salm wrote:Dillon wrote:
Interesting. Has it led to a decline in public health care facilities? I believe that is the primary concern regarding two-tier systems.
Not that i know of. It has lead to publicly insured people being jealous of privatly insured people but all in all i think it´s fine.
The main problem of our two-tier system is that its a TWO-TIER system.
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Its not reasonable (or fair, since you brought up jealousy) that those who the gouvernment deems
arian valuable enough... to have a high enough income and public servants can opt out and pay substantially LESS then they would under a "public" plan and get a higher standard of health care for it.
Let me explain for those here who don't know the german system: Everyone who earns less than what our glorious overlords have arbitrarily (is that the correct spelling?) choosen as qualifying for 1st class citizenship have to pay 14% of their monthly income (before taxes) into the "public" healthcare system, while those with entirely private plans pay fixed premiums that DON'T scale with income, thus spending a much lower percentage of their income.
But there is another part to it: that money never gets into the "public" health care pool(at least the way I understand it the recently introduced "health fund" is basicly the gouvernment forcing the "public" insurers to pool their ressources), thus all those that are to young, poor, old etc. to pay are cared for out of "everage Joe's" income while those with the highest ability to give - and who owe everything they have to the state and society, even though they like to forget that when discussing taxes - DON'T contribute. But less and less people will be working - and thus paying - in the future, while the baby boomers are just now starting to retire. Thus health insurance cost/"tax" will go up even more until those "public" insurers go broke(the number of health insurance companies in Germany is falling allready), IF we don't switch to a "non Opt-Out" fully (income) tax financed system in the near future. Both Taiwan and Japan have such a system and they have a higher live expectancy and better everage health than we (that is: germans) do.
So, is the german system better than the american one? HELL YES! Is it the final solution to all our healthcare woes? No. It IS good enough and so I guess your point - that it might be a good first step for the US to adapt it - stands, but its not indefinitly sustainable in a world of rising health care cost and falling employment numbers. Especially in a country with such a high income disparity. I don't think the US workforce could pay for all those that are uninsured at the moment without a MASSIVE tax increase, should the rich be allowed to opt out.
Oh and before anybody claims that you can't choose in a tax financed "public" system: our current basic "public" health care plan covers only what is neccessary from a medical point of view. If you want to spend that kind of money you can allready buy additional insurance so that you get a single room with a big TV, routine(spelling?) Botox injections or whatever you want.
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