The author recently experienced firsthand what many Germans complain about: after an emergency, the first hospital turned him away, and at the second he waited five hours for the initial examination. His personal experience matches the widespread impression that medical care in Germany is inadequate. But the statistics paint a different picture.
At a scientific conference, the author heard a lecture by health economist Boris Augurzky from the RWI-Leibniz Institute in Essen. Augurzky, who served on the hospital reform commission of Minister Karl Lauterbach (SPD) during the traffic-light coalition, refuted the anecdotal evidence with aggregate figures. Germany spends 12.2 percent of its economic output on health – more than Austria (11.5 percent), Switzerland (11.5 percent), or Denmark (9.5 percent).
Many doctors, many hospitals – but only mediocre results
With 4.7 doctors per thousand inhabitants, Germany is at the top internationally. Hospital density and the number of nursing staff are also above average. Yet life expectancy – 82.9 years for women and 78.2 for men – is below average. The Organisation for Economic Co-operation and Development (OECD) criticizes not only the high costs but also excessive bureaucracy, uncoordinated treatment pathways, and too many operations.
Financing problems are growing: if nothing changes, the social contribution rate will rise from the current 41.9 percent to 48.7 percent by 2035. At the same time, the number of patients is shrinking. According to Augurzky, the contradiction between individual perception and statistics has one central cause: society’s expectations.
The desire for maximum care blocks reforms
“Ideally, everyone would like maximum care on every corner,” says Augurzky. Health is treated as a “priceless good” that must not be economized. The result: every hospital must be preserved, every new service financed, every waiting time prevented. When a hospital in the neighborhood closes, the outcry is loud – amplified by mayors and district administrators who fear for their re-election.
The economist, by contrast, thinks in terms of marginal utility: the first rural doctor in a village brings enormous benefit, the fourth much less. But prioritizing health services is politically sensitive in Germany. The costs of reform are immediately visible, while the benefits lie in the distant future. As long as society demands one hundred percent security, little will change in the misery, the author concludes.
Source: www.faz.net
