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What Germany could teach America about health-care reform and government's role

Like Americans, Germans get frustrated by big government, but they share a conviction that it has a mandate to provide security and help citizens help themselves. America's ideological standoff over government's role, meanwhile, is paralyzing its politics and thwarting economic progress.

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Germany’s recent overhaul of its health insurance system was big news here. It was controversial and contained substantial changes to the way Germans pay for and receive care.

The bigger news was how it passed: rather quickly, quietly, and with the understated touch of a professional political establishment. In other words, wholly opposite to the hyperbolic dysfunction Americans have grown accustomed to.

This is not because Germany is a utopian democracy; nor because its coalition government is above ridicule; nor because its politicians are immune to incompetence, greed, and corruption. Instead, there is a near universal acceptance of a specified government role in society and economy. The same cannot be said for the United States.

Actually, Germans don't love big government

Many Americans make two mistakes when looking across the Atlantic. The first is the belief that citizens of European countries love big, intrusive government. False. A political conversation with your typical German, for example, reveals a loathing of bureaucracy and taxes equal to that of any ardent tea party activist.

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The difference is that Germans are likely to be more keenly aware of the nature and necessity of government. They understand how the government weaves itself into the socioeconomic fabric, and that the government must do this to ensure a minimum of fairness for its citizens.

Americans, meanwhile, are likely to demand that government keep out of even government programs, such as Medicare.

Freedom through security

It's not affection for government that keeps the “social” in social democracy, but the undeniable necessity for it. Americans are said to embrace freedom as their highest value, but there is little freedom in the nearly 10 percent unemployed, and the millions more burdened by college and household debt, who have no choice but to find whatever work they can get, regardless of their skills or potential, because there is little buffer between them and the unfeeling market.

As an English teacher in Germany, I regularly see how the government steps in to help individuals help themselves. There are government-funded training programs for those both looking for work and those looking to move up in their workplace. There are government subsidies for businesses that have avoided layoffs during the crisis and invested in workers. And in Berlin, many of my students come to me during their state-mandated education holiday – a week to focus on a skill that is in addition to the nearly four weeks of normal holiday leave they enjoy.

These and other actions better enable Germany to prevent or mitigate crises in a predictable manner, securing its citizens and providing much needed stability to markets. The US government, meanwhile, must scramble time and again to react to events as they arise. The result is corporate bailouts and ad-hoc stimulus that no one cares for and leave markets guessing.


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