Starnesville Health Care, Made in Germany, by Ulrich Biele
Big Head Press

L. Neil Smith's
Number 545, November 22, 2009

"Socialism is Death"

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Starnesville Health Care, Made in Germany
by Ulrich Biele

Attribute to The Libertarian Enterprise

January First this year, another health care reform law took effect in Germany. Another law in a foreign country, yaaaawn! Not really. This one came right out of Ayn Rand's Novel Atlas Shrugged.

Not only that health care became mandatory even for those who can't pay for it, in case you should miss a month payment is due retroactively as soon as you apply. Quite inconvenient, but not the worst part.

In order to exert more control over health care providers and their victims, a "Health funds" ("Gesundheitsfonds") has been established. A unified fee has to be paid to a newly created bureaucrazy, which distributes the revenue to all health care providers. The claim was that this measure would enhance competition and lower the fees the clients have to pay.

Funny thing, in order to stabilize the market the fees were raised to begin with.

As a typical German issue, things are far more complicated than necessary. Until this year, employers and employees had to pay half of these fees each. This had increased the gross salaries by about 40% above the level of the official (taxed) gross income and is a nuisance in itself, if nothing else.

Today, the employers' part is fixed and, according to its needs, the health care provider can raise additional fees from the client.

Doctors and hospitals in return, get paid by fixed "budgets" per patient and quartal. Medications and other treatments are rationed, sorry "budgeted" as well.

Any naïve observer might think this could at least stabilize the costs, but no avail, gross costs keep rising in an unbroken rate ever since this Ponzi scheme has been established.

Now, as this system has been established, even more evil shows up. Health care providers can claim "essential needs" for special groups of patients. Long term treatment for chronical diseases are interesting, cancer patients and handicapped people.

This has lead to a stealth HIV epidemic, discovered by ophthalmologists.

As the system is being administrated by experienced bureauc-rats, to use a complicated software is mandatory for all people involved in health care. Apparently some smart programmer had an idea how to increase the claims for "essential need" without taking the trouble to treat real patients. As soon as an ophthalmologist diagnoses a macula densa degeneration (loss of eyesight, mostly in advanced age) and hits the "enter" key after punching in the ICD-10 code, another ICD code will be added automatically. The code for HIV infection. As the entire system is cross-linked, this information, entirely invisible for the ophthalmologist, will be distributed throughout the entire system. All officials will be informed, from social welfare to labor administration (an atrocity in itself, some 90.000 bureaucrats administrating each other and destroying hopes to get a new job for almost four million officially unemployed, but that's another can of worms) and of course the health care unification board.

Several ten thousand mostly elderly people have thus been brandmarked as HIV positive. The effect for the health care providers is an "essential need" for about 160 million additional €uros. To have a HIV infection in your file can devastate your life. Especially elderly people often are subject to social welfare, due to another Ponzi scheme called retirement insurance.

The social welfare administration of course has access to your medical data and being marked as HIV positive does not exactly help you to get a decent treatment from our benevolent administrators. You are an outcast, no matter if the data are correct or not.

One health care provider has yet admitted that this is a problem, but nobody yet has taken action to repair the damage or at least limit it. This "glitch" is far too profitable for the health care providers and gives powerful leverage to rip off more funding than the neighboring provider.

Since September 27 2009, Germany has a new administration, consisting of Christian Democratic Union, Christian Social Union (Bavaria) and a surprisingly strong classical liberal faction, the Free Democratic Party. One major goal of these classical liberals was to put an end to this health care disaster and restore, at least partially, older structures which were not only more cost efficient but granted much more privacy for the patients. To develop a new structure, however, is a task, which will require strong efforts and much courage from all people involved. I hope that they succeed. There are many tasks overdue as the previous administrations have been piling up socialist project for too long a time in cuddly harmony with Social Democrats (SPD) and the Christian parties—which are basically wool-dyed statists—though with a few and inspiring exceptions like Mr. zu Guttenberg (CSU) who materialized earlier this year almost out of thin air and shows the antisocial habit to tell the truth. He even dared to call the Afghanistan adventure by its ugly name: war.

Our classical liberals have undergone a rejuvenation cure, which did apparently much good. They are no longer the docile helpers they used to be in the Kohl administration, but turned out to be self-conscious and ambitioned, a real nightmare to our beloved chancellorette Angie Merkel. She had been feeling quite comfortable in the previous grand coalition where she could easily duck all issues. Now she has to call a spade a spade and in her first state of the republic address she gave a good try.

I hope this impetus will hold.

Ulrich Biele
TANSTAAFL Consulting
Frankenberg 6c
93179 Brennberg
+49 172 8154941


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