For my second full week back in the United States, I got to experience the joy and delight of having a cold. I’ve been meaning to write a post about healthcare in Germany for ages, and being sick for the past week is a perfect lead in to the topic. Being sick in the United States is a very different experience than being sick in Germany.
“Sick Days” are a very American concept.
While I was employed at our German office, I had German health-care and I followed the local rules for being sick. In the German office, if you are sick, you go to the doctor on the very first day, and the doctor will give you a slip of paper that basically says don’t go back to work for however many days they specify. There’s no “sick time” in the German office- my benefits there included a generous count of vacation days, but the concept of “sick time” just isn’t used. If you’re sick, you’re sick. German employment laws are fiercely protective of the worker, and a company can’t easily fire someone while they’re out sick. So, sick people stay home from the office in Germany, and rarely come in to get their colleagues sick. That’s a very American behavior.
In the US office, however, the rules are different. I came back to the US with a very finite amount of sick time, so I was only able to stay out of work for the first day of my cold. On the second day, I schlepped myself into the office with my bag of cold medicine, tissues, and so forth. Nobody wants to see you in the office when you’re sick, but if you have no available sick time, you must go or risk a disciplinary action.
Socialized medicine is actually pretty nice.
When the Affordable Care Act first started to gear up in the US, I remember seeing this comic in one of the local newspapers. I saved it back then because I knew I’d be writing about this at some point:
My personal experience with socialized medicine doesn’t at all fit the negative talking points of the FOX News narrative. I found the entire system to be uncomplicated and reasonable. While I was in Germany, I had Techniker Krankenkasse, a large and ordinary public health insurance which was arranged with the assistance of my employer. Private insurance is available in Germany, of course- you just have to be willing to pay more. I never found it to be necessary.
Because this insurance is subsidized by the government, my tax rate was higher and I saw less of my paycheck. However, I went to the doctor several times in Germany without ever paying a cent. One of those visits included a very small procedure which even required after-care, and there was no additional cost. When I needed antibiotics, I paid only five Euros. The same doctor visits here in the US would be $20 or $35 per visit, and the generic antibiotic wouldn’t be less than $10. The higher tax rate in Germany was worth it, if only for the convenience of not having to pay anything to the doctor’s office.
The actual visit to the Doctor’s office.
I only went to one doctor in my time there, so I don’t have a frame of reference to tell you if my experiences are common. My doctor’s office was a nice, naturally lit affair with pleasant decor. The starkest part of the office was the waiting room, a square room with a table in the center and magazines to read- in other words, it’s just like every doctor’s waiting room you’ve ever seen.
Whenever somebody arrives to the waiting room, everyone already waiting says hello. Germans aren’t typically this inclined to greet people they don’t know, so I assume this is one of those cultural expectations that I just have to accept.
The checkup room is a big airy space. And this is the part of writing the post where I realize that my meager count of doctor experiences in Germany leaves me with very little to talk about in this post. Let’s move past this admittedly lovely checkup room, to talk about drugs.
Pharmaceuticals auf Deutsch.
One of the things that was difficult to get used to when I arrived in Germany was that you can’t get drugs in the grocery store. In the US, you can get aspirin or Tylenol in Publix. In a shop like Walgreens, you can get a can of coke, develop your film, buy a toy, and still fill your prescription. In Germany, everything is separated- food in the grocery store, drugs in the Apotheke.
Pharmaceuticals are more or less the same everywhere in the world, but the packaging is different. Germany doesn’t use those amber plastic pill vials that are so ubiquitous in the United States; most drugs are distributed in flat packs like the one pictured below.
Where an American pharmacy would print a label with specific instructions on how to take your medicine, a German pharmacist will just write the instructions on the box. See the handwritten 1-0-1 above? That means take one in the morning, none at lunchtime, and one at night. When they hand you the pills, they go over it verbally just once, and in my case, the pharmacist reminded me to be sure to finish the prescription.
Beyond that, things are more or less the same. The individual pain killers are all available in Germany, just under different names. Tylenol is Paracetamol, for example. Vicks products are sold as Wicks. Aspirin is still called Aspirin, though- Bayer is a German company, after all. The only drug that I was never able to find a German analog of is Sudafed. Any time someone visited from the United States, I had them bring me some 12-Hour Sudafed- that stuff is worth its weight in gold to me.
Being able to go to a Publix at 9pm here to get two more types of cold medicine, including one that will theoretically knock me out: That experience is priceless, and it made me realize that if I have to be sick, I’d rather do it here, even though it’s significantly more expensive.
Have you ever visited a doctor outside of your home country?