Table of Contents
Comparison of health care delivery in Germany and Denmark
Health care system in Germany
Germany health care system has been able to implement a health system that covers all its citizens hence ensuring equality for both low and high-income earners. The governments have made health insurance mandatory for permanent citizen and citizens of Germany. It provides its services through nongovernmental health insurance funds that are not profit oriented that are provided in the statutory health insurance system and substitutive health insurance (Mossialos et al., 2015). The municipality in the country plays the primary role in providing healthcare services in the country since it is the one that owns about half of all hospital beds while the state owns most of university hospitals. Various levels of the government are not involved in the delivery or directing finances of healthcare. Self-governing associations take a major role in the regulation of sickness fund and provider association which is provided by the joint federal committee.
On the issue of health coverage and financing, the Germany has both private and public financed health insurance. Most of the health insurance in the country is covered by the government. Sickness funds are financed by compulsory contribution levied as a percentage of total wages up to a ceiling. All employed citizens and other groups like pensioners earning less than $49, 500 per year are mandatorily covered by SHI, and those that depend on them but are not earning are covered free of charge(Mossialos et al., 2015). Those that their earning exceeds the earning threshold can opt to remain on the publically financed scheme or purchase substitutive PHI which is also used to cover public civil servants. However, two-thirds of German population receives their coverage through SHI while the others are covered through PHI. Less than a third of the population in Germany is covered and financed by private health insurance. Only about * million people are covered by substitutive private health insurance. Private health insurance, though being profit oriented, it plays a mixed supplementary and complementary role. It covers minor benefits that are not covered by SHI.
SHI covers all the health-related services and drug prescriptions except those that are excluded by the law that is, lifestyle drugs and those that are excluded following the assessment of benefits. Long care services are however covered separately by the long term care insurance scheme. Out of pocket spending account to about an eight of the total spending, and are mostly used to cover pharmaceuticals, nursing homes, and medical aids (Altenstetter, 2003). Children under the age of 18 are not involved in sharing the medical cost. Those that are not employed contribute to their Shi coverage that is rated based on their employment entitlements and for those that remain unemployed for a long period; the government contributes on their behalf
Germany health care system shares decision-making power between the federal government, state and self-regulated organizations of providers and payers (Mossialos et al., 2015). The government is also noted for the separation of the private and public health insurance coverage as well as the two long-term care insurance system. However, both statutory health insurance and public health insurance used the same healthcare provider to treat patients unlike in many other countries.
For the German government to ensure quality of care, it addresses a range of measures that are broadly defined by law and more detail by the joint federal committee. The government has established different bodies that are responsible for developing instruments for inter-facility and inter-sectorial quality assurance (Altenstetter, 2003). They have also developed means for evaluating quality and certificate targets and make sure that published results are comprehensible to the public. This is aiding the federal government to make sure that there is equal provision of services in the society. All hospitals are necessitated to provide published findings on provided indicators to enable hospital comparisons. The comparisons are aimed at ensuring that there is structural quality and providers have a quality management system.
Germany has developed some strategies that are aimed at reducing health disparities that are delegated to public health services and at the levels at which they are carried out in different states. The government has established more than 120 health-related institutions that are aimed at promoting the health of those that are socially deprived. The government has strengthened the health promotion and prevention and made sure that programs initiated by the institutions have been developed and financially supported (Andersen & Jensen, 2010). The German government has also implemented many programs to improve care coordination to improve coordination among providers in the ambulatory sector. The country has also shifted to electronic health record that is used to store an individual’s details.
The German health care system has conducting reforms in several areas. Over the past few years, the second act to strengthen long-term care was effected which was later followed by the first act which strengthened support for people with long-term care and their families. Both acts have seen health care services reaching individuals who were previously not eligible for long-term care services (Mossialos et al., 2015). The acts have been able to make services more equitably by making sure that services are eligible to people with financial difficulties physical, psychological and mental impairments.
Healthcare system in Denmark
On an international perspective, health status in Denmark can be characterized as being better compared to that of Germany on some factors. According to the comparison made on the type of services provided by the government and their way of distribution, Denmark has a much better health system compared to Germany. The Danish health care system also offers free and fair treatment for all its citizens(Pedersen et al., 2012). Most of the services offered in Denmark are thus free of charge for all its users. For the government to finance its operations, the go Danish government imposed a health care contribution tax. It imposes a health care contribution of 8% on taxable income. On the other hand for an individual to receive health care in Germany one has to be fully covered.
Unlike Germany, where health care is financed by statutory health institution and private health institution, the Danish health care is financed by four kinds of subsidies. The first is the state related subsidy; the second is a block grant from the state, the third one is a local activity related contribution, and the last source of contribution is the local basic contribution (Altenstetter, 2003). The state block covers two-thirds of the total contribution with the rest covering the remaining part. For the government to ensure equality, the basic contribution in a region is determined by the maximum limit that through parliamentary regulations(Pedersen et al., 2012). The activity related contribution is based on how much the citizens use the regional health care.
Unlike Germany where an individual has to be covered to receive treatment, in Denmark, the hospital sector is the one responsible for the five regions. Each region in the state must provide free hospital treatment for residents of the region and emergency treatments for non-residents (Pedersen et al., 2012). Hospital services are used to provide specialized care that cannot be offered in primary or social sector due to lack of specialized knowledge, intensive care or monitoring. This is, however, di from German health care system since most of its regions are equipped with healthcare facilities that can handle specialized care.
Unlike in Germany where citizens have no freedom of choosing where they can receive their treatment since they are regulated by the type of health care coverage that they have, in Denmark, citizens have the freedom of choosing the hospital they wish to be treated in as long as the hospitals have an agreement with the government.
Health care in Denmark is equally distributed in all parts of its region and to every individual in the society compared to Germany. The Danish government has for a long period ensured that its citizens receive quality and health care through government free services being implemented across all its regions. For over a decade, preventive health and health promotion have been given a high priority in Denmark. This is after the realization that lifestyle-related disease was affecting the vast majority of its citizens(Andersen & Jensen, 2010). The Danish government has either initiated or put forward policies and initiatives for public health and disease prevention programs. The programs are aimed at creating a clear focus on risk factors and preventive treatment or preventable disease. The government programs are aimed at increasing the quality of life for the elderly and those with chronic diseases (Andersen& Jensen, 2010). The programs have enhanced the role of an individual, civil society, social network and the social context as a whole for ensuring that the prevention programs are established. Unlike the German health sector, the Danish health care system has for long embarked on measures of ensuring that the general population has a clear knowledge of living a healthy life through taking measurements that ensure a healthy lifestyle.
Both the German and Danish health care system has plans of improving the quality of care and patient safety. Quality improvement is the central agenda of the Danish government. The government is striving at creating a more transparent and accountable health sector. On patient safety, the government established a national wide reporting system for adverse event. The system was aimed at improving patients’ health and safety(Andersen & Jensen, 2010). The main purpose of the system was to collect, analyze and communicate knowledge of adverse events with the aim of reducing the number of adverse events in the health care system. On the issue of electronic health records, both the Danish and German government has effectively instituted electronic health system in their health facilities (Pedersen et al., 2012). The digital connect is aimed at ensuring that there is a coherent development of digital solution at a national level.
- Altenstetter, C. (2003). Insights from health care in Germany. American journal of public health, 93(1), 38-44.
- Andersen, P. T., & Jensen, J. J. (2010).Healthcare reform in Denmark. Scandinavian Journal of Social Medicine, 38(3), 246-252.
- Mossialos, E., Wenzl, M., Osborn, R., & Anderson, C. (2015). International profiles of health care systems. The Commonwealth Fund, 2016.
- Pedersen, K. M., Andersen, J. S., &Søndergaard, J. (2012). General practice and primary health care in Denmark. The Journal of the American Board of Family Medicine, 25(Suppl 1), S34-S38.