*REAL* RECEIPTS: What my Birth in Germany Costs in the USA | Universal vs. Private Healthcare 

Thank you for explaining Americans what public health care really is. I talked to many people who were brainwashed into thinking this is "socialism" - total nonsense.

My son is almost 5 years old, and we are still paying off his birth. The labor, emergency c-section, and 4 day stay came to $30k. We planned ahead, but because of some fine print, insurance only covered 40%. Hospital had sliding scale prices for people without insurance. But because we had insurance, we were ineligible for the cash discounts. They “generously” put us on a 5-year at 5% payment plan.

I hear you. I'm a retired US expat who moved to France 6 years ago. After my first 90 days in France I enrolled in the French healthcare system, which is free. Last year I had a medical crises. At 3:30 in the morning I had such intense stomach pain I could not stand upright, so I called an ambulance. They arrived at my door in 7 minutes. I was rushed to the hospital. Long story short, I was in the hospital for 4 days. I had a myriad of tests the first day. The second day, they determined the problem... my gall bladder was ready to burst. The third day I had my gall bladder removed by a laparotomic cholecystectomy. The fourth day I was sent home. Here is the funny part... when I went to the desk to get my bill the nurse started laughing and said "you must be the American". She then said "there is no bill." The ENTIRE procedure, hospital stay, tests, etc including the ambulance was free. I did pay14€, which was the cost of the cab ride home. My post op drugs were 40€, but my insurance reimbursed me 37€. I'll never go back to the US. Why is it that the richest country in the world treats its citizens like corporate slaves, when almost ALL other industrialized countries provide free health care?

American in Germany here. My wive gave birth to our daughter here and the only bill from the hospital was roughly 150 Euros for an upgrade to a family room where I could stay with my wife and daughter. It also included food (nothing special, but still). I'm very greatful that we could spend the time before and after the birth of our daughter together in the privacy of our own family room.

I'm German, but I used to live and work in the US for 10 years. I'm very grateful that I had the choice to give birth to my son in Germany. I was shocked to find out that my US health insurance wouldn't cover any expenses related to a car accident that I was in. This and the uncertainty of what you have to pay when you need medical care is just very frustrating. That's one of the main reasons why we decided to raise a family in Germany. I understand that not everyone has this privilege.

In Europe we don't only have the freedom to do things, like in the USA, but we also have freedom from things; Like getting broke because of illness. (there is no such thing as not being "insured" because of a "pre existing condition"), or giving birth. We are not getting shot on the street, nor are we afraid our children will be shot at school.

My public healthcare, is literally the best in the world here in Norway. Without any stupid concept of ""health"insurance". The us have the dumbest and nastiest "healthcare" explotation system in the developed world!

My son was born with a congenital heart defect. Including all the prenatal examinations, the birth followed by a 7-day intensive care unit, the heart surgery with 11 days in hospital including 3 days of NICU and the six-monthly check-ups, our costs are 0 cents. The special thing is that the operation took place in the neighboring Netherlands, since the Beatrix Children's Hospital there is specialized by the UMCG and is right around the corner on the border with Germany. All that was needed was an application with one page, four crosses and two signatures. Just 2 hours later, the promise that our statutory health insurance company would cover the full cost was there. The most expensive were the fees for the parking garage. Together about 50 to 60$ 😄

We are Americans in Germany who are expecting a baby soon and this was such a helpful video breaking down the differences as we've never had a baby in the US. The care here in Germany has been phenomenal, and we couldn't be happier! Another amazing video!

As a military family we lived in an NATO environment and the only medical treatment in the area we could receive was through the US Navy Hospital. Some of the ladies in the German community gave birth there and we were shocked to find out that the prices were 3 to 4 times higher than in Germany for a C-section. Also every check-up for the kids etc was a lot more expensive than back home. Some of my US friends explained that living abroad was the only option for them to receive certain medical services like in-vitro fertilisation or orthodontics. They tried to explain their health care system to me but honestly I never really understood it. Some of them were left with huge bills at the end of the year for treatment for chronic diseases of their kids for example. And I met US military families who said they preferred living abroad because they had a sick child and received better treatment while on duty in a foreign country. And they tried very hard not to go back to the states for that very reason. That's not a concept I was familiar with before...

As a German who has lived in Texas for a number of years, I believe two things need to fundamentally change in the U.S. in order for any of these issues to be successfully addressed, be it health care, gun control, pensions, unemployment, furloughs, homelessness, violence in the cities, tensions between ethnic groups, etc., etc.: 1. Checks and balances must be restored (Yes, restored *is* the right word). I.e. concretely: a) There must be a news outlet that is financed by the public, without the influence of moguls who pursue their own agendas. PBS has no chance because it is not pushed and has no lobby, and b) the jurisdiction must also become independent of politics. Which idiot actually came up with the glorious idea that the highest judges should be appointed by the president - that is, by the leader of the government and the party currently in power - and that they should be irremovable? Five people I have to bribe to get my way for virtually ever? Pure idiocy. 2. Political donations must be severely limited and even more tightly controlled. Bribing politicians or parties is not free speech, no matter what your well-lubricated supreme court judges may have uttered decades ago. I bet someone will counter:"But its in the CONSTITUTION!". To those, I answer right now: Your Constitution currently has 27 *Amendments*. To answer the original question: Health care in Germany is good. Of course, there are problems here, too, but overall, I can't complain. I have never paid anything, except gold inlays for my teeth (maybe 400 Bucks ea.).

I'm a USA citizen living in USA. I had a medical issue that came and went several times when in the USA. Traveling in Amsterdam I got sick with the same issue again. Went to a doctor who sent me to the emergency room at OLVG hospital. She was very apologetic because the hospital was short staffed (this was soon after COVID), and it would take some time for the ER to see me. She repeated this apology and I finally asked her how much time were we talking about. “Oh,” she said, “you may have to wait 30 minutes in the ER.” It actually was about 15 minutes. (A 30-minute wait in our rural small town US hospital would be considered fast service.) My care was excellent. Even had a CAT-scan (which I would sometime have, and sometimes not have in a US hospital). Stayed in the ER about four hours. Got tested, treated, and sent on my way with instructions for self-care. Was told to stop at the desk on my way out. Lady at the desk asked for my ???? card. She saw my face, smiled, and said “oh you are a tourist, then I need your credit card.” I silently gulped, thinking here goes my budget for my vacation - as I now have to pay for a ER visit. I was not a part of Holland’s national health care, so I had to pay 100% of the costs for the ER. Total bill came to $350. In the US it would have been closer to $15,000, with my health insurance my out-of-pocket would be about $700. In addition to the $350 I had two prescription drugs to buy, which I got at the OLVG hospital pharmacy. Again had to pay 100% of the two drugs cost, for a total of $15. So my experience: $365 uninsured total cost for faster superior health care in Amsterdam compared to the same treatment for the same medical issue received in the USA.

I'm from Germany myself and couldn't imagine the struggle you depicted that is going on in the US. I'm just glad that you guys are here and happy ♥

As someone with a chronic condition living in Germany I can say, that I received excellent care during all my hospital stays and doctors appointments. Money was never an issue when discussing my treatment options (and my medication is sooo expensive. I looked up the price online. It is more than my monthly income and I am going to need it till the end of my life). I was even offered to see one of the best neurologists in the country just because he happened to be in the hospital at the same time I was. My case was not special or complicated. Still, we had a chat and he explained a lot of things to me. No questions asked, no extra costs for anyone. I am happy to have public health insurance. It probably saved my life more than once

Regarding quality of care here in Sweden. In 2020, just as Covid hit I had a cardiac infarction. It took about an hour from when it started to get into the operating room, so within 2 hours I'd had a stent inserted and was in recovery. This happened while they were moving wards around to have separate wards for Covid free patients but everything worked perfectly and I was in hospital for monitoring for 3 days in a private room. The total cost was about 40$ (essentially for food). Since then I do have a lot of pills to take daily which sets me back the maximum yearly amount which is about 250$ per year. I don't see much that could have improved except for entertainment: The TVs in the ward only had a few basic channels but I brought a tablet with me, so I had everything I needed (after a friend delivered a charger).

With my second pregnancy here in Germany…I paid in total about €100 . I had a pretty normal pregnancy but did have an US at every appointment as I had early bleeding. No bills. As the end of my pregnancy came, we discussed the birth. I was told well you had a section the first time but there is no indication for an automatic repeat, so you will be having a VBAC unless for psychological reasons you found the first too traumatic. I said I was fine. My OB in turn gave me his private cell number and said, if you have had enough and the hospital is not listening to you, call me day or night. My first labor was 38 hours. Labor was fine, fully dilated, no meds, I hardly labored in bed at all, staff was awesome but baby would not descend. More monitoring. Baby was a bit too quiet….I was asked to have another section. I agreed. Section was fine and normal. Well, about 2 hours post section, all hell broke loose. Emergency surgery. Head surgeon of the hospital involved. 2 day ICU recovery. 11 day total stay. I was treated so well. The pediatrician came to the hospital to do standard baby checks, I was given a private room for the entire stay. Of course my home midwife ( standard care here)took care of me once I was home. Everything cost me about that €100 with amazing care. My birth is not the only example I have of care here. My son broke both bones in his arm through the skin. Ambulance ride, ER, surgery, two night stay, physical therapy, checks every 4 weeks at the hospital, second surgery to remove the rods, checks at the pediatrician, meds….we paid €20 total for the ambulance. This is all under public insurance.

I'm Norwegian. 2 of my 3 children were born premature and needed the extra care and extra stay. As their mother I of course stayed with them both times. The only thin😢I needed to worry about was my children's health. Everything else was taken care of. In Norway we pay our taxes knowing that you never know what will happen in the future. I never planned for my children to be born premature. And one of them would certainly have died if I hadn't been at the hospital. Now she is living a great life with no complications from her birth. I don't get why universal health care is even a discussion in the US. It works and saves lives. And all I had to do when I left the hospital with my baby was saying goodbye to the other mothers I had befriended there. No bills and only a wish for good luck with my new baby.

Thank you for this take and sharing your experiance. I think a lot of germans should listen to it, so we can actually understand how truly valuable this is.

My boyfriend broke his leg two weeks ago when we were on holiday in Greece. I also broke my arm in the same accident. Being publicly insured in Germany (and thus the whole EU), we never once had to worry about the cost of any treatment (multiple operations), the ambulance ride, etc. We've had lots of other stuff to worry about, so I'm immensely grateful that this is not also weighing on our minds. The quality of treatment in Greece was okay and here in Germany it has been very good so far.

I am an American / Canadian who has lived in Germany for over 30 years, part of that time with private North American insurance, and part of that time with German public insurance. I have had diabetes, kidney failure, and a kidney & pancreas transplant while here in Germany. My impressions of the medical system here are that it is second to none in quality of care. The hospital's floors may be scuffed and the elevators a bit dinged, but the equipment that matters is state of the art. My wife gave birth to our four children in Germany, and even when we did see the bills (to submit to our US insurance), they were far less than what it would be in the States. Perhaps one of the big differences is that most German hospitals, at least in our area, are not-for-profit, whereas most in the part of the US I am from are. I had my transplant in the Uni Klinik in Freiburg, and the care and competency of the doctors was great. I will say that the German public insurance is not necessarliy cheap, 14% of your income, but so worth it.

This must lead to some awkward conversations between couples. Man: Let's have some fun tonight, 'Woman : We can't afford contraception this month if we want a baby next calendar year. Man: Siigh... I'll take a cold shower 😅

You can ask AOK (Edit: or the involved providers, so hospitals, doctor's practices, midwives....) for a "Kostenübersicht" or "Patientenquittung" - it might take up to 6 months for all the charges taken on by AOK to be listed, but after that, it shows you everything AOK covered. You can probably get it online at the "Meine AOK" portal, or you can have it printed out at an AOK office. Might be interesting to show how much the individual charges are different, too, and how US insurance is simply overbilled. Maybe it can be used as an example for the power of large negotiation blocs?

Here a Dutch person. The € 145/month pay for health insurance and the yearly € 385 "own risk". In 2012 while on vacation in France, I got a cardio problem and was dottered in the hospital in Fréjus in France. I was asked my Dutch health insurance name and my client number. I stayed in hospital for 4 days... never saw a bill. The (medical)care was excellent but the food was minimal. Since that incident I have appointments at the University Hospital in Amsterdam for the most high level cardio care (I grew a couple of bypasses in my heart) and never see a bill. My daily cardio medication for one year doesn't even have the value of the € 385 , so some years I don't even pay the full € 385. The different RU-vid video's comparing health care systems make me feel more satisfied about the Dutch health care system. I get all the care I need in a reasonable urgency. Sometimes when my local hospital (2km) is booked for a certain time for a certain treatment or diagnose, I have the option to go to another hospital just some 8-15 km more away in Amsterdam. A lot of people complain about the costs but, compared to other countries we have a good system too.

This makes me extremely grateful that both of our sons were born while I was on active duty. It didn't cost us a penny.

My child was in intensive care for 14 weeks after his premature birth. That was the most worrying, worst and most stressful time of my life. I can't imagine how I would have felt if there had also been financial worries, because I would have to pay for part of the hospital treatment. I am so grateful about our German health care system. And my baby got excellent treatment, everyone did their best and everything had a happy ending.

Publicly insured in Germany. Never really had any problems I could complain about regarding quality or availability. I have to say though I am 36 and hardly ever have health problems. The few times I had to go to the hospital were good and I would rather "complain" that the doctors incentivised me to stay longer than just a week because I got bored.

I am a retired person now living in Germany. Since I did not work in Germany I now have private insurance at the Basis care (lowest) level so medical bills are not usually completely covered but this is preferable to the US. I had Cancer 5 years ago which would have bankrupted me in the US even though I had insurance through my employment. (I am fine now.) Health care is one of the main reasons I won't return to the US to live. It might be different now (doubtful?), but when I was in the US my Insurer told me I could no longer see the primary care Dr. I liked. I felt she saw me as a person and knew my medical history. The new practice they sent me to had signs stating that visits were for one illness only, you had to make a second appointment to address another concern, visits were scheduled for 15 minute intervals, and often when you saw the Dr. (there were several in the practice) you had the impression they hadn't had time to read your chart so had no idea of your medical history. There were several other specific examples (even bordering on malpractice due to time constraints) I could state these but that would be too lengthy and specific. Suffice it to say I will not live in the US again until there is a change in the health care system.

I am glad & grateful that I am in Germany. Or else, I would be paying all those hospital bills until I die. It’s such a high amount which is deducted from my salary every month, but as you said, I won’t have surprise bills from the hospitals.

Hello from Germany! Staying longer in the hospital especially after the first birth is so important. There was a breastfeeding specialist in the hospital who came every day to help with this, who showed us how to bathe the baby etc. It was such a great chance to learn for clueless me at that point of time. Both my boys were born and raised in Germany and medical care were excellent every time we needed it. My grandparents are over 90 now and enjoying their life thanks to excellent free medicine and medical care. Abou general costs of health: only healthy people can work and pay their taxes. Ill and dead people will not be able to raise their children healthy and give them a good education, so it’s a never ending circle of poverty and misery.

I live in Sweden, married to an American woman with dual citizenship. Two years ago she suffered an aneurysm in her brain, causing a brain hemorrhage that put her in intensive care in one of the premier clinics in northern Europe for four weeks to the tune of $8,000 a day. Instead of paying $224,000, we just paid a nominal fee in our public health care system. I don't dare to think what it would've cost if she had fallen ill in the US.

Ha...can answer that without watching. In the US it would have cost too much.😔

As an American living in Germany who had a high risk pregnancy and NICU time with twins in the US and now I’ve had a singleton in Germany. The quality of care is a whole other topic. Insurance wise - with good insurance we were expected to pay out of pocket around 100k$. In Germany we’ve only had to be 200€ which was BEFORE I was insured.

8:09 „Ibuprofen 6 pills $18.30“ That's more than $ 3 for one Ibuprofen pill 😞 One can probably assume that a hospital buys this standard drug in large quantities at favorable conditions. In Germany you can buy for €1.29 (1.41 USD) per pack of 10 in a retail box with pretty colored cardboard around it, so one is $ 0.14 and 6 of them are $ 0.84, so in this example the price is about 21 times as high. (edited: 18.30 / 0.84 = 21.7 times)

Thank-you for this. I could bore everyone for hours about our healthcare related issues in the US, but the extreme short version is that healthcare costs were the largest factor contributing to a bankruptcy and losing everything - our business, our home…really, everything. We landed in Germany, and thanks to my husband‘s and daughter’s DE citizenship, we were instantly insured. Starting our lives over, living on welfare for 6 months was humiliating and so very hard, but I could not be more grateful for the new start, at 50 years old, I was given here. Since then we have not seen A SINGLE MEDICAL BILL, despite appendicitis, 6 broken ribs, an emergency with 100 wasps in our house (now THAT’S a story - police, ambulance, firetruck…) but we paid NOT ONE PENNY. Things here are NOT perfect - but when you compare…yeah. Also, when I gave birth to our wonderful daughter back in 1997, because we’d opted for “affordable” insurance (ha) the natural birth was not covered and we paid, for pre-natal care and hospital stay $12,5000. IN 1997. (In fairness, we’d been discussing adding pregnancy coverage to our plan, but hadn’t gotten to it, so that is our fault). Even so, many people can’t afford that; we barely could, but we did. However, for many folks that would have broken them. Thanks as always for your thorough research and thoughtful presentation!!

My mother died in Germany when I was 16.5 years old. Before that, she did spend 3.5 years in hospital with cancer. So her best friend, a neighbor lady, married to an American GI, tried for decades to convince me, to move to the USA. I did visit them in 1988. And you know what, I didn’t liked it a bit. People walking around with missing teeth, especially older Americans complaining about high bills or medication. My “aunt & uncle” as I called them, were disappointed. Fast forward. I lived already in Canada, right - “YOU MOVING TO CANADA…” 😮 - my uncle didn’t feel well. He then cut somehow is foot in their garden. Hospital. The hospital made some tests because the bleeding didn’t stop. Amputation of his foot and part of his leg….. and my uncle did bleed to death - literally. 😢 Visiting for the funeral service, my aunt looked at me and gave me an envelope. “Can you read it for me please. My English is still very bad. She was not only heartbroken for losing her husband, she was shaking from what was in the envelope. And no matter what language you speak, write - numbers mostly don’t need translation. My aunt in the late 70’s & I am in the middle 50’s at that time. So we did sit on the couch. I took the document out - and was close to get an heart attack! Americans! Seriously! For 9 days hospital stay & emergency care, medications - the bill was over $500,000…. I think that where my aunt was close to die when she got that bill from the hospital. I mean, my heart started pumping… and reading page 3, it said all is taken care of from my uncle’s military health insurance. I explained that to my aunt. Next morning, I asked around the neighborhood if there isn’t a service for veterans wifes who would help in this situation. I mean I had no clue what to do. Lucky me, I did find two veterans in the neighborhood. One actually called a veteran service who actually does this work. Visiting the wife or husband and giving help for all necessary documents to fill out. I had only a view days left of my stay, but I was able to meet the gentleman who took care of my aunt. - Still my aunt, after 39 years in the USA, she moved back to Germany. She said: That gave me the rest! I could never ever pay a hospital stay if I needed one. I talked to my sisters. I’m selling everything and go back - home. - I never understood why people call the USA a dreamland. It’s more of a nightmare if you get sick! // To your question: I lived 14 years in Alberta Canada. I did had a gallbladder surgery in 2012. My bill? I didn’t get one. All was covered by the Province & my health care plan. It’s like in Germany. I got a root canal done by a specialist plus my dental doctor’s bill. Pulling the tooth was covered. Root canal wasn’t. I was $1,200 out of my pocket. That’s when I thought. Seriously! My healthcare plan cashed in $400 ($200 my company & $200 from my salary) each month. And no root canal treatment was covered. Couple years, I did have problems with that tooth… Fast forward. I moved to Panama. I’m getting a tooth infection… The dentist in the public hospital in Panama is making X-rays. I personally thought, a tooth beside my crown is giving me that pain. - The dentist is checking the x-ray. “Who made that root canal treatment? I’m sure, you had a lot of pain over the years…” - Why is that? “It wasn’t cleaned out properly. You still have some nerve “leftovers” in each canal….” 😢 $8 out of my pocket, I had my 2,500 CAD crown leftovers (including the $1,200 disaster at the specialist) taken out. The $8 (US) included 10 pain killers and a control visit next day. I have no idea, why North Americans do not kick the responsible people in the health industry out of the country! It’s all about: Getting the last cent out of the people’s pockets! Nothing else.

What I find infuriating is also that in the US hospitals and Pharma charge way more for the same services and Meds than companies in Europe - because in Europe the medical market is regulated to avoid exploitation. Most people don't know, because as you said, we never even see the bills here in Germany.

I sometimes get the impression that the US is about value over people as people are a risk. Whereas in Europe it's more people centered. Not entirely maybe but in relation to the US it seems correctly.

All hospitals should be run by the state on a none profit based Model.

I enjoy your videos because they are so well researched. When we first moved to Spain (from the US) my wife Janet went to see the local doctor. When she wanted to pay for the visit they had no idea how she could do so. It took them several days to work it out.

I‘m honestly baffled by the question how all this can be free in Germany. How can it not be? Isn‘t it basic human decency to assist, support and care for others, as we want it for ourselves? Surely, there is financial cost, but the question should, in my opinion, never be asked an individual but considered a responsibility of society, which strength is the multitude of individuals contributing. I‘m happy for you and your family about the care you recieved and wish you all the best.

I left Montreal when I was 27 and I've been living in Germany for almost 30 yrs now. We also have universal health care in Canada but what I hear from my family is that often there's a huge wait at ERs and scheduling of non-critical operations. Sometimes waiting months! So when Germans complain about high premiums and terrible service, I am grateful for living in Germany. Love your videos Ashton! Tell me where you find the time creating these videos with 2 small children? Respect!

No wonder, perinatal mortality in the US is 5.7 / 1,000 births, as apart form for instance Sweden with 1.7. The US figures are actually higher than the Swedish ones when I started out as an obstetrician 40 years ago (this very year ...)! One little comment on the blood flow examinations: It's true that increasing resistance in the umbilical arteries is associated with fetal growth restriction, CP damages (if not detected at an early stage) and perinatal death. What DECREASING blood flow resistance signifies is still incompletely known however. As far as I know, there hasn't been found any radical increase in risk.

A very informative video. Thank you. One point though was missed. It was mentioned about being "in-network" but there are circumstances where the facility is "in-network" but the doctors, the nurses, the labs, are "out-of-network" because the hospital contracts all of those services out now. This has happened to us several times and it is shocking when receiving multiple bills. We do our best to stay in network but my wife's last ER visit we were advised we would be responsible for 3rd party, out-of-network care. :( The system in the United States is geared to harm and damage people at every turn or so it seems and feels.

Hey Ashton, thanks for your videos and also sharing your private life. Since you're member of the AOK, you can check in their APP what the hospital / doctors billed there. It is not detailed to an invoice but categorized and summed quarter-yearly. Might give you a better idea of comparison to the billing done in the US. Probably the AOK will share the bills with you directly, if you ask.

what me confuses as a german, is that you have all this dramatic bugs in your system, but still you get called a socialist if you call out for a social health insurance for everyone.

I looked up the cost of open heart surgery where I live and if I didn’t have Medicaid, I would faced a bill of $60,000 and the rest of the expenses could have been in the area of $150,000. The quality of my health care was excellent but truthfully, I wouldn’t have been able to pay for my health care without public assistance. None of us is financially prepared for a catastrophic condition and I have to confess I never thought about long term health care insurance when I was young because I never thought I would need it and I would remain in good health my entire life. That didn’t turn out to be the case and it was a lesson learned. Invulnerability is an illusion where our health is concerned. You can never begin planning too early for major life events.

I actually don't want to criticize your choice of sponsors, but as you were talking intensively about how your public health insurance here in Germany never showed you a bill, I think it is quite important if you talk about someone helping you choose between public and private health insurance here to explain, that there are significant differences how private health insurance works here. Perhaps I am a burnt child in this respect, as I realize how my financial advisor repeatedly tried to lure me away from statutory health insurance into private health insurance without explaining its long-term and very serious disadvantages to me in a reasonable manner. Yes, of course, private health insurance in Germany has a reputation for providing better health care. In practice, however, in most cases this simply means faster appointment scheduling, as this makes patients more welcome at the doctor's office. However, the quality of statutory health care is absolutely sufficient. If it's a matter of life and death, I can be completely sure of receiving equally good care in Germany. On the other hand, it is not uncommon for private patients to be persuaded to undergo nonsensical examinations simply because more money can be billed here. And in the long term, the risk of slipping into old-age poverty due to the much higher increase in premiums is simply too great for me. The fact that I already get to see the bill in private health insurance and only then submit it to the insurance company is actually only a small inconvenience, but one should also be aware of it.

that is interesting. i am german and have never lived in the US. i don't think things in the US will ever change. hospitals are a money-making business there in the first place. in germany everything is regulated and standardized. doctors don't earn a lot of money when working in hospitals. hospitals have much lower costs overall i assume. and they are considered being more of a service provider than anything else.

I used to work at a call center. We serviced Microsoft. After about 2 years, Microsoft pulled out and the call center was reassigned to a US Health Insurance Provider. I would not work there, because "refusing payment for health services not refusing health care" is still refusing health care, and the entire system is immoral.

I'm from the Netherlands and was a "NICU" baby in the late 1960s. Already too curious to stay inside for 9 months ;o). After that I've had 2 live saving treatments until today, and have some conditions which are being monitored and which I'll probably have for the rest of my life, all under our "universal" health care. My mother has had kidney failure and got treated with dialysis for almost 11 years before she past away. All covered as well. Being the care taker for my mother and with my own medical experiences I can comfortably say that I don't know how the medical treatment could have been better. The luxury options of private healthcare like private rooms (which we mostly get these days anyway) or whatever have no value for me. When I need medical treatment, I hope for the best medical treatment, not some holiday experience. What strikes me most about the healthcare costs in the US of A is not the high prices, but the the unpredictable nature of these costs and the horrendous healthcare system costs. Thank you for reminding me, and a lot of other Europeans I believe, about the fortune we have of living with these systems in place and not taking these for granted. These systems are always threatened by the same people/companies who are making a fortune out of the health care system in the States.

As a family doctor from Germany, I can assure you that at least me and every doctor that I personally know would never base their diagnostic or therapeutic dicision on the insurance of the patient. It may sometimes be a little harder for a public insured person to get a third or fourth prescription for physiotherapy, but on the other hand it is usually more difficult for the privately insured person to get a stay at a rehabilitation clinic. So there are pros and cons in both situations. So basically, every person will get the care that they need, no matter the insurance. 😊

Hi Ashton, another well researched video on a sad topic: the difference between civilized and extortionist healthcare, ie the rest of the world vs the US system. The more I hear about the practices that are common both by hospitals as well as doctors and I can't but be forced to conclude that the US Americans in the States suffer under a legal version of mafia like proportions. When you have no choice but die or go broke in a potentially life threatening situation the vast majority will select the "go broke" option over either permanent disfigurement, disability, or even death. Even if at the time of their choice they have absolutely NO idea how high their debt will be. Heck, mobsters are usually fairer than hospitals and doctors because the mobsters will usually tell you ahead of time what their "protection" is going to cost you. Agreed, mobsters rarely provide any real services except not rob or harm you. But usually mobsters also cut down their extorting to a level that their victims can reasonably pay. The US health business doesn't give a damn about how much they charge you, or how outrageous their prices are compared to other civilized countries. They charge whatever they can get away with, even if that leaves a patient that is already under pressure due to a medical condition under the potential threat of privately defaulting on their debts, leaving them broke and destitute. That's why I don't feel smug; I feel pity for US Americans still in the States who haven't woken up from the dream that their health business is worth the name of health CARE only for the ultra-rich. Edit: I am more than happy to contribute to the public health care system here in Germany. Thus I have participated a tiny, tiny amount to the outcome of your and Theo's birth; which is sooo satisfying in a strange way. I feel no, none whatsoever, reluctance to pay into the system when I hear stories like yours that validate my conviction that despite all of its flaws the German system still works. That's something I can really be proud of, as it helps the most people to improve our society in general. Thank you, Ashton, for sharing and reaffirming my belief in our shared system. It does improve my outlook on life in general. 😘❤ Edit 2: returning after your question. Nuanced answer: for the vast majority of my care, both GPs and specialists, as well as hospital care, I would give the answer: outstanding care. However, when it comes to mental health there is a significant dearth of psychiatrists, neurologists, and therapists in Germany. To find a therapist still taking in new patients in your area is fortunate. Finding a therapist that takes you in during an emergency is very difficult. However during an emergency you normally can find specialized mental health clinics that do take in emergency cases. But don't expect very warm, pleasant stays in the emergency departments of these clinics; the best you can hope for is being dosed up to the gills with certain antidepressants like Tavor, until an open spot is found in the department that deals with your special case. That can take anywhere from 14 days to several months, if you're unlucky. That's the caveat I have to throw out. My own medical history included way over two years of hospital or clinical stays in total over my 53 years of life. With my Krankenhauszusatzversicherung / add-on hospital insurance at the Barmenia in addition to my DAK standard public health insurance I usually got the perk of a single room, Chefarztbehandlung/chef doctor's treatment, and a few other minor goodies. But the total time in hospitals here in Germany or the rest of Europe cost me faaaar less in regular insurance premiums over my lifetime than even ONE expensive stay in the USA would have. So, yepp, I am incredibly happy, and consider myself fortunate to have been insured here instead. On the note of: has the care changed: yes, a bit; the more privatized the care became the more overworked, right up to overwhelmed the staff became while receiving far too low wages. That's a sad truth that with MORE privatization in hospitals the care has gone DOWN in Germany.

In US they charge like if the doctor was giving birth on behalf of you.

In Canada we do not pay insurance premiums and all we pay is for parking

It is not "only" the costs, it is also the worries that would accompany me every day in the USA. Nobody wants to get sick because it affects their health, their life. But then to have the additional worry of not being able to get the care I need without financial reserves or income in case of an emergency would be extremely stressful for me. Illnesses or accidents don't really happen intentionally or planned. On top of that, it takes a lot of time and energy to wade through all the insurance catalogs and offers, to compare them, to understand the fine print and, in the end, to research forever which hospital and which doctor you're allowed to go to, so that the insurance company doesn't stress you out - while you're lying on the floor bleeding. And since there have been a lot of TV series in the USA since time immemorial that show a health care system in which costs are almost never addressed, but all the doctors virtually sacrifice themselves for the patient (Dr. House, etc.) - and in the end everyone leaves the hospital cured - it is naturally part of the consciousness that medical care in the USA must be the best on earth - if one were to live in a TV series. This image has certainly taken root in people's minds like a national myth over the decades of "General Hospital," "ER," and the like.

The biggest difference imo is that in Germany, if you're publicly insured, it's literally impossible to go bankrupt for any kind of medical treatment. You can still go into debt with elective surgeries or experimental treatments that are not yet covered by insurance, but at least in the latter case you can often sue and get the cost awarded if you win. Importantly tho it will never be a surprise. You always have a choice

You made a valiant effort to cover this complex subject in a 25 minute video and I complement you on the result. Having lived in Germany, the US and now Spain I have seen the huge differences between the healthcare systems and their costs. The US system is vastly overpriced for the same, and many times lower, level of care. Unfortunately, I do not see the US system changing for the foreseeable future for many reasons. The main reason is that who provides the care has changes in the last couple of decades. This has been a change for the worse, not the better, when there was a chance to make the changes for the good. In the past the model for hospitals had been more of a public or non-profit ownership and management. Now a majority of the hospitals, labs and other service providers has moved to being owned by "for profit" corporations. Many of these company's goal is not to serve the community, but to squeeze every last penny out of the operations to please the CEO (via his multi-million dollar bonus) and the stockholders. When this much money and self-interest are involved, change will be difficult if not impossible. One note: You are comparing what are the best (Germany) and what may be the worst (US). Others in Europe are not so lucky. Here in Spain the public health sector is in trouble. Lack of funding, understaffing, poor management and a terrible administrative plan have brought it close to failure. The bureaucracy involved, that would make Machiavelli jealous, and the waits for care have driven many to private insurance, at personal cost, just to get timely and adequate care.

I have a "decent" insurance (since I work for a hospital In Oregon, USA), but because my baby is due in January and my year deductible is $3000 which I will probably have to pay again in January and have no idea of what other complications or charges I could have. I decided to go home with my family in Bolivia and spend that money there. Where I have a support system, and even without insurance, I can choose any private clinic I trust and still pay less than just the deductibles in case I need a C-sectio compared to the US after deductibles. I would also have a consistent provider and better care. It is sad, but it is the reality. Insurance companies in the US are a complete scam! 😂

8:28 Yeah ... 6 pills Ibuprofen 18,30 USD .... and at Wallgreen or such store, you pay .... 5 USD....? .... for ..... 50 pills .... ?

Here in the Netherlands it is almost the same as in Germany. I pay a premium for myself only 155,00 euro a month and I have an own risk to pay every year of 385,00 a year. About 2 years ago the doctors in hospital detected a tumor in the colon and metastase in the liver. They started with an intensive chemotherapy and I am still on a ;lighter chemo at home. It is going well so far. But if you look at the bills my health insurance had to pay every month, it is huge. I think only last year it was more than 30.000 euro. I did not have to pay for anything.

In Austria, we do have a system that can be summed up like this (in US terms): You are automatically insured through the taxes you pay. The coverage is 100%, except for take-home prescription drugs, which cost a maximum of 6,85 Euros per box. The overwhelming majority of doctors are in-network. There are a few things you can get that cost extra, like a single room in the hospital, but everything that's required is covered.

Here in Belgium, the state pay a big part of the bill (but that's one of the reason my country is the one where you're the most taxed) and the insurance cost you pay is even called "complementary insurance fee" as it is used for additional perks like glasses reduction, sport licences reductions... We also have Hospital and Dental insurances but they exist to cover non life-threathening things or confort supplements. Also, the price of most medical action is fixed by the state. Doctors can charge more ifor their work out of hospital buildings and if they do the difference is paid by the patient then. Overall, Belgian health care system is often considerate as one of the best of the word and I was never scared of the cost of it so... I'm pretty happy with what I have here :D

In addition to all the other interesting information, I was once again shocked by the strange relationship to opioid painkillers in the USA. Which doctor in Germany gives a woman oxicodone after a complication-free delivery?

American health-care equates to extortion. Note: I lived in the US for 22 years and raised two children there, so I know the drill in that sense.

I'm from Germany. I also was both insured privately and via the GKV. And I have to say, I couldn't see any differences. And, although my premiums for the statutory health insurance are staggeringly high, I am glad to be part of this concept and happy to pay my share, even if private would be way cheaper, at least first glance. I can see the point made about the closure of hospitals. As soon, as you are not allowed to bill fantasy prices, the market will take over and shutdown uneconomical businesses. But that is, by itself, not necessarily a bad thing. Healthcare is nothing one could make a profit of and also help the people. It is a costintensive task, helping people getting better. But when everybody is participating in something like a statutory health insurance, the people, in this case the government, of course, then can decide how much healthcare is worth to society. And even if a hospital is not profitable anymore, it might be necessary to the society, so the society can decide to put extra funding into that specific hospital. With all the money currently bound to the medical care system in the United States redistributed, there are almost endless opportunities. Although that money won't end 100% in the Medicaid programs, it sure will suffice to fund those programs for all Americans. It is as always, when you cut out the middleman, you win.

When we moved to the Netherlands we were pleasantly surprised at how low our insurance costs were. In the US we were paying per month about what we pay here in the NL per year, and here we also have opted to include dental, which wasn't even an option in the US. Also when my husband was in an accident here, there was no bill for his visit to the ER, or followup visits. One thing you missed in your coverage, is when you have an issue in the US you in general lose your insurance, but are offered COBRA, which since, it's not supplemented by your employer is twice as expensive. It happened to me, and was out of the question, since my disability payment was so low. I ended up on medical.

I am privately insured as I am a civil servant and had the choice when I started my careeer as a teacher. My husband has mandatrory insurance with the same insurer like you. Being in our seventies we had operations and hospital stays etc etc. Both of us are/were cared for really well so far independent from our type of insurance. Maybe we are lucky as we live in a city with a university clinic like you ? What we noticed is a strain on our local GP center since Covid but.

I’m a Swede that has MS. During all my time in hospital I’ve payed roughly 500$ excl taxes. And yes taxes are high but I haven’t payed Nearly enough taxes to cover the total cost of more than Twenty MRI’s, a total of Nine months in hospital, Three months of Rehab, a Wheelchair, meds etc etc. I’m a conservative and know of No other conservative in Sweden that are nothing but For universal healthcare. I Hate it when quasi conservatives in the US call it “Socialist”. I wonder how many Socialist countries there are that have universal healthcare…

I'm from Belgium (where there's the same kind of public health care) and I think the Healthcare is pretty good and probably better than your average American hospital. You pay nothing or next to nothing and you can even take cheap private insurances on the side that cover the extra cost (such as single rooms which comes with extra cost while the shared room is free). Ofc you have hospitals that are more renowned in this or that field where you can go if you want or you can always fall on someone not competent or caring but that can happen in any country. The US may brag they have the best specialists which is debatable but might be true but even then, they would only be available for the .001% who can afford it. In Europe we pay more taxes but we have basically insurances against any weird surprises that could happen. We have Healthcare, we have secured retirement benefits that can't be stollen or lost by employers, employers cannot fire us without proper cause, we get a severance package/delay depending on the time in the company and if we weren't fired due to serious causes like stealing...we get unemployment benefits for a while. It basically guarantees no bad surprises and if we're getting paid less, we have less to pay and stuff like rents/house prices are scaled with the salaries (due to the law of offer&demand)

I'm from Sweden and we had 2 children in the 1970s, we had bad finances but it didn't cost us anything. Later in life I have had 4 operations, shoulders, stomach. Free except for a cost of SEK 200 per day at the infirmary. All tests and x-rays are included.

Thanks for another informative, well researched blog. Always looking forward to ALL your posts. Best regards to your GUYS.❤

My son was born in Adelaide, South Australia. We also have a Medicare scheme, so I had no out-of-pocket expenses. While my pregnancy was fairly non-eventful, my labour was not. I ended up with a stalled labour, not fun. For the most part the staff were excellent. All rooms in my ward were single/private rooms and we were recommended to stay a full 7 day week to ensure we were both okay. On ward was a fridge full of ice packs and a lactation consultant. Also each new Mum was sent home with a gift pack containing samples of pads, nipple protectors, nappies, wipes, moisturisers, etc, etc, etc.

Birth in USA: Money and Panic Birth in Germany: Love. Just Love

Argh! Twice! Once in Poland and once in Canada. I had to pay for the PARKING! Why is the hospital parking so expensive 😢 . That's all I had to pay for.

Yet another excellent deep dive into the topic. The only thing I would suggest you add is how much your yearly insurance payment works out to be, and compare that to what you (or your employer) might pay in the USA. I live in Australia, and even though Medicare is a kind of universal heathcare, it's been considerably weakened over the years and we're becoming more and more like the USA. That said, when I had a heart attack about 10 years ago, the only bill I received was for the medications I took home, and I consider the care that was given to me to be excellent. Were I living in the USA at the time, I fully expect I would have become yet another medical bankruptcy.

I think something that is really important as well is that neither I nor any Doctor has to worry about if I can pay for treatment. Usually payment is never mentioned. Only my treatment and I think that's so important for recovery.

Hello from poland! The biggest issue I faced with universal healthcare are wait times for appointments with specialists and even for family doctors in some areas. Thats one of the reasons why many peoplehave private insurance or just go private out of pocket. My father for example had to have knee surgery but would wait even two months for one through universal healthcare, so he did it privately. We are blessed enough that we could afford it. It created a funny situation, that in our capital you can sometimes get a visit with a family doctor under universal healtcare faster then private, because so many people don't even try scheduling under UH. The looks of some hospitals and clinics also could be better and pay for doctors, nurses, paramedics and rest of the staff, so more people would go into this careers in poland than moving abroad for better earnings.

Maybe I missed that information in the video, but in case I didn't: Costs are not only significantly lower for the insured individual in Germany, but overall as well! According to an Viactiv (German Health Insurance Company), a birth costs the insurance company in average about 2-3.000 Euro. In the US the average birth costs about 13.000 €. That's about 5 times the costs in Germany! This is the perfect example for why free markets may lead to very inefficient solutions, when information is distributed asymmetrical and multiple principal-agent-problems are involved.

I'm living in Germany and and a big proponent of one(!) Healthcare for everyone, not even secluded in privat/public, and different insurance companies. Have everyone pay a small but consistent portion of their income into said insurance. The overall quality for everyone is going to rise.

My wife had a high-risk pregnancy and gave birth to our twin girls by planned c-section. Twins are usually brought out early if possible (less wear and tear on the mother) so my wife had hormone shots to help the babies develop their lungs faster. It worked on one but not the other. Despite the fact that my girls had a tag-team weight of 15 pounds, one of my girls was in an incubator for most of a week. My wife was able to keep her room in the hospital until we were all done (i.e. most of a week) and then we all left at once, rather than have us day-trip-it back and forth to see the one in the incubator. Cost us nothing but parking and vending machine snacks. We are Canadian.

Your experience relects my experience and that of my kids (with 5 births between them). In other words, very postive. However, I have often heard the statement "in Germany, privately nsured patients subsidize publicly insured patients". In the US, the hospital bills are at best a joke, at worst a scam. I think that the numbers are just made up to scare patients into being happy to pay high deductibles, because the insurance companies don't pay what's on the bill either, rather only a fraction of it.

Everyone in the US is so afraid to pay taxes. But then having to pay a lot of fees and healthcare for a much higher amount of money is apparently much better!

When politicians here in the US say that women aren't willing to have babies because feminism poisoned their minds, I laugh only because I will scream with rage otherwise. Women aren't willing to have babies because it is financially and life-ruining. The medical bills are insane, there is no support for raising them, and houses are so expensive that I can't afford one in a nice area that won't burn down -- and I make a six-figure salary. You need a HALF MILLION FSCKING DOLLARS TO BUY A HOUSE. Are you out of your mind? If you have a kid and can't manage it yourself, the politicians sneer and go, "Guess you should have kept your legs closed then, huh?" Then, women keep our legs closed, and they complain about THAT, and blame feminism of course. The US has managed to create a country where literally no one who isn't a multi-millionaire (or married to one) can reproduce. Congratulations, us. Way to go. USA, USA, USA, etc.

25k for a "Semi private" bed and 26k for "delivery room" is a Rip off, a Scam. It's like they pull prices out of their imagination. Here in Lithuania, It's not only It's free (delivery, bed for as long as you need, help, doctors, courses, etc) you get "Newborn Create" with 2 months worth of supply for your baby

My parents as well as I are chronically ill (rheumatism for me and my mom, the aftermaths of a brain bleeding for my dad). We never had anything serious to complain here in Germany. The medical team in our clinic sure safed my dads life when he had that bleeding and the clinic in Heidelberg did good as well, so he is mostly healthy today with minor issues. And I as well was taken gread care of when my rheumatism came up 2 years ago. I have to pay 10 Euro for my medicine as co pay, but if the yearly costs exceed 1% of my income, I can reclaim that amount (normally it is 2%, but that is halved when you're cronically ill).

Thanks so much for this interesting video! I gave birth to my first son last summer here in Germany and for some reason, I was sent a copy of the bill which was sent to my insurer. This way, I know exactly what the insurer had to pay for my relatively easy birth at a "normal" clinic (not a specialized clinic): ***1800 €***. To be fair, I didn't have any operation and didn't need any pain meds. Also, my partner and I only stayed for one night and I got further care from my midwife who visited us at home and helped with breastfeeding and all the things you don't know as first time parents. It's always shocking to me how much more medical services cost in the US!

As a point of ihterest: AOK stands for "Allgemeine Orts-Krankenkasse", meaning roughly "Common Local Healthcare Provider". AOK are the non-profit statutory health insurance providers founded by Otto v. Bismarck in 1876. Ever since, it is mandatory in Germany to contribute to healthcare as soon as a person enters the wotkforce, the contributions being split halvesies between employer and employee. There is also a possibility of getting private insurance which only means you pay way more for minimally better service... however: the systwm is not perfect but good enough so as to provide almost everybody with medical care, even homeless people and hookers.

In my opinion, the US healthcare system is a disgrace for the population. Health should not be a case of "making money" but of human restoration. Those responsible have the wrong perspective. It is obvious that a hospital has to cover its costs, but why is the insurance system staggered so that not all costs are capped? That's the shame of the system... There is full insurance coverage everywhere in the world, but the richest country in the world is starting to charge its own population for insurance... Of course at the expense of people-----is that fair???

On top of all that, Germany can also calculate much better because of real (and not blown up) prices. On average the total cost for a natural birth is 2000-3000 €. With a C-Section it's 3000-4000 €. These numbers are from health insurers and accurate. Compare that to the US bills, you presented. It's what we would call in Germany "Mondpreise".

I am German. I had private health insurance for some time but now I am back to public insurance. I did not experience any real problems with public insurance. What I did notice: As a private patient you are likely to get an appointment sooner and there tend to be more "frills". One MD really has a separate waiting room, which is more nicely decorated (I do not mind, that is very low on my priority list). I am not a MD myself, but I had the distinct impression that I occasionally received treatments chiefly because of financial reasons instead of medical reasons while being on private insurance. (They just found somebody whom they could bill more).

Ashton, I have now watched several of the videos from you and Jonathan and I continue to be impressed. Many of those videos, and this video in particular, though highly instructive to American viewers, are a significant contribution to European civilisation in that they highlight the ways in which Germany and its neighbours have become the most successful nation states in the world. Thank you. As @skinnyjohnsen states in their comment, "not only ... freedom to do things, ... but ... freedom from things". It may surprise you to know that to some European observers, Germany's older, often insurance-based model of universal provision (not just medical but other universal services), seems clunky and involves too many, sometimes profit-taking, actors. Here in Scotland, medical care, apart from dental where there is a system of partial charges and capped billing, is all free at point of use, including things like pharmacy and eye tests. This is paid for by Scotland's non-monetarily-sovereign second level of government that is in a similar position to a German Lander or US State. Nobody pays anything for emergency medical care regardless of their citizenship or residency status although there may be surcharges for other care for some overseas visitors that is aimed at detering medical tourism. The result is a healthy and worry-free population and health spending that is about the OECD average and 40% of USA health spending. Even from a hard-nose financial point of view, this free non-contributory system makes perfect sense. What is the economy? PEOPLE ARE THE ECONOMY. When a component of the economy goes wrong, we do everything to fix it. When a new component of the economy is born, we do everything to to ensure it can grow into a healthy functioning part of the economy. I can even put real numbers to this. Some government departments, when recently establishing life-saving services, have used a "Value of a Prevented Fatality" of two million pounds sterling. While many shiver at the thought of actually putting real numbers against the value of human life, in practice, it helps to prevent us from dithering over the detailed cost of things that keep people alive!

I'm in Australia, have had three children through the public health system and didn't pay for a thing for their births. I cannot imagine living with a system like the US - it seems so inhumane. I recently watched footage of elderly and sick patients being walked by security guards away from the hospital and being left on the footpath a block away because they had no insurance. One lady was laid on the footpath with a towel thrown over her head and her belongings in a plastic bag nearby.

"how health insurance works in the US" Wait, health insurance works in the US? Like, at all? It's the main reason I absolutely refuse to ever even consider applying for US citizenship. E: regarding private insurance here in Germany, it bears mentioning that as a government official (Beamter), it almost always makes no sense remaining in a public insurance. Sure, you usually have to submit any bills you receive to them yourself, but the government (Beihilfestellen) will actually take care of half of your health insurance. You will only pay 50% of the private insurer's premium, and in turn they will only pay out 50% of the cost of any medical procedures. The rest will come from the government. Once you retire, the amount due from the government increases to 70%, and the insurer's drops to 30%. Which means you will always have to submit any bills to both your insurer as well as the Beihilfestelle. There are some things the Beihilfestellen won't pay for, so you actually need to have an "addon insurance", but that's only a few bucks on the whole. At worst, you'll end up with a ~49/51 split, so the difference is rather academic. This does not generally apply to public insurance (IIRC some states have exceptions), so if you remain with that, you will pay 100%, but not have to worry about having to submit any bills. And to add insult to injury, you will generally pay 100% of a sum that is greater than even the usual 100% sum of a private insurance is. Which is also an interesting point regarding our military budget. Retired lifetime soldiers also fall under that 70/30 insurance pay structure, and that money is actually deducted from the military budget, same as their pension. Consider now that there are still a lot of retired soldiers around who were made lifers before the end of the Cold War. That's a huge financial burden on ourMoD - especially because as we age, healthcare intervention always increases in frequency and in value.

In America, we have socialized medicine... in the military. When my dad was in the Navy, my birth cost my parents 52 cents. I still have the bill. My parents were changed for registering a live birth in California and the bill had nothing to do with the military hospital. According to a research group at Yale University, socialized medicine would save Americans almost half a trillion dollars a year. The medical industry in the US is one big grift. If Republicans need a reason... Sixty years of socialized medicine could save enough money to pay off the national debt.

Healthcare in Germany is currently confronted with massive problems mainly due the "Fallkostenpauschale" (case-dependent flat-rate allowance) system, introduced in the 1990s. Within this system clinics get a fixed sum for each case based mainly on diagnosis and treatment duration, which is pre-negotiated by the association of statutory health insurances and the umbrella organization of hospital owners (DKG, Deutsche Krankenhausgesellschaft = German Hospital Corporation). That however led to misallocations, unnecessary surgery treatments and financial difficulties of hospitals due to unpaid costs for provisions (including e.g. providing capacities for events like a pandemic), underpaid "conservative" treatments, uncovered complications and so on. That's the reason for the currently debated reform which (inter alia) aims to appreciate the providing of excess capacities for emergencies etc. and also to offer better payment for hospital staff.

How are those markups om medical legal? Like that stool pill or nipplecream? What if I bring my own to save on costs. Would they kick me out?

I am German, but lived in the U.S. for almost 10 years and both of my children were born there. Ou first daughter was born while my wife was studying at the University of Minnesota as a foreign student. Therefore, my wife was insured through the University‘s health plan for (foreign?) students. She received exceptional care, had a spontaneous birth without complications, stays in the hospital for two nights. Co-Pay was ZERO. At the time she gave birth to our second child, she was covered through my health plan as an employee (in a management position). As I had no point of reference, I believed my co-workers that our plan was „very good”. our second child was also born without any noteworthy complications, however, my wife received an epidural. The stay was also 2 nights. Co-Pay: 8.000 USD. And yes, EVERYTHING would have been free of charge in Germany, except, of course, our monthly contribution to the social health care system.😊

Want to know why a lot of Americans don’t travel? Healthcare costs. I think it’s also lost on a lot Europeans that Americans are well aware of the issues but we are not able to vote our way out of our bad healthcare system bc of structural limits endemic to a presidential vs parliamentary system of government. Sono parlo come un cittiadino d’Italia Anch’io I unisci stati.

German nurse here, working 10 y in german hospitals..pls be aware that someone is paying the price..in germany its us the nurses and Assistenzärzte who are severly underpayed and exploited. Statisticly proven. Check income comparisons in relation to the rest of german cititzens and then check nurses income compared to their countrys average in the us and other european countrys. Our healthcare system is equally bad as the us, probably worse cause of its dishonstey. Even many German friends of mine who dont work in healthcare dont know how bad it actually is, and they dont believe it to its fullest, because it dosnt fit their reception about germany. As you can see in the many patronizing comments about whats wrong in the us. Covid made the Situation worse, but it was there before. I will probably make a yt video why i love the us and dislike germany, just to provoke my patriotic countrymen. I lived in the us, as an exchange student for one year, so i have at least some humble real life comparison. Greetings from Frankfurt. PS. Still waiting for the money Mr. Lauterbach(Gesundheitsminister (Health care dude in the goverment)) promised for our Covid effort, which was hell and led me to quit my job last year. I will never work in german health care again. PPS. Any US Women around? I need Citizenship, 41yo male, decent looks.

I work for a call center that sometimes has USA medical issues. The fact that I can't say to them that healthcare is a scam and they're better off without it, hurts me 😢