Living in two cultures can be enriching, sometimes it’s just plain baffling. Being a citizen of two countries helps - it makes it harder to dismiss baffling behavior as “typically German” or “typically American”.
I often take groups of Americans to Germany, one of the things I try to explain about that mysterious country is that healthcare is not a political issue there - or in any other European country. Political parties do argue over details concerning premiums and coverages, but no one across the political spectrum questions whether a system of universal healthcare should exist. Healthcare is simply considered as something society organizes, like education, infrastructure, and national defense.
My American guests are often surprised to learn that Germany’s healthcare system is not government-run, but involves public corporations that compete with each other. What the government does do is set the rules of the game, so insurance companies cannot exclude people with pre-existing conditions or charge them higher premiums. Every employed person pays roughly 7 percent of their paycheck and their employer pays the same percentage. This does mean that people with high incomes pay higher premiums – but before you suspect a communist plot, consider that they can opt out of the public system and purchase private insurance.
For Europeans, the American emphasis on individual responsibility can be baffling. Granted, there are things people can do to take care of their own bodies, but these behaviors are not guarantees against, say, cancer, and certainly don’t do anything to prevent injuries from traffic accidents, a fall on an icy driveway, or a spill of boiling water. Young people are not immune from these risks either, and a comprehensive health care system cannot work without young people.
My own bafflement came on my very first visit to this country, when I met a man who had lost his wife to a terminal illness, and their house to the overwhelming medical bills. While I’ve often heard people make a moral case for universal healthcare, I haven’t often heard the economic argument. If people are too sick to work, or lose their homes to medical bills, I can’t see how that benefits anyone-the rest of society, the economy - or the health insurance companies.
To this dual citizen, at least, America would be even greater if healthcare were not a political issue.