Germany’s Health Care System: A Suitable Option for a Measured U.S. Health Reform

April 2021

In 2019, the United States spent 17% of its GDP on health care. This is over 8 percentage points higher than the Organization for Economic Co-operation and Development (OECD) average (Tikkanen & Abrams, 2020). Indeed, the U.S. spends 26% of its national budget on health care (McGraw, Lecture 5.1, 2020). Despite this enormous cost, the US has some of the poorest health outcomes amongst comparable countries. For example, the U.S.’s life expectancy is the lowest of comparable OECD countries at 78.6 years (Tikkanen & Abrams, 2020).

It thus comes as no surprise that Americans are pushing for health care reform. Medicare-for-All, in particular, has become popular and is based on single-payer health care systems such as in the UK and Canada. However, there are many different actors in the public policy process that influence health reform; no one actor makes the decisions in American politics. Therefore, to increase the chance of health reform success, diversifying policy options is necessary. Indeed, there are other nations, such as Germany, that utilize successful health care systems but are often overlooked in the U.S. reform discussion. Analyzing Germany’s health care system may prove useful to U.S. policymakers, as it is a multi-payer system that is based on principles that the U.S. tends to value culturally, such as private industry, competition, and consumer choice. This fact may make such a reform option more politically feasible in the U.S. than a single-payer system. Specific policies that suit the U.S. economy should be considered for implementation. In order to be relatively politically feasible, this implementation process should begin with a non-profit administered public option.