Karen received unscheduled medical treatment in Germany last May. We could learn from their system.
The night before we arrived at the end of our river boat cruise in Passau, Karen vomited repeatedly until she became dehydrated. The boat had no medical services so people advised us to go to a hospital for an IV with medication and fluids. She’d received an IV in a China hospital that worked.
We loaded our luggage into a taxi at 10:30 am assuming we’d miss our train to Vienna at 2:30.
The emergency room had no check-in. We saw 5-6 white-coated medical staff working at desks and instruments, but no patients in a waiting room.
A doctor explained Karen would receive better care in a doctor’s office. Germany’s system required her to be vomiting before emergency services could diagnose her condition and administer an IV. They’d have to keep her under observation all night. That felt perfect for Karen, but she couldn’t muster up another upchuck. The China hospital hadn’t required one.
Then he amazed us. He telephoned a service that identified the only local doctor required to serve all patients on this Saturday in this city of 50,000 people.
“A taxi driver will come to pick you up at the spot where you are standing,” he said, pointing at the floor outside his office.
Ten minutes later he arrived at my spot to deliver us to what I expected to be a spot at the end of a miserable mass of people waiting for medical service. We hauled our luggage into a small waiting room with one patient and one worker in a spotless white uniform.
She quickly finished serving the other patient before explaining we’d have to pay for our service. She keyed in Karen’s symptoms, drew her blood and examined it in a microscope.
“I found a virus,” she said. “You can see the doctor immediately.”
In my local walk-in medical office one person takes my information before sending me to the lab for a blood draw, from which I return to wait with a contaminated pool of patients while someone, somewhere analyzes the blood before I see a doctor. Not surprisingly, Germany’s medical system costs less than ours on a per person basis and as a percent of our GDP.
We met the doctor at her desk reading about the blood results on her computer screen.
“We’re seeing this virus a lot,” she said.
They weren’t seeing them that date.
She examined Karen, pressed on her abdomen and gave her two shots. She keyed in her notes and printed out Karen’s prescription for four medications to be filled at the pharmacy on the street below.
I paid the assistant about $65 by credit card.
“A taxi will be waiting for you after you fill your prescriptions,” she said.
We hadn’t asked for her to call one. We left after twenty minutes.
Ninety percent of Germans receive these services through mandated insurance they select from over two hundred different insurance options. People pay for insurance as a fixed percentage of their income. Ten percent choose a more expensive private system.
Why weren’t more people needing services? Did universal access for preventative care mean fewer needed emergency care? Were we in a magical medical kingdom?
A March 2012 report by the American Institute for Contemporary German Studies at John Hopkins University compared the US and German medical systems on their ability to coordinate care among different insurance systems, provide access, control costs and charge people equitable prices. Both face challenges.
“The United States faces severe challenges in access to health care, cost effectiveness, equity, and to a lesser extent in coordinating care. Meanwhile, the German system is confronted by problems in coordinating care and controlling costs.”
We accessed immediate excellent unscheduled care at reasonable costs and boarded a train departing two hours earlier than our scheduled departure.
Based on our experiences as retirees visiting emergency rooms in Portland, Wenatchee, New Orleans, and China we never expected that quality of medical care.
We could improve our medical system by learning more about what the Germans do.