Healthcare: another thing that the Germans just do better

Germany has rejected restrictions on doctors visits.

Recent Conservative ideas to restrict the number of GP visits in a year may be discounted as too controversial. But with the concept of universalism in health and welfare under threat we should not be so complacent. This is another area where we should follow the current trend of noting what has happened in Germany: consultation fees for visiting the doctor were abolished in Germany on 1 January 2013.

Co-payments, as they were called, of €10 if you visited the doctor in any given quarter or if you went to a specialist without a referral, were introduced by Schroder’s government in 2004. Addressing similar concerns to the NHS at present on health costs and the waste of doctors’ time on trivial conditions it was thought, at the time, to be a good idea by all the main parties in Germany. It was supposed to deter the practice in Germany’s compulsory health insurance system of patients hopping from specialist to specialist. They also thought it would bring in approximately €2bn per year.

Once in opposition the Social Democrats (SPD) and Greens turned against the idea of co-payments. As you would have predicted the charges deterred many people from going to the doctor. So it is obvious that the cost in dealing later with deteriorating conditions and in personal misery was great. Even on the projected revenue the German government did not meet its targets. When the abolition of co-payments was debated in the Bundestag last November the Financial Times Deutschland reported that medical practices spent approximately 120 hours a year collecting the fee, a total administrative cost of €360m. Once it came to a vote at the end of last year – coincidentally on the historic date of 9 November – the ruling conservative-liberal coalition (CDU/CSU and FDP) also changed their minds and the Bundestag voted unanimously to abolish the charge.

Could co-payments be introduced in Britain? The idea could be sold as a fairer method than restricting the number of GP visits per patient, it would be said "only those who can afford to pay will have to make this small contribution". But people of all income brackets have commitments to meet, whether it is a mortgage, rent or bills and any fee, no matter how small will deter people from seeking medical help. For those with long-term conditions the need to see your doctor regularly is clear. For the rest of us, also, we need to see the doctor when we have concerns. We may dismiss our niggling symptoms, but we will all get something serious eventually and it may happen sooner if, being human, we decide to spend our tenner on something other than going to the doctor for a trivial matter.

I would suggest that following recent top-down healthcare reforms it is only a matter of time before a formal proposal on GP visits is made – the Tory idea on restricting the number of visits is just to test the water. Universalism has not been defended but is a sound principle. It is more straightforward, we all contribute (even those on out-of-work benefits pay VAT) and we all benefit. The bureaucracy of means-testing is avoided. The case for the better-off benefiting is clear, we are all part of the community and the costs can be recouped by looking at the tax paid by the better-off. In terms of GP visits this is another case where we can learn from the way the Germans do things – a mistake was made but they reconsidered it and put it right.

Photograph: Getty Images
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Just you wait – soon fake news will come to football

No point putting out a story saying that Chelsea got stuffed 19-1 by Spurs. Who would believe it, even if Donald Trump tweeted it?

So it is all settled: Cristiano Ronaldo will be arriving at Carlisle United at the end of the month, just before deadline day. It all makes sense. He has fallen in love with a Herdwick sheep, just as Beatrix Potter did, and like her, he is putting his money and energy into helping Cumbria, the land of the Herdwick.

He fell out with his lover in Morocco, despite having a private plane to take him straight from every Real Madrid game to their weekly assignation, the moment this particular Herdwick came into his life. His mother will be coming with him, as well as his son, Cristiano Ronaldo, Jr. They want to bring the boy
up communing with nature, able to roam free, walking among the lakes and fells.

Behind the scenes, his agent has bought up CUFC and half of Cumbria on his behalf, including Sellafield, so it is a wise investment. Clearly CUFC will be promoted this year – just look where they are in the table – then zoom-zoom, up they go, back in the top league, at which point his agent hopes they will be offered megabucks by some half-witted Chinese/Russian/Arab moneybags.

Do you believe all that? It is what we now call in the trade fake news, or post-truth – or, to keep it simple, a total lie, or, to be vulgar, complete bollocks. (I made it up, although a pundit on French TV hinted that he thought the bit about Ronaldo’s friend in Morocco might not be too far-fetched. The stuff about Beatrix Potter loving Herdwicks is kosher.)

Fake news is already the number-one topic in 2017. Just think about all those round robins you got with Christmas cards, filled with fake news, such as grandchildren doing brilliantly at school, Dad’s dahlias winning prizes, while we have just bought a gem in Broadstairs for peanuts.

Fake news is everywhere in the world of politics and economics, business and celebrity gossip, because all the people who really care about such topics are sitting all day on Facebook making it up. And if they can’t be arsed to make it up, they pass on rubbish they know is made up.

Fake news has long been with us. Instead of dropping stuff on the internet, they used to drop it from the skies. I have a copy of a leaflet that the German propaganda machine dropped over our brave lads on the front line during the war. It shows what was happening back in Blighty – handsome US soldiers in bed with the wives and girlfriends of our Tommies stuck at the front.

So does it happen in football? At this time of the year, the tabloids and Sky are obsessed by transfer rumours, or rumours of transfer rumours, working themselves into a frenzy of self-perpetuating excitement, until the final minute of deadline day, when the climax comes at last, uh hum – all over the studio, what a mess.

In Reality, which is where I live, just off the North Circular – no, down a bit, move left, got it – there is no such thing as fake news in football. We are immune from fantasy facts. OK, there is gossip about the main players – will they move or will they not, will they be sued/prosecuted/dropped?

Football is concerned with facts. You have to get more goals than the other team, then you win the game. Fact. Because all the Prem games are live on telly, we millions of supplicant fans can see with our eyes who won. No point putting out a story saying that Chelsea got stuffed 19-1 by Spurs. Who would believe it, even if Donald Trump tweeted it?

I suppose the Russkis could hack into the Sky transmissions, making the ball bounce back out of the goal again, or manipulating the replay so goals get scored from impossible angles, or fiddling the electronic scoreboards.

Hmm, now I think about it, all facts can be fiddled, in this electronic age. The Premier League table could be total fiction. Bring back pigeons. You could trust them for the latest news. Oh, one has just arrived. Ronaldo’s romance  with the Herdwick is off! And so am I. Off to Barbados and Bequia
for two weeks.

Hunter Davies’s latest book is “The Biscuit Girls” (Ebury Press, £6.99)

Hunter Davies is a journalist, broadcaster and profilic author perhaps best known for writing about the Beatles. He is an ardent Tottenham fan and writes a regular column on football for the New Statesman.

This article first appeared in the 12 January 2017 issue of the New Statesman, Putin's revenge