When I began my master’s studies in Germany, I also enrolled in German public healthcare. At that time, I wrote a (somewhat naive) blog post about my first experience with German public healthcare. This is an update to that post.

Since I was a student at the time, I was only paying the student rate for public healthcare (about 80€ per month). Since I also have a chronic disease, I was taking much more out of the public healthcare system than I was putting in.

While most German-taxpayers were compassionate and understanding of my situation, I did piss a few readers off by cheerfully pointing out how the system worked in my favor. They complained that I was taking their money, draining the system, and that I wouldn’t be so happy once I had a full-time job.

Well, I am back to tell you that (1) I have a full-time job, (2) 15.6% of my income is paid into the German public healthcare system, (3) I am (usually) paying more into the healthcare system each month than I am taking out of it, and (4) I am okay with it.

First, a few facts about the German public healthcare system:

  • Everyone that makes less than approx. 57,000 EUR (63,000 USD) must enroll in public healthcare
    • If you make more, you can choose to become privately insured (price depends on level of coverage and pre-existing conditions) or continue paying into public healthcare
  • The system insured 71.6 million people in 2016, which is about 88% of the country’s population (source)
  • People earning over 850€ per month have to pay 15.5% of their income for public healthcare (8.2% is paid by employee, 7.3% by employer)
This system is widely accepted within Germany, and very few political leaders push for significant reforms. When I was a student in Germany, taking more from the system than I was putting in, I also never heard anything negative about my situation from the Germans that I would speak to about this topic. Germans would generally laugh as I spoke so highly of the public healthcare system, telling me that not paying extra for doctors appointments and prescription medication is how it’s supposed to be.

The entire premise of Breaking Bad is basically a mystery for Germans, and people would often ask me how a person in an industrialized country like the U.S. could go into bankruptcy just because he was diagnosed cancer or got into a car accident.

Solidarity
The principle at play in any publicly-funded healthcare system (whether it be German public healthcare or US Medicare) is solidarity. The healthy will end up paying for (at least some) of the health care services for the sick. The wealthier will pay for services used by the poor.

In the US, the prevailing mindset seems to be, “I don’t want to pay for somebody else.” For better or worse, people only want to be responsible for themselves and their families. The problem is, of course, that a serious illness or accident that often lead to financial hardship (at best) for middle- to low-income families.

Everyday, I see my American friends and family sharing fundraising pages on Facebook to help someone with their medical bills. Just the fact that this webpage exists is, in my opinion, a sign that the US medical system isn’t okay.

Such websites don’t exist in Germany because people don’t need them. Public healthcare in Germany covers everything*, so insured people would never be financially burdened by medical bills.

There is strength in numbers, and with over 70 million people belonging to (mainly) just a handful of public health insurance providers, healthcare and medication fees can be negotiated strongly. Thus, health spending per capita is significantly lower in Germany than the US.

If you have a solid income, never get seriously sick or injured in your entire life, and you never have any children, is this system benefiting you? No. But the problem is that you cannot predict when you are going to get sick or injured, and (in my experience) Germans are willing to pay for the safety of knowing that should something happen, they are covered.

If you are curious what your net salary would be if you lived in Germany, and how much of it would go towards public healthcare, check out this salary calculator:
http://www.brutto-netto-rechner.info/gehalt/gross_net_calculator_germany.php

*German public healthcare does not cover everything, there are required “co-pays” (e.g. 5€ for a prescriptions, 10€ per day at the hospital), but these are fairly insignificant and would not cause financial hardship.