I DON'T LIKE TO BE CRITICAL of anything in Germany, because in general we like it here. Besides, no one or no country is faultless - including our home country - and there's really no need to point out if there's things that don't agree with us. But in the case when we see differences, I figure there's no harm in pointing them our for the sake of cultural reflection.
AMONG THE DIFFERENCES, one can take medical care as an for example. In general, Germany has an excellent medical system. They were among the first nations to consider the idea that all people should have access to affordable medical care, and the first to implement universal health care, <begin political satire> championed by that radical no-good left-leaning liberal socialist Democrat Otto von Bismarck in the late 1800s. Time will tell if this 130 year old experiment is really economically sustainable. </ end political satire>.
If there is a difference in the US versus German medical system it lies not in the politics, but in the medical culture. We've found, in general, that the German medical system is much slower to intervene than the US. Sometimes that's probably the best thing, but to a bunch of Americans who are used to an over-aggressive and probably over-prescribing medical system, it can be a little frustrating.
For example, when we moved here a year and a half ago our daughter had been on a certain prescription for quite some time - which had been an tremendous help to her. When we tried to get our new doctor here in Germany to reissue the same prescription, we got a litany of rationalization and delays. "I'm not comfortable with that treatment." "That prescription is not approved here." "You can't get that outside of the US." "That's too strong of a dose." "Maybe she should just go to a psychologist." "Maybe she just needs better parenting." (oooh, that one got Momma mad). When I finally called the doctor to tell him we either need his help - importing the medication or working through the local US hospital, etc - or we need to find a doctor who will, he responded with "Oh...OK, I didn't realize you felt that way. I will have my lab mix up the medication tomorrow." Super, that would be excelle....wait, what?
I don't blame that doctor, it's just a difference in medical culture. I think the German medical system rightly focuses more on prevention, which makes perfect sense to me during the 360 days a year that I am not sick. But on the other five? Oh, don't get me started.
Pharmacies (rather, Apotheke), are located on every street corner, but I am not sure I understand why. Over the counter medications either are expensive or difficult to find. Its difficult to get Childrens cold remedies, or cold medicines in general. I'm still not sure I have ever seen DayQuil or NyQuil. I definitely have not ever found Pepto Bismol. Not much luck with Ibuprofen or Zycam.
And getting a prescription? Not likely. Not until you have exhausted all other medical remedies, which include such things as drinking hot tea, eating a lot of fruit, not eating meat, keeping warm (because everyone knows cold air makes you sick), taking an alternative hot / cold shower (because everyone knows a cold shower helps make you not sick), and going to the sauna. If you're desperate there are plenty of herbal remedies available, most of which seem to me to inexplicably come in the form of a nasal spray.
And antibiotics? Forget about it. You and I both know that everytime an antiobiotic is issued bacteria gets more and more resistive to it. US doctors and PAs seem to sort of shrug that off as a cost of medical care, but in Germany it calls to mind that line from the little girl in It's a Wonderful Life (paraphrased), "Every time a prescription for Penicillin is issued an Angel dies." Antibiotics are roughly as common of a medical intervention as a kidney transplant.
So this week in the US, after putting up with a nagging head-cold for about a month, I walked into a convenient care clinic in the US, announced I had a self-diagnosed sinus infection, and walked out 5 minutes later with a prescription for antibiotics that made the pharmacist remark of the dosage, "OK, don't take this without food because that's pretty strong. I mean really, don't take it without food." What a country!
And here's the confession part (medical types, you can stop reading now). I have about 20 of these little beauties in an orange bottle....I plan on taking at most 10 of them, and the rest are coming back with me to Germany where they will get stored away in our medical cabinet with gobs of other US imports that were at one time tucked in various shipment or pockets in our luggage - ibuprofen, children's tylenol, Zycam, Pepto Bismol, sore throat spray, decongenstant, and all manner of cold remedies.
There those little white pills will stay until the next time I can't kick a cold and get a medical recommendation to try wearing a scarf and have a nice hot glass of lemon tea. But next time, that's going to work wonders...because I'm planning to have that tea with a strong dose of Amoxicillin and a small dose of guilt.
And after that guilt wears off, I bet I'm going to start feeling alot better.