I've been remiss of late to post on my blog. Lots going on and very detailed interviews that I have to process. I suspect I will be doing a lot of post-trip blogging as I am able to full digest everything that I have seen and heard. In fact, I only have a few minutes now because I'm heading out for a tour of the Reichstag. So here are just a couple of quick things that caught my attention.
I met with Anissa Kirchner and Flaminia Bartolini of MediBuro Berlin. Like MediNetz, they are staffed by a collective of volunteers and refer patients (asylum seekers and undocumented) to a group of about 100 doctors who will privately and confidentially see the patients. MediBuro pre-negotiates prices with the providers and raises funds to help patients out when their treatments are very costly. Also like MediNetz, they have a political operation, although theirs is much more vocal and self-described "leftist." Two things (of many) that struck me during our two hour conversation were medical status and barriers to care for asylum seekers.
Unlike in the U.S. where the only issue for getting insurance (now that pre-existing conditions are off the table) is your ability to pay for it, in Germany your status (worker, student, unemployed, etc.) is directly linked to how you are covered. Anissa described to me how she fell into a gap after she graduated from high school and did not immediately want to enter university. She was no longer a dependent, was not a student, and did not have a job. These are "status portals" (my term) for coverage. Before a law change in 2007, Anissa said, she would have in fact been uninsured. Now, like the ACA, German law requires you to have insurance, so she had to decide between foregoing what she wanted to do (volunteer at an NGO) or paying a very high cost for insurance. An interesting twist from the situation as we know it in America.
Flaminia also talked about how asylum seekers are assigned to a specific area of Germany (the concept is to avoid having any one section of the country overly burdened with caring for migrants), and the healthcare "permit" that they are given is only valid in that area. If they were to, for example, visit relatives in another part of Germany and they got sick, their only option would be emergency care. In addition, even within their home area, asylum seekers must go to a government office and get specific permission to seek care before they can go to a doctor. Flaminia says MediBuro and groups like theirs are advocating on an on-going basis to change the law in these areas.
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