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Michigan Universal Health Care Access Network

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Germany

Germany is home to approximately 82,797,000, nearly 1/3 of the U.S. population. To match this, we will have to take the Midwest's 64,392,776 and add in Texas' 20,851,820, to come up with a total of 85,244,596. Germany's infant mortality rate is 4.77 deaths/1,000 live births, and its life expectancy at birth is 74.3 years for men and 80.75 years for women. The life expectancy is barely better for men, and almost a year better for women. The infant mortality is clearly better than the US rate of 6.82.

The per capita GDP of Germany is $22,700. Today, Germany spends 10.6% of its GDP on health care, resulting in a per capita expense of $2406. This means that Germany actually spends 55% as much as the US, a figure that by now might seem surprisingly high. This high figure means that the US could realistically cut health care costs in half, if only we could figure out how.

In 1883, Germany was the first country to establish the foundations of a national health insurance system and has since gradually expanded coverage to over 92% of the population. Everyone in Germany is eligible for health insurance, and individuals above a determined income level have the right to obtain private coverage. The German health care system is predominantly characterized by Sickness Insurance Funds (SIF's), which are funded by compulsory payroll contributions (14% of wage), equally shared by employers and employees. SIF's cover 92% of the population and account for 81% of health expenditures. The rest of the population (the affluent, self-employed, and civil servants) is covered by private insurance, which is based on voluntary, individual contributions. Private insurance accounts for 8% of health expenditures.

GP's have no formal gatekeeper function. Private physicians, over half of which are specialists, are paid on a fee-for-service basis. Representatives of the sickness funds negotiate with the regional associations of physicians to determine aggregate payments. Physicians who work in hospitals are full-time salaried specialists, whose work is entirely devoted to in-patients. All medical and nursing education is free.


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