The German health insurance system also has a deficit of 6 billion euro, while doctors are leaving the profession. Do you think that's sustainable?

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pavlov 17 hours ago | parent | next [-]

For a country with a $4.5 trillion GDP, a 6 billion deficit is a drop in the bucket and easily covered from taxes. It’s just a political question of what you want to fund.

For comparison, the New York City public transport system (MTA) runs a deficit of about $3 billion. Six billion for universal healthcare in a country of 83.5 million people seems like a total bargain.

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jacquesm 15 hours ago | parent | prev | next [-]

> Do you think that's sustainable?

Yes.

To help you think a bit more clearly: the health insurance system is not a for-profit system, even though some people mistakenly hold on to the idea that it should be. It is a risk spreading mechanism.

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tiagod 14 hours ago | parent | prev | next [-]

Not everything needs to be profitable.

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nickpp 11 hours ago | parent [-]

I lived under the very system this principle enabled and I can tell you that without the profit motive we were cold and starving since there was no motivation for people to work and sew clothes or grow food.

	▲	tiagod 11 hours ago \| parent [-]
		I didn't write "nothing needs to be profitable". I live under a system where even very expensive treatments are covered by the state using taxpayer money, and I'm not starving. Sometimes you need to optimize for human dignity.

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hermanzegerman 16 hours ago | parent | prev [-]

10 Billions of that deficit are coming from the State paying insufficient contributions for unemployed insured people. It is a policy choice to offload those costs onto Publicly-Insured-People (excluding rich and healthy people) instead of funding them through taxes (including those groups).

The German Healthcare System also has some historically developed peculiarities that don't make much sense in today's age, but they are difficult to address without pissing people off (The duality of Private and Public Health Insurance, allowing the first one to get rich and very healthy people out of the risk pool, and then loopholes to switch back into the public system when they grow older and don't want to pay the then high prices in private insurance)

The Hospital Reform is already working to reduce costs by reducing the number of small hospitals, and concentrate them into bigger ones. (As a side effect, quality of care will increase too, since outcomes are correlated with experience)

Also more care will be shifted to outpatient setting.

Otherwise we are fighting with the demographic change. But these problems are also hurting all other developed nations including the US, where funding problems in Medicaid are also expected in the next decades

tl:dr We have problems due to the demographic change, but these are in line with other developed nations. There are some efforts to address them, but politicians are hesitant to do real reforms, because old people have the most voting power