Don’t Make Me Sick

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:

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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.

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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.

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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.

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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?

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First thoughts on readjusting to life in Florida

I’ve been back in the US for roughly a week and a half now, and the re-entry has been pretty smooth for the most part.  There have been a few tricky things, however.

The currency – After three years with the Euro (and that wonderful €2 coin,) I’ve been having a difficult time readjusting back to the Dollar.  Especially the coins.   The paper money is confusing though-  with the Euro, every denomination is a different size and color.  All of the paper money here is the same size and color, whether it’s a $1 or a $100.  I’ve already flubbed at least one cash transaction.  Speaking of which….

The credit card usage – I went out to lunch with three of my co-workers, and when it was time to pay, I looked around the table-  each of my colleagues had a credit card out for their check, and I had cash out for mine.  I simply forgot how prevalent credit card usage is here, and how little Americans use cash for many things.  That will take a while to remember.

The deodorant – I forgot that some of my regular use products simply aren’t sold in the United States.  My deodorant is a perfect example of this.  During my time in Germany, I’ve become fond of a Nivea solid stick which is simply not sold in the US.    I’m going to have to choose a new deo when my current stick runs out.

The dishwasher – After three years of hand washing all my dishes, it’s utter bliss to be able to just put them in a machine again.   This one isn’t a problem readjusting, it’s just something I wanted to take note of.

The paycheck – In Germany, I got paid once per month.  Here, it’s twice a month.  Having a significantly shorter time between paychecks makes me feel a little bit like time is passing more quickly.

The elevators – Whenever I get into a lift in Germany, the ground floor is either EG or the numeral zero.  The first floor is up one flight of stairs.  Floor two is what an American would call the third floor.  Fast forward to this weekend, in an elevator-  on two or three separate occasions, we reached the floor marked 1 and I stayed in the elevator thinking I still had one more floor to go.

The sugars – I need to find a new caffeine delivery system, I think.  Three years in Germany where the Cola is made with real sugar has spoiled me.  I seem to have lost my tolerance to high fructose corn syrup – any time I drink a normal US Coke product here, I have terrible heartburn.  This is especially frustrating because these amazing Coke machines are all over the place here, and the flavor mixing is fantastic. (Rasberry Coke, anyone?)  Mexican Coke (made with cane sugar instead of high fructose corn syrup) is available here, but it’s comparatively expensive.

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The drink ice – Ice isn’t common in drinks in Germany, so I forgot about the behavior of a cup filled more than halfway with ice-  when I tilted the cup forward to drink, the ice shifted position and caused a splash.  This in turn caused a mini tidal wave in the glass, which then proceeded to wet my pants.   Amelie was terribly amused.

The measurements – It’s going to take me a little while to stop thinking in terms of kilometers and Celsius.    All I know for sure is it’s freaking hot outside and sub-arctic in my office.

The air conditioning – In Germany, I had no air conditioning in my home or my office.  I thought I would enjoy returning to the land of AC, especially since the temperatures have been in the 90s much of the time since my return, but I was wrong.  Americans don’t use AC sparingly, they crank it.  In Germany, it’s been around 50F and I consider that almost t-shirt weather.  In my office, I have to wear a hoodie.  Every restaurant I’ve been to is freezing, almost literally.  It’s astonishing that I feel far colder in Florida than I ever did in Germany.

The shopping – I thought the weirdest thing here would be the Sunday grocery shopping, but the thing that is hitting me more strangely is the ability to walk into the grocery store to get pain killers and basic medical needs.    After three years with that only being in an Apotheke, having aspirin at the gas station is just weird.

Expats, what differences have you noticed between your homeland and your current home?

Doc Holiday or: How I Learned To Stop Worrying And Love The Urlaub*

By the end of July, I’ll have been to Prague, Barcelona, Amsterdam, London, and Edinburgh, all within a four month span.  In September I’m visiting Berlin again, and possibly Vienna.  I’m also planning on trying to spend two weeks back in the US much later in the year.

I was talking about my copious travel plans with a friend back in the US, and their next question was “How?  How do you have that much time off?”

The answer to that question is very simple- Europeans just have more vacation than Americans.  Whenever this topic comes up with friends and family, I say more or less the following:  Americans may talk a good game about having a proper work-life balance, but Europeans actually do it.

My benefits at Mr. Company** changed significantly when I moved to Germany.  I am officially “localized” here, which means that my US benefits ceased and I was brought into the same package of benefits that our European office uses.  This means that my 401k got a giant pause button, for example, and my health insurance switched over to a German health insurance plan.  It also means that my available vacation time increased quite a bit.

Germany mandates that employees have four working weeks off, minimum.  Plus public holidays. For a five day work week, that’s twenty days off plus the holidays, and some employers give more time off than the mandated minimum.  In other words, I have significantly more time away from the office here than I did in the US, despite working consistently longer hours.

I keep a list of things that will suck when I leave Germany to return to the US, and having my vacation time revert back to US levels is definitely on that list.

This weekend on Real Time, Bill Maher did a New Rule about this very topic- I’ve included part of the video below.  He mentions in the clip that 138 countries mandate the amount of vacation that employees receive.  The US is not one of them.  Study after study has shown that people who take their vacations come back more focused and more productive, with lower instances of burnout.

And you know what?  It’s all completely true.  I’ve taken the time off now, and I’m a believer.

Here’s Bill Maher to preach the gospel:

*Urlaub is the German word for vacation or holiday.

**Any reference to my employer on this blog will be said as “Mr. Company.”  The opinions expressed in this blog may or may not reflect the views of Mr. Company.  Probably they don’t, because Mr. Company is a multinational corporation and is not, strictly speaking, a sentient entity.