What would you say the main challenges are for the German healthcare system?
Many people consider our healthcare system to be one of the best in the world. And as a society we can undoubtedly be a bit proud of that, not least because it offers a large part of the population access to a full range of services. Yet when people talk about the high quality of our healthcare system, it reminds me of the story of the frog in the pan of water. If you heat the water up quickly, the frog jumps out. If the temperature is only increased gradually, the frog grows lethargic. Ultimately, it no longer has the strength to escape. In other words, we need to be wary of changes that creep up on us.
There is growing pressure for reform in all industrial nations, since people are getting older and the number of chronic, degenerative illnesses is growing. More and more people need many years of treatment or nursing care. In addition, costs are rising because of advances in medical technology. We therefore have to ask ourselves how we’re going to deal with the resulting financial burdens – through the existing statutory insurance system, through additional private insurance or, in case those two are not sufficient, by increasing government-funded social assistance programs. Those are the challenges facing policymakers and society at large, and both must react. The sooner they do so, the easier it will be to jump out of the pan.
Another problem typical of highly developed countries is that there are people who are receiving too much care, people who don’t receive enough care and people who are receiving the wrong care. That means despite the high quality, the system is not necessarily providing patients with what they actually need. Some procedures are carried out far too often, others too rarely or in a way they shouldn’t be. That’s an issue, and not just in Germany. Here’s an example: In our project Faktencheck Gesundheit (Healthcare Fact Check), we’ve been able to show that tonsillectomies are performed in some parts of Germany eight times as often as in others, a difference that cannot be justified from a medical point of view.
Treatment outcomes, moreover, are often only average, despite the fact that people in Germany go to the doctor and are treated in hospitals much more than people in other countries. And there are clear differences in the quality of the country’s hospitals, doctors and nursing homes – a very important consideration for people using the system, since they are, for the most part, free to choose their own provider.