The UK and German healthcare systems compared

I’m a coach in languages and so I am keen to explore languages – especially German – but at the same time provide useful content for a wide audience.

Following a suggestion from a colleague, I decided to look at the question of the UK’s health service, the NHS and how it compares to the German health system. I may use this information in a future video or online course.

The article presents personal opinions as well as general information based on research.

Which health system is better? The British NHS or the German healthcare system?

It’s complicated! So put I together some key facts and I am also going present some medical-related words and phrases in German that will be useful for everyone.

OK, so what is the fundamental difference between the UK system and the German system?

The UK NHS is owned and run by the state and it’s free at the point of use.

The German system is mostly free at the point of use but it’s paid for through contributions to a state-run health insurance scheme.

In Germany people pay for the health system by paying social insurance contributions into a health fund – Gesundheitsfonds – which then goes into a Krankenkasse or health insurance ‘pot’. The money is taken out of their salary and the employer also contributes 50%.

In the UK, the money to support the health system is paid by the government, mostly through general taxation.

The NHS was launched in 1948 at what was then Park Hospital in Urmston near Manchester. Today it’s Trafford General Hospital. A blue plaque commemorates the launch. British people are proud of their NHS and often compare it unfavourably to the US system. They like the fact that it’s free, unlike the American system which relies mostly on private health insurance.

Aneurin Bevan was Labour health minister and he is credited as the father of the NHS. A statue of him is in Cardiff.

The UK system is more like the old East German system and that’s not a criticism. The East German health system provided a good, basic service, though without the expensive equipment found in the West.

After the end of Communism – nach der Wende – the West German system was introduced into the East.

The German system goes back to the late 19th century, when under Otto von Bismarck, Germany pioneered the welfare state.

This system is still in use today. Krankenkassen are non-profit making organisations, that are governed by strict regulations.

The biggest state-run Krankenkasse is the Allgemeine Ortskrankenkasse. There are many private Krankenkassen offering a range of packages at different contribution levels.

You are required by law to pay into a Krankenkasse. You can see it on your pay slip. If you earn above a certain amount, you can insure yourself with a private Krankenkasse. Many cater for specific professions.

In the UK, the National Health Service is paid for by the government. The amount paid by the government varies depending on which political party is in power, whether Labour or Conservatives or a coalition .

Statistics indicate that the NHS received considerably more money under Labour governments than the Conservatives, though the Conservatives dispute this.

It’s important to note that the UK also has a private healthcare system which people can gain access to by paying for private health insurance. People also receive private healthcare as a benefit or ‘perk’ of their job.

So in theory, whether you are in Germany or in the UK, if you have a higher income and/or a better job, you can get better healthcare by paying more. To what extent that is true lies outside the scope of this essay!

The NHS has been had a funding crisis for many years – German system is not perfect but it’s well-funded.

Due to Brexit, the NHS has a serious staffing crisis and it’s getting worse. Many staff are leaving and new people are not being recruited. A no deal Brexit would be very bad for the NHS for many reasons. Staying in the EU is better for the NHS, though it still needs to be improved.

So which system is better? Well, before we answer that question, let’s ask a few more…

How much do both countries spend on health? Germany spends 11.1%. on health care, the UK, 9.8%

Which are the best hospitals in the UK and in Germany? Here are some famous ones: famous UK hospitals include Guys Hospital in London, Queen Elizabeth Hospital Birmingham, The Christie in Manchester and more.

in Germany Universitätsklinikum Heidelberg, the Charité in Berlin, Asklepios Klinik Barmbek – Hamburg and the Uniklinikum in Köln are well known.

What are the practical differences between UK and German hospitals? For this article I went for a walk around a few hospitals in the UK and in Germany.

In German hospitals, each department or  unit functions as an independent practice – Praxis – like this Children’s emergency Praxis in Cologne.

In the UK most departments and units mostly display the NHS logo. Services have been organised into NHS trusts to provide more autonomous control. Some services are provided by outside companies.

In UK hospitals you’ll see adverts for fundraising – sometimes to pay for basic hospital equipment, like scanners.

In Germany you won’t see this, everything is funded.

This is especially true of hospices. St Ann’s Hospice near Manchester receives just over a third of its funding from the NHS. That means it needs to raise around £20,000 every day just to keep the hospice running.

They organise glamorous celebrity dinners, midnight runs and many other great events. They run charity shops as well, but is it right that a facility providing a basic healthcare service needs to do this?

In Germany hospices are fully funded.

Here are some more differences I found:

The emergency ambulances in Germany have a two-tone sound but in the UK, they have an oscillating tone. The German siren is called the Martinshorn, named after the company that makes it.

In Germany they’re red and in the UK they’re yellow and in both countries you often see the same basic vehicle, the Mercedes Sprinter.

On the side of the ambulance you’ll see the emergency number – Notruf – in Germany neun eins eins – nine one one  and in the UK – nine nine nine – neun neun neun – or for non-emergency calls, one one one. You can also dial 911 neun eins eins in the UK.

In recent years, smaller hospitals have closed and their services, including A&E have transferred to larger single-site hospitals.

This means ambulances have a longer distance to go than before. I hear many ambulances passing every day in the UK but in Germany, I seem to hear fewer? Is that really the case? I’m not sure.

Parking at hospitals is an important issue. At German hospitals, it’s generally free for a period, then there’s a charge.

This is also the case in Britain, though some have very expensive charges, for instance Stepping Hill hospital in Stockport.

If you are citizen of another EU state,  you can receive healthcare on the same basis as German nationals

Thanks to the UK’s membership of the EU, citizens from other EU nations are treated for free by the NHS – or more exactly, the NHS charges the cost of the treatment to the home country.

I once had a bike accident in Germany, and I was given first class treatment at the local hospital. The bill of 233,50 Deutsche Mark was charged to the UK and I didn’t have to pay anything.

If you do suffer illness or an accident in Germany you’ll be able to gain first hand experience of healthcare in Germany and you’ll be better able to answer the question of which has the better healthcare system, the UK or Germany.

But before I answer that question, let’s take a little language lesson and I’ll ask another question: What do doctors say when you go and see them?

Doctors in the English speaking world say ‘What seems to be the problem? What can I do for you? or maybe ‘How can I help you?’

German speaking doctors might ask you ‘Was fehlt Ihnen?’ – what’s wrong with you, literally what’s missing from you? Also ‘Was kann ich für Sie tun?’ or maybe ‘Wie kann ich Ihnen helfen?’ – How can I help you?

Let’s look at a few complaints
Ich habe Kopfschmerzen. – I have a headache.
Ich habe Halsschmerzen. – I have a sore throat.
Ich habe Magenschmerzen. – I have a stomach ache.

If the pain is coming from your hand, foot or leg you can say ‘tut mir weh’ – (it) hurts

Meine Hand tut mir weh.
Mein Fuß tut mir weh
Mein Bein tut mir weh

For other parts of the body, consult a good dictionary!

If there’s been an accident and you need to phone 911 you can say:

Es gab einen Unfall – there’s been an accident
Es gibt Verletzte – there are injured people

Okay, so let’s get back to the important question: Which system is better, the UK healthcare system or the German health system?

In doing my research I found an interesting video on the BBC website (link below) with some interesting information:

• Waiting times for operations are shorter in Germany, typically three to four weeks in Germany compared
• Germany has three doctors per 1000 population, but the UK has two.
• Germany has 3 times as many hospital beds compared to the UK.
• For instance Germany spends 11.1%. Britain 9.8%
• Germans pay 7% of income for healthcare + employer

Most people I’ve spoken to think that the German healthcare system offers a higher level of service. But people in Germany have to pay for their system directly out of their salary. Some  pay many hundreds of euro each month.

The British healthcare system provides a good system too, and though people don’t pay contributions directly towards the health system, the NHS is paid for through taxation and a share of National Insurance contributions.

So that’s it, a quick and hopefully entertaining overview of a very complex subject. I hope it will arouse people’s curiosity and encourage them to look for more detailed information online.

If you’re interested in learning German, go to www.aidan.co.uk/german/.

If you’re visiting Germany, I wish you gute Reise! and if you’ve visiting the UK, enjoy your trip and if you’re a national of an EU country, don’t forget your EHIC card!

Here’s the link to the BBC video I found.