Text 26959, 69 rader
Skriven 2009-01-29 08:16:48 av Robert Bashe (2:2448/44)
  Kommentar till text 26943 av Roy Witt (1:397/22)
Ärende: Health Insurance
========================
Roy Witt wrote to Robert Bashe on Wednesday January 28 2009 at 10:02:

RB>> There's no need (in Germany) to ever actually visit a government
RB>> insurance office unless you have some questions that can't be handled
RB>> by mail, email or phone.

RW> In order to do your 'social welfare' business by mail, email or phone,
RW> one has to know 'where' to get such services, right!

You're right, although such things are so well-known in Germany that nobody
really has any problem with them. The largest government health care
organization is called the "Allgemeine Ortskrankenkasse" or AOK (general local
health care system) and they have offices all over Germany, even here in
Datteln. The rest are scattered throughout the country, and some cater to
specific occupations (my son, unfortunately government insured - but with
additional private insurance to make up - is a member of the Techniker
Krankenkasse = government health care system for technical/engineering
occupations, since he's a gardening "engineer"). All in all, there are at
present around 150 different government health care systems ("insurance
companies"), and within certain (politically stipulated) restictions, you can
switch from one to another. This used to save you a considerable amount of
money, since some "companies" were better managed than others and charged lower
rates (as little as around 12.5% of your gross salary), but that's a thing of
the past now that the federal government has started setting one single rate
for the entire system.

AND allows the individiual companies to extract an additional 1% of the gross
salary from their "customers" (who can't just give notice and leave the system)
if the rate set by the federal government doesn't cover all expenses. Naturally
this benefits the more poorly run "companies" (or those who provide more
service - the coverage is essentially the same for all, and is set by the
government and an advisory group of physicians and hospitals).

The system is very complex, very expensive, very political and very poorly run
- but don't count on any real change in our lifetimes. I'm glad that at least I
and my wife are privately insured. And even that is a complex subject, since
she has worked as a teacher (here a tenured public servant), and her situation
was and is (she's now set for retirement) that half her medical expenses are
paid by a penny-pinching department in the state school system administration,
whereas the other half must be privately insured.

Said penny-pinching department, the so-called "Beihilfe", also pays half of the
medical expenses for dependent children and - hold your hat - SEVENTY PERCENT
of the medical expenses for spouses earning less than EUR 18,000 in the
previous year. Theoretically, I could reduce my private insurance (which pays
100% of all medical costs except dental work, for which I get 75% at present,
increasing by 5% a year to max. 100%) to 30% reimbursement and doubtless save
money - BUT the Beihilfe is like the government health care (second-class
medicine, not so much the treatment as the service - long waits aor
appointments, hospital rooms with 3-6 people and the like), and there would be
no way back if I ever take this path, since my age and health condition would
make it impossible to _increase_ my private insurance coverage (at least at
some halfway reasonable cost).

All very complex, as you see, but as Germans grow up with this, they can more
or less find their way around in the system. Takes some doing, though, when you
first arrive here... I can still remember how I, as a freshly-immigrated
American, wanted to visit a doctor just to "get to know" him, as was common at
that time in the States. I was surprised to get a bill later, and only
understood why after talking to the doc again. He was as flabbergasted that
people in the States go to a doctor just to "get to know" him as I was that a
"getting to know you" visit was billed in Germany.

Hope all that has confused you enough for today ;-)

Cheers, Bob

--- GoldED+/W32 1.1.5-0613
 * Origin: Jabberwocky System - 02363-56073 ISDN/V34 (2:2448/44)