7 – 7.9% of your salary, depending on your insurance company.

    More benefits are:
    They do not only pay your medical bills but they will also pay you an income ('Krankengeld') if you can not work due to a long term medical problem.
    Your co-pay is capped off at 2% of your annual salary per year, 1% if you have a severe chronic illness.

  8. The 800 euro is the highest amount you have to pay in relation to your salary. Otherwise it is less (for students it is 100-110 euros). Also, half of the 800 euro is covered by your employer , so the effective cost for someone with a high salary is around 400 euro.

  9. Hi, greets from Germany. SHI is % of your income. Starts with around 150€ max is 840€, PHI depends on your age, your health, what you want to cover and so on, it can be from 350€ up to 1000€.

  10. not sure why you keep asking how much it costs….who cares in Germany?Nobody.We are payed enough to live well,have a happy and normal in our standards life and never have to care if we get sick that we cant afford treatment or a ambulance or whatever.So even if it costs 1000 euro its still cheaper than the 450$ americans pay.How? Becouse if you need a ambulance you pay 0,americans will pay 800-3000$….if you a woman and give birth you pay 0 while americans will pay 10.000$.So it really dosnt mater how you put it,its still much cheaper than what America offers.

  11. SHI charges 15% of your salary (you pay half), and PHI charges based on age.

    The age when SHI becomes cheaper than PHI is about 50. And no, you can not switch back to SHI at your convenience.

  12. 850$ is the max value. Even if you earn 20,000 EUR, you pay 850.

    The rate is about 15% of your salary, but half is covered by your employer.

    Byt do you know that it covers dental care! (Not denturist)

    BTW Minimum is about 180 if you pay out of your pocket (artists, freelancers etc), half of that if you're employed.

  13. We in Czech Republic (also EU) do also have (version of) the German system.

    The video sounded like this type of merge between competing insurance companies and European health system is somehow unique to Germany.

    It isn’t. It’s one of two general branches of European health systems. One branch is called “French” and is generally little more similar to what Americans imagine socialist health system would be. And the second branch is called German and it incorporates more of the market power and competition… You already would not find it socialistic… it’s just heavily regulated private sector … with European Health results. In Czech Republic, if I am not mistaken, insurance companies are even more- for profit than the German ones. Still -> we citizens pay no bills for medical treatment, only mandatory insurances … (and unless I am of working age, the bill for insurance is paid by a government – that part is bit socialistic I guess? 🤔) … also Government will pay your bill for a time if You lose your job and You register for unemployment/search for new job (it will be the same in Germany)

  14. You automatically pay around 7% out of ur salary meaning you never even see that money and you don’t pay it by hand which makes it easy to not even notice the (super cheap) cost that the healthcare system is, I’m a 22 year old German and last year I had to be in the ICU for the 3rd time in my life, I stayed for 3 days and an additional week in the hospital itself, got tested for everything and anything and payed nothing (I will eventually have to pay 10€ per night that I stayed in the hospital if my provider doesn’t choose to cover that) but the big thing is: I was transported there, got surgery, got intensive care, got food and shelter and it cost me nothing meanwhile my American friends are scared to go to the hospital even if they can barely breath anymore let alone call an ambulance to get there

  15. So I'm in Düsseldorf and I have never waited long for an appointment at a specialist my family neither. Maybe like a week or two mit that's not that much and I'm in the public system. 

    What the Krankenkasse also covers is, that when you are unable to work because of sickness they pay you 70% of your income (before taxes and maximum of 90% after taxes) but the highest payment is 112,88€ a day. You get this payment for 78 weeks out of 3 years for the same sickness.

  16. It's more compulsory to insure you than you being insured. If you are unemployed or make below a minimum, the state has to pay for your insurance. Understanding of the German insurance system is incomplete without mentioning the strong state social welfare system, which might blow some minds: It's illegal for the state not to provide for you if you have too little. You are guaranteed to be given enough to eat, a home, electricity, education plus some extra for culture ect. It sure isn't comfortably much and there are debates to raise the welfare rates, but it means in theory you never have to fear being too poor to live here. So, if you earn too little, healthcare is still covered. Implementing our healthcare system in the US wouldn't work without a major change of perspective: The state owes you insurance, either by means of providing a stable work or by paying the insurance. If you find yourself uninsured (due to some bureaucratic nightmare or homeless people who chose to slip out of the system ect) you still receive healthcare if you are a German citizen or a somebody with a legal stay. No hospital will turn you down. You will not receive a huge bill. Nobody here even checks the insurance status in case of an emergency. There might be some elective procedures that might be postponed, thats all.

  17. about the waiting times. i never had to wait more that 3-4 weeks to meet up with a special doc. and thats only for non emergency cases. if you are serious injured, sick , ill, whatever is an emengency you get help immeadately. ahh, and what was not in the vid. medication is almost free also. you have to pay a small fee (5-10 euro and that has a yearly cap also, arround 270 euros) the medication itself is covered by the insurance. in short. you cant go bankrupt in germany for paying medication bills or hospital bills.
    USA healthcare works perfect for its design – to make money and profit
    german healthcare works also perfect – to keep the ppl healty


  18. The thing with the German system is that it is the oldest in the world, with first roots for it in the middle ages. Since it has grown over such a long time, it is sometimes unnecessarily complicated as well as having quite a big mountain of paperwork attached to it. And that makes it quite expensive overall in terms of cost needed to keep it running, but it is not expensive for the average person…and here is why:

    The difference between state insurance and Private insurance is that with state insurance, your payments are based on your earnings. So if you earn little, your fee is very low, if you earn a lot, it is high (but it is capped eventually). With Private insurance, it is cheap if you are young and healthy, but gets more expensive the older you get. Which is why it is only a good idea for a low percentage of people. BUT you can basically buy extra-insurance on top of your standard one.

  19. I moved to Germany about 40 years ago and I got used to having a health insurance that covers most medical costs and where you do not have a large amount that you have to pay before the insurance steps in and pays the rest. Here in Germany you do not have to worry about the cost of your meds you only need to pay a small percentage and this is not more that 10 euros per perscription this is about 10,90 dollars . I know that my sister pays more per pill than I do for a pac of 100 pills. The system is not perfect in Germany but at least you do not have to decide if you take your meds or buy food.

  20. French health system work in a different way but the results are I'd say probably similar as Germany :
    – Part of the medical costs is taken care by the government, through something called "l'assurance maladie"
    – The remaining costs are mostly taken care by private health insurances, these are called "mutuelles". And by law these costs have to be covered by the employer for at least 50% of their cost, some companies even cover 100%, and usually the money is taken from your paycheck so you don't even have to worry about it. If you're not an employee, there are other "mutuelles" that focus on students, other that focus on self-employed people, etc. And "mutuelles" are not that expensives, the range in somewhere in the 30-150€ per month range depending if you live alone or if you cover your whole family.

  21. I am from Portugal. Our national public health system covers all the population, even unemployed people and the just arrived immigrants. Its a constitutional right. The employed population pays to the so called Social Security monthly 11% of the salary and the employer pays monthly 23,75% of that employee's salary. Everything is free except medication, esthetic procedures and dental care. But even the medication has different generic so much cheaper available. If the public system is unable to provide a surgery on time, the patient is allocated to a private clinic to make that procedure at public expenses. All my entire life i didn't have to worry about my health care or my family health care at all. I am so shocked to know about American system. Oh God!

  22. As it has been mentioned before, the details of German Healthcare may be complicated, but the general rule is: if you work, you need health insurance, and your employer pays half of the the 14%, and your familiy (kids, spouse) is covered as long as they don't have their own income. I just want to add my personal experience and say why I'm so grateful for our system (which has its flaws, of course!): in 2019 I got sick, and all throughout the year, I was in and out of hospital, a total of 17 weeks, I was on medication the whole year and could not work. The employer paid for the first six weeks, after that for the rest of the year, public health insurance covered 70% of my pay until I could work again after 14 months. I had to pay 140 Euro for my hospital stay if I remember correctly, and about 30 Euros each month administrative fee for meds, and that was basically it. All the rest was covered by my insurance, doctor visits every week, pay, hospital, and of course I have paid a lot during the years to the insurance, but I was covered when I needed it. I happily pay a little more into the fund than someone who does not earn as much as I do, just knowing that they will have the same chance to get healthy again regardles of what their income is! This might sound "socialist" to Americans, but I'm grateful for the way it works, even if it is not perfect.

  23. as a student you will pay way less 60-120€ a month .. if you are employed its usually ~300€ from your salary a month .. you dont even have to do it on your own its automated but you have to have an insurance company 🙂 .. if you are unemployed its covered.
    if you dont have an insurance they WILL insure you for 600€ a month. so make sure you always have your insurance 😀 or you will be charged more.

  24. In Luxembourg, my partner, who is British pays €110 per month for healthcare. This covers about 90% all health costs. Ambulance, scans, x-rays, hospitalisation. E.U. bills are not close to U.S. prices.

  25. The 840 euros isnt really right…it depends on your salary….most pay less…way less…and it gets cheaper if your married and/or have kids

  26. Wait times: for certain opt-in surgeries, and any kind of mental health care, yes, wait times for standard scheduled appointment can be up to four weeks or so in advance.
    But if you have an urgent medical situation, wait times will be usually less than an hour, probably less than a few minutes, depending on the urgency and criticality of your case.
    Also, as you don't have to check if any hospital is covered, you can call ANY emergency service, get an ambulance, and get taken to the closest hospital ASAP if needed. No bill for you.

    Little technical correction: you can voluntarily switch to PHI even if your income is lower than roughly $60000 a year.
    But it won't cost you less, nor will it gain you significantly more, better, or other treatments.
    But as a self-employed person (or a freelancer) you HAVE to go into PHI, meaning that the roughly 14.4% of your monthly pay-check will go into your PHI fees, all out of your own pocket.
    So yes, PHI fees can be quite steep.

    The current suggested cut-off limit where it is strongly suggested that you look for PHI instead of remaining in SHI is around 58050€ a year, or the mentioned $60000 a year.
    SHI is set at 14.4% of your gross salary. Of these 14.4% roughly one-half (7.4%) is paid by your employer, the other half (7%) is taken from your pay-check.
    There is a top limit to how much have to pay into your SHI, depending on your income. This cap is the mentioned 840€ a month.
    But these are only for top income classes. The low to average income person pays between 180€ to 450€ (~$240 to $560) a month total, depending on your income range.

    This cap conveniently is pretty much exactly at the 58050€/year limit.
    You also need to gain ABOVE a certain limit per month before your absolute base level of SHI fees will be increased.

    But no matter how much you pay into your SHI, everyone recieves the same treatment, the same prices, the same everything.
    PHI simply adds a few conveniences in most cases. The only area where PHI can be a real benefit is when you look for mental health treatment. That is one area of expertise that is currently underrepresented in SHI coverage.

    In addition to the services of SHI there are a handful of add-on insurances you can get, such as a Krankenhauszusatzversicherung, a hospital add-on insurance. The benefits of that (very cheap) insurance varies from company to company. But most include the 10€ per day fee for the food you consume in hospital, plus the add-on fees for a single-bed room, Chefarzt / head doctor treatment selection, etc. Another one is for additional dental care that covers more elusive costs for somewhat elective dental treatment such as other, fancier materials during tooth reconstruction, or more comprehensive elective beauty treatments. These are also very cheap.

    But here comes the clincher: no matter if you are in SHI or PHI, when you visit a doctor, are in an accident and have to be picked up by an EMT in an ambulance, or even get you via an emergency helicopter to a hospital, ALL costs for all treatments are covered. Period. The doctors and nurses and staff at a hospital don't have to worry about not getting paid because you got were not in the network, or you were not sufficiently covered.

    Everything (weeeell, nearly everything) is 100% covered.
    The only copay is for prescription pharmaceuticals in the pharmacy. You pay 5€ per PRESCRIPTION for non-brand drugs, and 10€ per prescription for demanded specific brand drugs.
    And there is a 10€ per day hospital food bill, up to a maximum of 240€ per YEAR of stay in a hospital.
    SHI also doesn't cover the more exotic or extensive dental reconstructions. Those bills will be the only ones you might have to foot by yourself. But even then most of those dental bills will not exceed around 3000€ for extremely extensive reconstruction with advanced materials.

    Dependents includes all kids up to the age of 25, and a spouse that is not employed nor has their own income. Those are covered under the SHI of one employed family member or guardian.
    Same coverage, no additional cost.

  27. Some more informations from my side as a 25 year old university student in Germany. I was until I got 25 in the SHI of my father. Every year I get 100 € for professional tooth cleaning. This are two sessions at my dentist a year. I just had my last professions tooth cleaning on friday. I went in gave my SHI customer card and went into the room. The dentist cleaned my teeth for 20-30 minutes. after that I went into a next room for a chech up by a different doctor, if everything is okay and I get a filling for 30€ I think or it could be free.
    Also don't forget that ambulances don't cost money in Germany. The only time you have to pay the ambulance ride is when you make joke to call an ambulance to a random place where nothing is happening.
    A difference with SHI and PHI is, that doctors get more money for a patient when a PHI is paying the bill. Therefore you get a faster treatment when you are in a PHI. Real story happened to a friend who was in a PHI by his father and got into the SHI as he had to pay for it. He calls a doctor for a medical appointment and the told they have time in three months. Then he said, that he was in a PHI and got a free spot at the next day. So you get some time or a faster treatment but when you get older you have to pay a lot of money. Last year on a christmas market an old lady asked for a cigarette from my aunt and they started talking. She had problems because her husband died and she isn't able to pay the PHI now. She has to struggle with her money because of it.
    But a PHI is cheaper when you are young. This is a reason people enter it.
    Some people (me included) would want to close all PHIs and only leave SHIs for everyone.
    Also if you have an emergency you normally don't have to wait for a free spot at the doctor even if you have a SHI.
    With 25 I now am in a student SHI. I pay ca. 110 € per month for everything.

  28. I'm German. Health care is expensive. Obviously.

    But when I had my cardiac arrest, they took me to a intensive care unit, I spent two months in intensive care, 6 months in rehab, another 4 month in "return-to-work" program, had several minor additional heart surgeries and permanent cardiac and neurological care. Basicly for free. The public pension funds has recognize me as disabled person, so my payed vacation days are 35 instead of 30 and my hours per workweek is reduced to 25 hrs. The rest is payed by the pension funds for the rest of my "worklife" – in my case 13 years.

    No debt.

    Worth of last three years medical costs- about 100.000 €

  29. Many people already commented, that 840 € is the max fee, where it is capped. But I also want to remind you, that this system is cheaper, than the US one. The video claims that at 3:12, where the average American pays 10,200$ per capita and Germany a little bit under 6,000$.

  30. Have you check out U.K. health care?
    Apart from medication, or health care is free, no matter if you are rich or poor. Don’t get me wrong, we do have private health care, but the majority of Brits use the free NHS hospitals and General Practitioners (GP for short).

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