How the German health care system works.

[blackbird]

Canada would do well to seriously examine the German health care system.  The problem is in Canada we have two major levels of government and the provinces are mainly responsible for health care.  There are major problems in the Canadian health care system but it seems there is no way to fix the problems.  The system is paralyzed.  I don't know how Canada can rectify that.  It seems our confederation is more of a hindrance to fixing the health care system than a help.  How do we get around that.

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Public Health Insurance (GKV)

Eligibility: Mandatory for employees earning below €73,800 per year (2025 threshold), students, pensioners, and people receiving unemployment benefits. Freelancers and self-employed individuals may choose GKV or PKV scienceinsights.org+1.

Funding: Contributions are income-based, currently around 14.6% of gross income, split equally between employer and employee, with additional supplementary contributions varying by fund www.doctolib.de.

Coverage: Includes doctor visits, hospital care, prescription drugs, preventive services, and long-term care. Non-working spouses and children are covered at no extra cost scienceinsights.org.

Administration: Managed by about 105 non-profit sickness funds (Krankenkassen), which negotiate fees with providers and hospitals. The Federal Joint Committee determines covered services and quality standards commonwealthfund.org.

Private Health Insurance (PKV)

Eligibility: Available to employees above the income threshold, self-employed, and civil servants.

Premiums: Calculated individually based on age, health status, and risk factors. Young, healthy individuals often pay lower premiums, but costs increase with age. Each family member requires a separate policy scienceinsights.org.

Benefits: Often include faster access to specialists, newer treatments, and more comprehensive coverage than GKV. Switching back to public insurance later can be difficult scienceinsights.org.

Historical Context

Germany pioneered social health insurance under Chancellor Otto von Bismarck in 1883, initially covering workers and gradually expanding to universal coverage by 2007 commonwealthfund.org+1. The system is built on principles of solidarity, subsidiarity, and corporatism, ensuring access for all while allowing self-governance by insurers and providers Wikipedia.

System Features

Universal access: Nearly all residents are insured, and hospitals and doctors treat patients regardless of insurance type commonwealthfund.org.

Self-administration: Providers, insurers, and patient representatives share decision-making, with the government regulating but not directly delivering care www.doctolib.de.

High-quality outcomes: Germany has high physician density, low infant mortality, and strong life expectancy, reflecting effective healthcare delivery Wikipedia.

Funding scale: Healthcare spending is about 12–13% of GDP, making it one of the most expensive systems globally www.doctolib.de.

Challenges

The system faces pressures from an aging population, workforce shortages, rising demand for services, and administrative complexity. Policy priorities include addressing climate change, infectious diseases, and antibiotic resistance www.doctolib.de.

Summary

Germany’s healthcare system is a dual, universal, and highly regulated system that combines public and private insurance to provide comprehensive coverage. It emphasizes solidarity, equitable access, and self-governance, ensuring that nearly all residents receive medical care while balancing cost, quality, and efficiency Wikipedia+2.

unquote

 

Edited May 9 by blackbird

[John Stone]

sound socialist. 

Many would rather die, free! 😄

............... and penniless. 

Edited May 10 by John Stone

[Michael Hardner]

11 minutes ago, John Stone said:

sound socialist. 

Many would rather die, free! 😄

............... and penniless. 

9% more is spent in the German system per GDP than in Canada.

 

 

[John Stone]

8 minutes ago, Michael Hardner said:

9% more is spent in the German system per GDP than in Canada.

 

 

............. and arguably spent wisely and efficiently? 

A one-payer cannot be efficient if the 'model' cannot keep pace (or wont') with the consumer. 

 

Edited May 10 by John Stone

[I am Groot]

On 5/10/2026 at 8:40 AM, Michael Hardner said:

9% more is spent in the German system per GDP than in Canada.

Perhaps. But look what they get for it. I'd take it over our system any time.

[blackbird]

This article helps explain the problems with out system.  Because health care falls primarily under provincial responsibility, it seems it is up to each province to fix their system.  The problem with socialized systems like this is the governing party is under tremendous pressure with demands for every kind of thing under the sun.

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Canada's healthcare system is facing a significant crisis characterized by a severe shortage of healthcare professionals, leading to long wait times and limited access to care for millions of Canadians.

Overview of the Crisis

Canada's healthcare system is currently under immense strain, with emergency rooms closing in rural areas and millions lacking access to family doctors. Approximately 2.5 million Canadians do not have a family physician, and many healthcare facilities are unable to meet the growing demand for services. This crisis is exacerbated by a shortage of healthcare professionals, including nearly 23,000 family doctors and 28,000 registered nurses needed to adequately serve the population forcitizenship.ca+1.

Causes of the Shortage

Several factors contribute to the growing gap between healthcare needs and supply:

Aging Population: Canada’s population is aging, leading to increased demand for healthcare services while the workforce struggles to keep pace with this demand www.cihi.ca.

Burnout and Workforce Exits: Many healthcare workers are experiencing burnout due to overwhelming workloads and long hours, resulting in a significant number leaving the profession. In 2023, 40% of nurses reported plans to leave their jobs or the field entirely forcitizenship.ca.

Fragmented Licensing Systems: Internationally educated healthcare professionals (IEHPs) face barriers in obtaining licenses to practice in Canada, leaving many qualified individuals unable to contribute to the workforce forcitizenship.ca.

Inadequate Training Capacity: Medical schools and training programs have not expanded sufficiently to meet the growing demand for healthcare professionals, leading to a bottleneck in new entrants to the workforce rednwhite.ca.

Impact on Patients

The shortage of healthcare workers has dire consequences for patient care. Canadians are facing longer wait times for appointments and treatments, with some patients waiting an average of 131 days to see a specialist. This delay can lead to worsening health conditions and increased hospitalizations amhg.ca. The crisis also results in overcrowded emergency rooms and a reliance on temporary staffing solutions, which can compromise the quality of care cdhowe.org.

Potential Solutions

Addressing the healthcare crisis in Canada requires a multifaceted approach, including:

Increasing Training Opportunities: Expanding medical and nursing school capacities to produce more graduates who can enter the workforce rednwhite.ca.

Streamlining Licensing for IEHPs: Reforming the licensing process for internationally educated healthcare professionals to allow them to practice more quickly forcitizenship.ca.

Improving Working Conditions: Implementing measures to reduce burnout among existing staff, such as better support systems and manageable workloads www.cihi.ca.

Investing in Technology: Utilizing digital tools and AI to improve efficiency and patient data management, which can help alleviate some of the burdens on healthcare workers amhg.ca.

In conclusion, Canada's healthcare crisis is a complex issue that requires urgent attention and coordinated efforts from government, healthcare organizations, and communities to bridge the gap between the growing need for care and the available supply of healthcare professionals.   unquote

Canada's Healthcare Crisis: The Growing Gap Between Need and Supply - Search

[I am Groot]

Nothing can be done to fix Canada's system. It has to be changed to match the better run systems in Europe. But nothing will work until we get more doctors and nurses. Training spaces in medical and nursing schools need to at least double, even if that means bringing in retired doctors and nurses to teach or importing them on temporary visas. We also need more diagnostic machines and technicians. 

All of which can be solved with more money and willpower. Unfortunately, the federal Liberals have shown no interest in doing anything to solve this, having convinced their gullible supporters that the provinces are entirely responsible.