Exploring Healthcare System in Germany
An ideal community requires an effective healthcare plan. HealthCare plan plays a significant role in supporting the community during health emergencies. It refers to a means that develops individual care and treatment and records and shares them with the persons involved. It is imperative for the healthcare system to provide an engagement framework for approving and evaluating the values of a particular program of treatment and care for a patient in the event of his/her recovery to ensure efficacy. Additionally, it should facilitate adaptation adjustments and changes accordingly. The community benefits from a healthcare system in several ways. First, its care plans help in identifying a community problem and establishes achievable goals. Second, with the implementation of a healthcare system, the hospital focuses on addressing the community needs. Third, the system engages the community in the care planning strategies; therefore, individuals become committed and responsible for attaining their health and social goals. Finally, it promotes continuity of healthcare among the relevant fields. The focus of this paper is to explore the healthcare system used in Germany.
A brief Description of Germany
Germany lies at the peripheral of Western Europe. It borders Denmark, Poland, Czech Republic, Austria, France, Belgium, Netherlands, North Sea, and Luxembourg among other countries. As documented by Sawe (2015) the country is also strategically located on the North European Union alongside the entry point of the Baltic Sea. Regarding coverage, Germany covers approximately 357,022 Km2. The nation measures 876 kilometers from the North to the South and the 640 kilometers from East to West. Among all the European nations, Germany has the largest population of approximately eighty million with a density of 230 persons per square kilometer. Furthermore, Germany has a varied topography. The region alongside the Baltic Coast is sandy, with sandbanks and small hills. Additionally, along its coastlines are woodland ridges and other numerous water bodies.
The Type of Government and How the Government Relates To the Healthcare System
Germany’s system of governance is a federal republic, whereby the President is the chief of State as well as the head of the government. As reckoned by Oberlander and Marmor (2001) the regulation of the healthcare services is divided between the federal, state and local levels. Essentially, the entire population is covered by Health Insurance. For example, the government provides statutory sickness funds, which cover nearly eighty-eight percent of the population. Care providers receive direct payment for the services they offer to the members. As reckoned by Deber (2003) the sickness funds have been classified into two: the State Insurance Regulation (RVO), which covers approximately sixty percent of the entire population and the Substitute funds, which covers about 28% of the population. The insured usually have no choice, particularly while seeking the RVO funds. It is mandatory for every member to enroll. The private insurers cover approximately 10% of the entire population, and the compensation payments are offered in terms of cash and other forms of payments to the care providers. The federal, state and local governments are part of the funders because of their critical role in financing public health services and making hospital investments. Furthermore, the funds are sourced from various areas. For example, Greiner and Schulenberg (1997) assert that about 60% of the health overheads are financed using compulsory and voluntary contributions. Additionally, 21% of the health expenditure is sourced from taxation, with 7% being sourced from private insurance and 11% representing unreimbursed and out-of-pocket disbursements. The Care providers include public health services, pharmacists, and physicians in both and public and private practice
The Various Components of the Healthcare System/Infrastructure and How It Is Financed
The healthcare system in Germany is classified into an Insurance sector with the public and private insurance funds as well as the healthcare industry. The healthcare sector takes into account an assortment of services and departments, including ambulatory outpatient (offered by private practitioners) pharmaceutical, and inpatient care and rehabilitation services among others.
As mentioned, Germany has about 82million people, with about 85 percent of the population receiving legal insurance funds, 11% receiving private insurance funds, and around 4% offered by various institutions and out-of-pocket expenditure. Indeed, Germany uses approximately 250 billion euro annually on medical care, which represents 10% of the GDP. The role of the Central Health Fund since the year 2009 has been to collect and disburse funds for the Statutory Insured persons. Furthermore, since the year 2004, the funding for the health services is embedded in the federal budget, which supplements about 12 billion euro annually and by the year 2012, the funding had increased to nearly 14 billion euro. An employee with an income level of 4162.50 euro monthly can switch to using private insurance funds. Indeed, a person that chooses to use the private funds only under particular conditions, for example, loss of a job can get reimbursement via the statutory funds. By the end of the year 2009, Germany had more than 170 Insurance funds.
The payment remitted by each member is channeled directly to the central fund and thereafter redistributed to the Insurance funds based on the specific morbidity criteria. The compensational disbursements reflect the funds received by each population. For example, some of the funds may be disbursed in a higher proportion than others, such as the case of elderly persons or those with critical conditions. Furthermore, if a person is incapable of balancing the income and expenses, irrespective of the criterion, a member can claim extra fee. Without taking into account the level of income of the members, the funding may require about eight months. The other component of the healthcare system is the ambulatory outpatient care, which the practitioners provide from their hospitals. Nevertheless, special instances, such as ambulatory surgery, therapy for cancer clients, and pediatric social therapy compel the doctor to provide ambulatory outpatient care. The inpatient care in Germany is funded by the German Diagnostic Related Groups (G-DRG), a method that is often used annually.
Staffing Of the Healthcare System And How It Is Managed
The staffing of the healthcare system in Germany plays a significant role in ensuring that the welfare of the patients or the enrolled members. The nursing staff encompasses the largest percentage of patient caregivers in a given facility. Nursing care in hospitals is important because the increase in patient’s acuity requires rigorous nursing care. Recently, the nursing profession has raised great concerns concerning the nature of changes happening in the healthcare sector. Numerous reports of hiring freezes and layoffs of hospital staffs have resulted in an increase in anxiety among them, which may influence the aspect and level of care rendered to the patients. Furthermore, hospital staffs have raised concerns about the implementation of various care delivery systems. Indeed, physicians are very important in ensuring the success of the healthcare system. Physicians include the general practitioners and the specialists in the ambulatory care facilities who is reimbursement by the SHI or by regional agencies that enter into contractual agreements with sickness funds. Indeed, regional associations of SHI or the certified physician are responsible for the coordinating healthcare requirements within specific regions and act as financial arbitrators between the sickness funds and the specialists in the ambulatory care. The certified physicians in the Ambulatory Care system are usually compensated on a fee-for-service framework based on standardized fee program negotiated between the sickness funds and the physicians. Indeed, nursing is a core aspect that determines the quality of care provided in the hospital and the nature of patient outcomes. Historically, hospitals have been at the peripheral of Germany’s healthcare system, and the nursing services are pivotal in administering care to patients.
The Healthcare Problems of The Population
Most of the Germans would attest that the current health care system is confronted by many problems. As suggested Kirkman (1990) the lack of access to available health insurance and increasing health care costs is a major concern for most Americans. Many families in the employment sector fear to fall sick or sustaining injuries because of the inaccessibility of health insurance or basic health care. Insurance agencies are turning away many people because of their pre-existing health conditions or diseases. Some of them end up losing their health insurance covers after they are losing their jobs or after changing their jobs. Indeed, 8 out of every ten people without health insurance are from the employed families. The numerous deaths reported on an annual basis are because of the non-existence of health insurance coverage.
The lack of obtaining affordable quality care is a major problem affecting most Americans. A high number of people are unable to raise the high insurance premiums because of their economic status. It is important to note that the current health care system embeds the health insurance cover with the employment. Incorporating the health insurance with the employment status is sometimes upsetting and ineffective. It is projected that over 24% of the Germans lack access to insurance coverage either because they have lost their jobs or changed their jobs. The objective of the health insurance companies was to reach out to every American citizen and enable them to obtain quality health care. However, most of these companies are profit-oriented hence require these premiums to ensure smooth running. Therefore, they tend to eliminate any person that is unable to raise the premiums needed.
Although the major reason for the lack of access to health is insurance costs, the preexisting health conditions also contribute to the lack of insurance. According to some people, health insurance may cancel or even leave unpaid bills because of severe illness or injury. As mentioned earlier, most of the insurance firms, especially the privately owned are profit-oriented. Therefore, if the company considers an applicant as a high risk, there is the likelihood of turning down the offer. The lack of health insurance cover particularly to the uninsured limits their access to medical service such as regular check-ups, immunization and so forth. Therefore, most of the uninsured persons live without access to quality medical care, and only access the service during emergencies. In this case, the smaller medical problems may proliferate and become severe, while the treatable cases become terminal after the delays, or may even die. The inaccessibility to health care can also affect young children. Studies reveal that children without health insurance are likely to get ill and miss school compared with insured children.
The health insurance and health care costs are increasing at a higher rate compared to the speed at which the wages and inflation rise. The findings from Hopkins (2005) revealed that between the year 2000 and 2006, the overall inflation rate elevated by 3.5%, wage augmented by 3.8% while the health care insurance increased by 87%. Most of the uninsured persons are employed Germans that are unable to afford the high health insurance cost. A large number of the Germans who afford to pay the health insurance do so because of the subsidies provided by their employers.
Strengths and Weaknesses of the System
- Germany’s healthcare system offers a wide-ranging coverage of health-care costs to nearly 100% of the population.
- Standardized or rather universal covers ensures equitably broad coverage of interventional treatment for acute diseases
- Healthcare innovation rapidly permeates into the patient care because of special compensation for new diagnostics and treatments
- The German Ministry of Education and Research supports the continuity of translational research which aims for the swift conversion of research into patient care
The economic inducements provided by the government may facilitate procedures rather than comprehensive patient care.
Germany has been ranked third in healthcare expenditure compared to the GDP, followed by France, U.S.A, U.K with 11%, 16%, and 8% respectively. According to Deber (2003), the healthcare system for the U.S. differs greatly with that of Germany. Germany maintains universal multi-payer health care system paid using various statutory health insurance usually referred to as the “sickness funds” as well as private health insurance known as private “sickness funds.” On the other hand, Goran, Gleason and Ridic (2012) assert that the U.S. maintains a single-payer health system, whereby the government is the primary administrator whose role is to gather all the health care fees and remit all health care costs.
Recommendations for Improving the Healthcare System in Germany
Irrespective of the issues affecting the healthcare insurance cover, an increase in Federal funding may play an important role in combating some of these problems. For instance, the government should think about establishing Community Health Centers and school-based centers that care for persons without health coverage.
The major orientation of health care delivery is to offer care and cure for the sick. A healthy society offers greater resources that nurture the growth of individuals and families. Nurses are at the liberty of using public health approach to work with the community in promoting healthcare plan, the intervention of diseases and assisting with the recuperation process. In essence, the population in Germany faces a greater health problem of limited healthcare center, and nurses ought to engage the community nursing diagnoses in solving the problem. A healthcare plan is pertinent to a community as it plays a significant role in supporting and assisting the community during health emergencies. Furthermore, as indicated in the discussion, the implementation of a healthcare system is a means that develops individual care and treatment, record and share with the persons involved.
Busse, R., Blümel, M. (2014). Germany: Health System Review. Health Systems in Transition, 16(2):1–296.
Deber, RA. (2003). Rekindling Reform: lessons from Canada. Am J Public Health 93:20–24.
Goran, R., Gleason, S. and Ridic, O. (2012). Comparisons of Health Care Systems in the United States, Germany and Canada. Material Socio Medical, 24, 112-120.
Greiner W, Schulenberg JMG. (1997). The health system of Germany. In: Raffel M, editor. Health care and reform in industrialized countries. University Park, PA: Pennsylvania State University Press,
Hopkins, J. (2005). Health Insurance Costs Dog Would-Be Entrepreneurs.” USA Today, August 8, 16
Kirkman-Liff BL (1990). Physician Payment and Cost-Containment Strategies in West Germany: Suggestions For Medicare Reform. Journal of Health Care Politics, Policy, and Law (Duke University) 15 (1): 69–99.
Oberlander J., Marmor, T. (2001). The path to universal health care.” In: Borosage R., Hickey, R., editors. The next agenda. Boulder (CO): Westview Press; p. 93- 125.
Sawe, E. (2015). What type of government does Germany have? World Atlas. Retrieved from: https://www.worldatlas.com/articles/what-type-of-government-does-Germany-have.html