A look at Germany’s intriguing long-term care system

I was in Berlin, Germany, last week and did some research into their long-term care system during my visit. I was curious about how it might be different or similar to ours, given the country’s national healthcare program.

Briefly, the German system has public and private healthcare insurance options and 100% of the population has coverage. That’s compared to the 28 million Americans without insurance and the 48% of Americans between ages 19 and 64 who are underinsured1. Private insurers in Germany are not profit-making enterprises and people cannot be turned away for pre-existing conditions. There are caps on charges for services so that healthcare is still affordable even when medical needs increase. They have better health outcomes than the U.S., and at significantly lower costs.2

The system has financial incentives for exercise and regular medical checkups, rather than cost-prohibitive copayments that can lead to delays in medical attention.

Long-term care insurance

About 79 million of Germany’s 82 million people have long-term care insurance, composed of 88% public and 12% private insurance.3 Payments can be used for care at home, given to professional, family or friend caregivers, or applied to one of the 12,000 care facilities in the country. If the insurance payment, along with pensions and other income, isn’t enough to cover facility costs, then families contribute or the elder applies for social assistance.

Exploring LTC in Berlin

I had dinner with Ilse Biberti, an actor and director who authored a best-selling German-language book on the six years she spent caring for her aging parents. I chatted about parents with middle-aged Germans over birthday cake at a party. And I got an informative tour of the aforementioned nursing home by Amélie Herberhold, one of its social workers.

I was staying in a friend’s sixth-floor walkup apartment. This wasn’t an anomaly; there were walkup apartments all over the city. “What do the old folks do?” I queried everyone I met. The answer: “They put a chair on each landing and they take their time.” This sounded very much like apartments in New York City, with elders somehow managing to walk up too many stairs until it’s no longer possible.

Journalist Johannes Buck shared an idea he had come across for those unable to reside alone. Multiple families bring their older relatives to live together in one home and then share the care for all of them as a collaborative effort. The concept of cooperative family responsibilities could be a welcome step on a continuum of care for some organizations or communities in the U.S.

For the entire article, visit:

A look at Germany’s intriguing long-term care system

Leave a Comment