I recently had the opportunity to travel with a contingent from the Southern Medical Association to Denmark and Germany to study healthcare systems abroad.
Denmark is a small Scandinavian country of 5.6 million people, from which hales our own Dr. Dody Washington. We arrived in Copenhagen on a warm and sunny June afternoon. The people were busy embracing the sunlight and warmth that graces them only a few months a year. There was a festive atmosphere everywhere—drinking games in the parks, open-air cafes alive with music, and merriment amidst one of the premier cultural centers of Europe.
The Danish health system was state-of-the-art by any standards. Their largest hospital, Rigshopitalet, had a 20-bed trauma center and over 1000 beds altogether. Denmark has chosen a National Health Service model similar to England’s. The population enjoys limitless access to primary care, and small, privately run, government-funded clinics were interspersed throughout the countryside. Although the Danish spend about half what we in the US spend per capita on healthcare, they have an equivalent life expectancy.
Germany’s healthcare system was more similar to our own. Like the United States, they have an employee-sponsored health insurance industry (albeit, a not-for-profit one). They also have a thriving private for-profit and not-for-profit hospital industry. Technology is in abundance. At Charite Hospital in Berlin, we watched Dr. Karl Strangl perform a transcutaneous aortic valve replacement, which he does over 300 times a year. Germany has the second most expensive healthcare system in the world, yet it costs only 2/3 per capita what we spend in the United States.
Both Germany and Denmark have universal care and lower costs per capita than the United States. Would their system work here? Not likely. Both countries had income tax rates of 55-60%. Furthermore, many Europeans are dissatisfied with their healthcare system. Like here, they think it is too expensive. In Denmark, the primary care union is threatening to walk away from the current government contract in September. Prime Minister Angela Merkel of Germany too has worries of escalating costs and geographic disparities in care that threaten to derail her Christian Democratic Party in the next election. Healthcare is indeed tough everywhere.