Probably some of it but I suspect the lack of limitations on services rendered plays into it as well. If someone in the US wants to see specialists 50 times in a month due to munchausens then they'll just be charged their co-pay each time (in most insurance plans). In Germany I suspect they'd not be allowed to book appointments anymore or would require a gatekeeping referral. Same with expensive drugs that don't help outcomes but are advertised to patients and doctors.
Thats not right. You can easily get an appointment in Germany, even multiple times. If you have a referral, you usually get an appointment earlier than people who directly went to the specialist. However, if you have acute pain you will quickly get an appointment on the same or the next day.
Source: Me. just made the second appointment with a specialist within a week thanks to pain, appointment is tomorrow
In the US on self-referral plans (60% of health plans) you can get an appointment without any acute symptoms and with no delay versus a referral. I'd say that's a fairly large difference in ease of access without probably any impact on patient outcomes.
> In Germany I suspect they'd not be allowed to book appointments anymore or would require a gatekeeping referral.
This is the kind of comment that immediately classifies the commenter as never having lived outside the US and/or not reading anything but US news sources. And with the wilful blindness to how exactly those gatekeeping referrals are present in most every single healthcare plan in the US.
>And with the wilful blindness to how exactly those gatekeeping referrals are present in most every single healthcare plan in the US.
This is only required by HMO plans which cover around 40% of the US population. PPO plans don't have such a requirement.
So please don't call other people willfully blind when you yourself make broad factually incorrect statements. Pot please meet kettle.
edit: Also my statements about Germany are based on comments Germans have made on hacker news regarding their own health plans. So you should really go yell at those Germans for not knowing how their own health system works.
