I learned an interesting thing today at the dentist: German health insurance will cover fillings in your front teeth, but not in your back teeth. "Anything that can be seen," said the dental assistant, with a shrug and a roll of the eyes at what weird logic that is.
Now let me say first of all, I have few complaints with Germany's health care system. It works, it covers an amazing range and level of care, it understands (in most cases) that paying for preventive care now saves costs later, and everybody has coverage. No appalling gaps in care like in the US, no horrendous waiting times like in Canada, no being locked into one provider like in the UK (at least in my shaky grasp of that system, which I admit is only based on a sole experience of once having had to take a local friend to the emergency room in Scotland.)
In Germany, you have a choice of which doctor to see, you generally get an appointment within a reasonable time frame, and if it's necessary care you're receiving, your insurance pays for it.
How does Germany afford this? Yes, a hefty government contribution. (This is where the whole European high-taxes-in-exchange-for-high-quality-of-life thing comes in.) But also everyone's pays insurance costs that are a percentage of their earnings; for those who can't pay, the government steps in. The more you earn the more you pay, up to a certain limit, and then you're allowed to opt out and buy private insurance instead.
(This is my one major complaint, that it's two-tier system – everyone below a certain cut-off has regular, compulsory insurance; those over the cut-off can choose instead to buy private insurance at a fixed price, which at some income level becomes a better deal than the percentage-based compulsory insurance. This is problematic because private patients get preferential treatment – some doctors will only see private patients. Hard to propose a better alternative, though, when this is the natural result of an income-based payment system. Maybe keep the percentage-based payments, but have a certain cap to the amount any one person has to pay? But it does seem to me everyone should have the same basic coverage, and then optional extras could be, you know, optional: e.g., those who want to add on, say, full dental coverage have the option to do so on top of the basic coverage they share with everyone... /End of digression.)
Anyway, one of the system's little oddities I've been thinking about lately is that insurance will cover the cost of a consultation with a doctor – which includes the doctor writing a prescription – even if it doesn't cover the actual thing the doctor prescribes.
(For example: An ophthalmologist visit, including an eye test and a prescription for glasses, is free, even though the glasses themselves aren't. Consultation with a gynecologist about which birth control to use is free, but the birth control itself isn't covered. Emergency appointment with a G.P. for flu/bronchitis/whatever is free, but there's a copay on the medication prescribed. I'm not saying insurance necessarily needs to cover eyeglasses or whatever, it's just funny that it would cover the visit to the doctor who tells you that you need a specific thing, but stop short of providing the thing you need.)
The insurance is also a bit odd when it comes to dental care – two yearly check-ups are included, but a routine cleaning (something every person needs) isn't. Yet the exorbitant cost of treatment for gum disease (which you might well get if you never have a professional cleaning) is covered!
Ah well, coming from a country where generally no dental care is covered, I still think Germany is doing a great job.
How interesting, though, that while Germany wants to fill cavities in your incisors, it doesn't care about your molars.
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