March 14, 2012 -- BERLIN -- As the Republican presidential candidates try to outdo each other over criticizing the Obama administration’s healthcare plan, several German healthcare officials who watch the debate in the United States are in disbelief as to why the American public doesn’t want a national plan.

Their reactions come as the German public healthcare system reached a record € 4 billion ($ 5.28 billion) surplus for 2011.

"For me as a German, what I cannot understand is that you make the question of health insurance an ideological question,” said Wolfgang Zoeller, a Bavarian politician who has spent the last 22 years in the German parliament or Bundestag.

Americans talk about whether having a national health plan “is going in the direction of Socialism or Communism,” Zoeller said in an interview in the Bundestag. The nearly 70-year-old politician said he’s far from being a Socialist, noting that he had recently voted to reduce bureaucratic problems surrounding Germany’s inheritance tax.

“For me the question of a national health insurance is a humane question. I would like that every person, regardless of his or her age, income, pre-conditions or financial possibilities, be helped if they are sick.

“Otherwise you have the famous phrase: Because you are poor, you have to die earlier. And I don’t want that,” Zoeller said.

Germany has one of the oldest public healthcare systems in Europe and while the rules can get complicated, it’s based on a simple principle: If you make more money, you pay more into the system. The premiums are based on a percentage of your income. That’s why, as the economy booms here, the national insurance system is producing strong surpluses, Zoeller and others say.

Under the German scheme people who make less than the equivalent of $58,212 per year are required to have health insurance on the public plan. Those earning more than that can insure themselves on the national health plan -- and pay the top rate -- or they can opt for private insurance which is mainly for high wage earners and self-employed people.

Still most Germans are on the national plan, though many complain that they get second-class service compared to those with private insurance, which pays doctors more.

The legal requirement that people be insured – which is under attack by many in the United States – is accepted in Germany – not only by left-leaning parties, but by pro-capitalist ones. The current German health minister, Daniel Bahr, is a member of the pro-business Free Democratic Party and strongly supports the system.

“Not every S is about socialism,” said Ann Marini, a spokesperson for the Statutory Health Insurers in Germany.

“It’s not a socialism principle. It’s a solidarity principle,” she said. The idea is that everyone is in a big pool and feels connected to the community, she said. Marini said it’s really tough for people in Germany to understand the debate in the United States.

“In Germany we have a society that has certain rights and responsibilities for each of its members,” while in America it seems that there’s a strong tendency toward individualism.

“You (in the U.S.) have risks but you also have opportunities….but for us it’s clear. Health is a risk that cannot be placed on the shoulders of the individual.”

Marini is even more confused as to why Americans don’t accept a national health plan because she views the United States as a much more religious society than Germany, where people may be a member of a church, but hardly ever go.

She notes that most religions teach people to “love their neighbors” as a central part of what spiritual life is about. When this principle has such a central religious function – and the United States is so religious – “then why can’t you get it across that people should contribute a bit to support others, for example in health insurance.”

Image for this story by Armin Kubelbeck under a Creative Commons -- Attribution Sharealike 3.0 Unported license.