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Two-tier medicine - differences, causes & effects

The term ""two-tier medicine"" describes the perceived or actual inequality of medical care between different population groups - usually between those with private and statutory health insurance.

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Things worth knowing about "Two-tier medicine"

The term two-tier medicine describes the perceived or actual unequal medical care between different population groups - mostly between privately and publicly insured people.

In Germany, the statutory health insurance (SHI) privately insured people enjoy the benefits of private health insurance (PHI)quicker access to specialistsshorter waiting times and more comprehensive services.

This unequal treatment is not only evident in appointment management and in the individualised medical care, but also in the provision of certain diagnostic, therapeutic or preventive services. Private patients are often given preferential treatment by doctors because higher remuneration rates can be billed via the German Medical Fee Schedule (GOÄ). At the same time, people with statutory health insurance often report long waiting times, rejected treatments or self-payer services that are not covered by the health insurance fund.

Two-tier medicine is the subject of critical debate, as it can increase social inequality in access to healthcare. Critics are calling for an harmonisation of the systems, e.g. through a citizens' insurance, while supporters call for freedom of choice, innovative power and competitive dynamics in the dual system. In fact, there are significant differences in care, which are influenced not only by insurance, but also by regional care density, socio-economic status or education 

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