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Jim Tait 02/01-02/28/17

home : letters : letters August 17, 2017

6/16/2017 7:28:00 AM
About that German health care bonanza...

To the Editor:

I read with interest Kristy Lutz' recent letter praising the benefits of the seemingly costless healthcare she's received since moving abroad in 2002 ("Having babies in Germany: cheaper and better care," May 26). Ms. Lutz lauds the "freedom" of the German system and asserts that besides a monthly insurance fee beneficiaries pay "nothing." ("Most Germans never see the bill"!)

She further challenges the idea that socialized medicine brings rationing and longer waits for care, before presenting ("just for fun") a comparison of her maternity care experiences in Stuttgart with those of her sister in Milwaukee. Spoiler alert: Germany wins.

A few thoughts came to mind while reading her letter, which I'd like to offer for consideration.

Beginning with the obvious, I think most of us would concede that the American health care system is greatly flawed and has much room for improvement, even as we recognize its strengths in research, innovation, critical care, and chronic disease treatment. But equally obvious is the fact that we're not likely to see much rationing of pregnancy care in any westernized health care system, much less requiring patients to wait. Good luck with telling Mom she can't have her baby until month 12.

Other types of medical treatment, however, are more conducive to rationing and postponement, and surely Ms. Lutz wouldn't deny that waiting times and scarcity are problematic in many government-sponsored systems? Even my sisters-in-law in Vienna and London - who are mostly content with their health care - admit that longer-than-ideal waits for non-critical care are not unusual, leading many citizens to "go private" (that is, pay) for certain types of treatment rather than languish in the queue and accept the risks of delay. And they've been surprised more than a few times at the broad definition of "non-critical care."

Closer to home, stories of Canadians crossing the border for U.S. medical treatment are not hard to find. https://www.usnews.com/news/best-countries/articles/2016-08-03/canadians-increasingly-come-to-us-for-health-care.

We could spend a lot of time debating the pros and cons of socialized medicine, but I'm no expert on the German specifics and have no reason to question Ms. Lutz' satisfaction with her own experience. Frankly, I'm more interested in the irony of her apparent belief that Germany's premium health care comes with little to no cost simply because she finds herself in the enviable position of not "having to consider the question of how I am going to get or pay for health insurance."

That's a remarkable statement. Let's be honest - somebody has to think about how she's going to get that care. And somebody's paying for it - via taxes, subsidies, and competing opportunities foregone.

At the risk of being accused of "American-splaining," would it be too much to ask for a hint of recognition that a not insubstantial factor in Germany's ability to spend so freely on pregnant mothers and their children might have something to do with the luxury of being able to spend less elsewhere? Surely it can't come as a surprise, for example, that there are more available resources to pour into the social and medical welfare safety net when someone else is ensuring - for 45 years - that the Nationale Volksarmee and the Stasi stay on their side of Checkpoint Charlie? And when that same someone continues today to guarantee Germany's national defense for going on three-quarters of a century?

Is that impolite to mention?

I'm glad her family is doing well on the healthcare front (as I am regarding my Austrian and British nieces and nephews), but Ms. Lutz's barely suppressed self-satisfaction - without so much as a "Hey, thanks for taking care of that national security stuff!" - does make one wonder about her grasp of the bigger picture.

Free ultrasounds are great, but if I were in Ms. Lutz' shoes I might be a little concerned about some of the more recent tradeoffs that now come with those benefits in Germany. The U.S. can patrol the sea lanes and - as the 800 lb. NATO gorilla (still very much the case despite the president's gripes about allies' payments) - can continue to keep major international threats at bay. But it's harder for us to help with Germany's increasingly self-inflicted domestic issues.

I refer to the growing problem described by this randomly selected headline from a British newspaper last November: "180 rapes and assaults by migrants in ONE German city." (Capitalization in the original) http://www.express.co.uk/news/world/736402/violence-against-women-german-refugees-rape-sexual-assault-robberies-stuttgart-battered.

For those unable to access the link, here's the opening, featuring ... Stuttgart:

"Increasing numbers of female refugees - including youngsters fleeing forced marriages - are abandoning their accommodation centres in Germany to seek sanctuary in battered women centres as they are subjected to sexual and violent assaults. In and around Stuttgart alone there were 105 rapes, assaults and robberies of women and 77 against children in the refugee centres, but the local government admits that the number of unreported cases is 'significantly larger.' In the state of Saxony-Anhalt there are no figures available but 20 female shelters have now opened their doors to provide a refuge for battered women and children... Yadav, a Stuttgart-based counselling centre for young women in danger of forced marriages or 'violence in the name of honour,' says the number of case will rise in coming years."

Some believe Germany's refusal to decrease immigration by means of discriminating on the basis of ethnicity, nationality, or religion is the right thing to do. After all, whatever additional medical and social care is needed will presumably be paid by the government - at least if the welfare demands of unassimilated immigrants and massive unfunded government pension obligations don't deplete the national coffers first. (Both are serious questions.)

But it's a little incongruous to be lectured in the local paper about the healthcare perks afforded German women even as the threat of sexual assault in Germany (and throughout Europe and the UK) has only appeared to worsen following the horrific New Years' Eve attacks in Cologne, Stuttgart, Dusseldorf, Hamburg, Dortmund, and Beilefeld.  (https://www. nytimes.com/2016/01/15/world/europe/as-germany-welcomes-migrantssexual-attacks-in-cologne-point-to-a-new-reality.html)

It doesn't help to see the Merkel government respond to the assault epidemic by (a) blaming the victims, (b) warning women and girls to be careful what they wear and how late they stay out, and (c) attempting to cover up the extent of the attacks and the curiously consistent connection to one particular religious group. (http://www.dw.com/en/opinion-go-ahead-blame-the-victims/a-18962917).

Under the circumstances, one might have expected a woman chancellor to exhibit a little more sisterhood, and Ms. Lutz to display a little more humility about her adopted home.

At the current rate of demographic change in Germany (as in much of Europe) - and given its leaders' stubborn refusal to acknowledge or address the problems of unassimilated immigration - I won't be too surprised if Ms. Lutz comes to rethink her decision about where to live and which features of domestic welfare and tranquility are most important to her in the next decade or so.

If she at some point decides to take advantage of the privilege of dual citizenship to return home, I hope it will be with an appreciation of her good fortune to be among the few who have that option.

G.D. Holcombe


Reader Comments

Posted: Monday, June 19, 2017
Article comment by: Tim Stolar

G.D. Holcombe,

What an astute observation regarding security! One can argue the same case with all of these socialized countries within Europe. For many years, the United States has kept the Soviets at bay. And of course, continues to keep the "conspiring" Ruskies at bay.

Equally interesting are the countries that were forced to live under the Iron Curtain and how they have abandoned a socialist type of government. Also note that they are not allowing unfettered "migration", and as such, are safer places to live.

Good letter!!!

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