One of my Dad's lessons when I was a teenager was "how to deal with health insurance." I'm sure when I was 16 I found it an occasion for eye-rolling, but today I was very grateful for that lesson.
Upon our move to Berlin last year, Ryan and I became enrolled in the German public health care system. This is government-mandated health insurance run by private insurance companies. The insurance companies in the public system cover mostly the same things and have the same fee structures. There are small differences to each, but it didn't seem like choosing amongst them was particularly important. Ryan paid 7.5% of his income, which his employer matched, and we paid 10 Euro a quarter to visit a doctor. Both of us were covered and life was pretty good.
Last March, when I started working full-time, I was disappointed to discover that I, too, was expected to pay into this scheme. The problem is that my income varies quite widely from month to month. After much back and forth with the insurance company, it was decided that I would pay 316.00 Euros per month. On a good month that's about 15% of my income, but on a bad month, that's 33% of it. I told the insurance company that it was "bullhockey" (to quote Dad) that our premiums would basically double and we would receive no extra benefit. But that's the German law. (I guess I'm just supposed to stay home and have babies.)
So I started looking for private health insurance (not subject to the German mandates). If you have a regular job, you can only qualify for this if you have earned over 4000 Euros a month (w/out dependents) for the last three years or more. But freelancers and business owners can also qualify for private without this minimum income.
I've had meetings with two health insurance agents so far, and the process is pretty confusing. Private health insurance is more similar to the American system, with a few exceptions. The standard beginning for the conversation is the same "How much do you weigh? Do you have AIDS?" etc, and I was surprised to see that companies can choose to exclude you based on certain factors, (i.e. those times I visited the student counseling center in college, apparently I'm uninsure-able by certain companies) but mostly they just charge you extra for each "pre-existing condition." The nice thing about the public system is that you don't have to answer private health questions and pay extra for these things. Also, the benefits in the private scheme vary so widely that they're pretty much impossible to figure out without an agent to help you. Luckily, on my second try, I found a very helpful agent. We spent nearly two hours today going over every detail of private health insurance, fee structures, etc. The most bizarre thing is that some companies don't cover mental health, or teeth cleanings, but all of them cover alternative medicines and acupuncture. Just what I need. Maybe they can cure depression by rubbing crystals on one's forehead?
But at last, I've chosen a company. Soon I'll see whether they accept me, and then I will have to see whether this private system is all that it's cracked up to be. I know that if I were a true socialist, I would stay in the public system no matter what, but I guess I'm only socialist up to the point that it gets too expensive. Is that my American upbringing? Maybe so. But lest I excite the ghost of Ayn Rand too much, I am happy to live in a country where everyone has access to health care. And no, it's not cheap. But I'm glad that Germany puts a priority on the health of it's citizens, and I hope that the U.S. will do likewise. (I will still probably buy cheap health insurance, though.)