American vs. German Healthcare Financing

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Healthcare financing involves the payment of the healthcare services’ cost by the government insurance company or private coverage. The US public programs, including Medicaid and Medicare, have been developed to cover the needs of children, older people, individuals with disabilities, and low-income families. Other citizens are required to use private plans to protect their health, which is expensive. Germany is a developed country that has also invested much in its healthcare sector to ensure that people can access and obtain quality medical care services. Therefore, this paper compares the US and Germany’s healthcare financing to determine their various similarities and differences.

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The procedures and guidelines for acquiring an insurance coverage are lengthy, and, in some cases, people might fail to obtain it. The US system, unlike German, has not insured the citizens with health and safety protection (Hahn et al., 2020). Moreover, the German system is essential to individuals since it involves obligatory healthcare insurance (Hahn et al., 2020). Therefore, it allows health insurance coverage to all citizens with other comprehensive coverage at lower rates. These aspects regarding German system reveal that medication coverage in the US health care system is expensive compared to Germany.

In the United States, employers ensure that workers are registered with a particular insurance company to cover their medical needs. For the unemployed people, the government insures them together with their spouses. The elderly and retired in the United States benefit from Medicare Insurance to access healthcare services (Emanuel, 2018). Children’s Health Insurance Program (CHIP) is also used in America to help children access healthcare services at a low cost.

The German government has ensured that individuals can access healthcare services regardless of their differences. For instance, in Germany, all people must have insurance coverage, whether employed or not (Hahn et al., 2020). The German citizens and the legal residents are entitled to free medically necessary public healthcare funded by social security contributions (Hahn et al., 2020). However, citizens must also have private health insurance covering hospitals, outpatient medical treatment, and pregnancy (Emanuel, 2018). Public healthcare covers treatment and services, including immunization, prescription, and dental checks for the retired, children, and the unemployed. This coverage makes the country’s healthcare system one of the best and cheaper healthcare systems globally.

In case of referral, a patient can see any specialist in Germany without an appointment. In the US system, referral cases follow a particular protocol (Emanuel, 2018). The referral programs are essential as they help patients obtain the required treatments and manage their complications. The US health system obliges patients to visit their primary physician for evaluation and refer them to specialists. The patient should be verified by the insurance company for the referral application to ensure the organization covers the costs. After confirmation, the patient then makes an appointment with the specialist when approved. Thus, the requirements to get a referral to see a specialist in the US healthcare system are complicated compared to Germany’s structure.

The pre-existing conditions are the illnesses that recur to the patient whose coverage has already been sustained by the insurance company. In the United States, the 2014 act forced the re-insurance of pre-existing conditions (Sparkes et al., 2019). This law ended the pre-existing disorders insurance plans and helped the citizens cover their conditions that recur and require special treatments. The German system covers all the pre-existing conditions for its citizens using private and public insurance plans (Hahn et al., 2020). Therefore, in Germany, people can access health care services easily despite having a pre-existing sickness.

Financial implications for patients concerning the healthcare delivery differences between the US and German healthcare systems can also be analyzed. Economic issues are experienced in the US health system due to the growing population, aging seniors, and increased chronic diseases. Overbilling during healthcare delivery has also led to many patients experiencing financial challenges. In Germany, the country has a universal multiplayer healthcare system (Hahn et al., 2020). Employers and employees are insured and pay most healthcare services through premium using a contribution pool. All workers contribute about 7.5% of the salary to this public health insurance pool covering the citizens (Edwards & Dunn, 2019). Other individuals in the country, such as the refugees, have benefited from the improved healthcare system (Hahn et al., 2020). Therefore, patients in Germany experience minimal financial challenges when accessing healthcare services. The enhanced system has also led to more people accessing various services such as free screening and medical check-ups, which minimizes the cost of treating diseases that are not detected early.

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Similarities between the two healthcare systems can also be noted. For instance, healthcare insurance in Germany operates the same way as in the United States in terms of aggregating demand and negotiating prices. Nonetheless, funding source differences and management are what lead to some variances. Another similarity is that both systems have largely considered some groups of people. For instance, the governments have guaranteed that older people and people living with disabilities can access healthcare services easily. Therefore, although there are various differences between the German and the US healthcare systems, some connections can still be noted.

To conclude, health is an essential aspect that all countries should consider when implementing various programs. The healthcare financing in Germany and the USA has revealed that countries should develop the plans to guarantee that citizens can access medical services. Older people, the unemployed, and children must also be considered when introducing healthcare coverage. For instance, other governments can embrace Germany’s approach that allows all citizens to have their medical insurances. In essence, health financing is an essential aspect that should be analyzed by all governments when developing their healthcare systems.


Edwards, E., & Dunn, L. (2019). How two Americans fared with the German health care system. NBC News. Web.

Emanuel, E. J. (2018). The real cost of the US health care system. Jama, 319(10), 983-985. Web.

Hahn, K., Steinhäuser, J., & Goetz, K. (2020). Equity in health care: A qualitative study with refugees, health care professionals, and administrators in one region in Germany. BioMed Research International, 1(4647389), 1-8. Web.

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Sparkes, S. P., Bump, J. B., Özçelik, E. A., Kutzin, J., & Reich, M. R. (2019). Political economy analysis for health financing reform. Health Systems & Reform, 5(3), 183-194. Web.

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NursingBird. (2022, July 23). American vs. German Healthcare Financing. Retrieved from


NursingBird. (2022, July 23). American vs. German Healthcare Financing.

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"American vs. German Healthcare Financing." NursingBird, 23 July 2022,


NursingBird. (2022) 'American vs. German Healthcare Financing'. 23 July.


NursingBird. 2022. "American vs. German Healthcare Financing." July 23, 2022.

1. NursingBird. "American vs. German Healthcare Financing." July 23, 2022.


NursingBird. "American vs. German Healthcare Financing." July 23, 2022.