Fixing the NHS – some thoughts based on my experience of the German Healthcare system

At the Chemist!This is a very different topic to the ones I normally post! But a recent Facebook discussion on the ills of the NHS in the UK have been apparent to me for many years now – my recent move to Germany highlights the way that you can get great healthcare,

One of the biggest complaints I see in the press today is about NHS funding – and for me, that’s where the problem lies. I see so many comments like “the government isn’t putting enough funding in place” but let’s remember, it’s not the government that funds the NHS, it is you, the taxpayer! So when you say the state isn’t paying enough, what you are really saying is “I am not paying enough!”.

And that is where the German system is so much better! Funding for healthcare is all done through the various “Krankenkasse” – an insured scheme whereby the funding for healthcare is isolated from your general taxation. And yes, I have to pay a lot for it – but isn’t that the best way to ensure that the service I receive is top class? None of my payments to healthcare get diverted to fund illegal wars & there is no variation from one county or country to another if I need specific drugs. Pensions and long term care are also separately funded and unlike the UK’s National Insurance Scheme, there is no shortfall between funds coming in and payments going out.

The quality and speed of getting access to medical help is vastly different to the UK – here’s a comparison based on my own experience here: (for those that don;t know me, I have had a long association with nasal polyps!)

NHS- Make appointment to see GP, undergo treatment based on his general experience, eventually, get a referral to a Consultant and wait 6-9 weeks to see him. If X-rays or CT scan needed prior to that, make an appointment separately to get that done.  Any prescription charged at £8.05 per item

NHS + Private Medical Insurance – Make an appointment to see GP, ask for the referral straight away, get an appointment within a couple of weeks. X-ray equipment on site, CT Scan wait was just 1 week.Any prescription costs are at cost price of the drug – for many items, this may be lower than the NHS prescription charge. if not, a smart Consultant will write you up for enough for a few days and refer you back to your GP where you can then have further prescriptions at £8.05 per item.

Germany – without an appointment or referral, go direct to an ENT specialist and simply present your health insurance card. I had to wait just 30 minutes to see a Consultant who had all of the specialist equipment on site. Prescription charge (which does depend on which insurer you are with) just €5 regardless of how many items.

As you can see, a superior experience than I ever had in the UK even with BUPA cover in place!

Of course, many will ask “What about the unemployed and low income families”? Premiums for the Krankenkasse are based on income and if you choose one of the State approved schemes (there are 2), the premiums are also regulated by the State. If you are unemployed, you will be covered for your healthcare under the separate payment you have to make towards Unemployment Benefit.

So in summary, healthcare funding is ring-fenced to ensure a properly funded healthcare system. And in my opinion, that is exactly what is needed in the UK to get the NHS back on track. National Insurance payments need to be also ring-fenced and at a level that can sustain the service we all want to receive. That will mean people earning more pay more – I’m not a Labour supporter but even they ought to approve of that!

The NHS funding problems cannot be fixed without a radical overhaul of the National Insurance scheme with a focus on employer/employee contributions being at a level where a proper service can be delivered. If we really want a world class healthcare system in the UK, it is we, the taxpayers (and yes, I am currently still paying some UK tax!) who have to accept that we have a part to play in this through more realistic contributions into a a scheme where we can be sure that our payments all go towards healthcare.

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