In Germany, the healthcare system is readily accessible for people who are insured by one of the providers of national health insurance [1]. However, doctors need to process a large amount of patient per day to make ends meet.
Note, I chose the word "process" with intent, because that's what it feels like with 9 out of 10 doctors in Germany's cities nowadays. Go in, have a less than 1min chat about your health, get screened with a medical move set that rivals street food artists in Bangkok, then get a run-of-the-mill answer with little effort to personalize treatment according to your medical history.
The younger the doctors, the more intense is this issue. This isn't because younger doctors are less empathetic or something. The system simply demands this or else. People are more cattle than anything...
Oh and fitting right in with the Instagram fame, young medical professionals are all moving to the fun cities in Germany. Smaller towns and villages are hemorrhaging doctors. They are just not attractive in any way, especially with Germanys catastrophically bad Internet and mobile infrastructure.
Last time I was at my general doctor, I was in the room for an hour with Doc and nurse. Talking about how I’m eating, how I feel after running long distance, if this blemish has changed shape, how I’ve been sleeping, etc etc.
It took 10 days to make an appointment which is annoying, but I have never once felt rushed or that staff was rushed.
Like I said. Annecdote, but polar opposite.
Not too long ago, I still had my general physician who could sit down and talk it all through. He retired... and another one in another city did as well. Younger ones seem under much higher economic stress. Maybe also stress from peers?
It seems more of an emergent problem to be honest.
Recently my wife & I were forced to use the public service, and after 3 days of traveling back & forth, day after day, to another city, being told to visit another ward next day, and come back the day later, I was begging for someone to throw money at to make our problem go away. And I'm not really blaming the staff; they're all severely overworked, underequipped and underpaid. There's a huge problem with public health care here, kind of an opposite to the US problems. Poor or rich, you will get medical attention, just possibly months after when it's needed.
Imagine visiting a hospital for an emergency, and receiving 10 bills from different doctors totaling to few thousand dollars then fighting with insurance to pay for it.
Universal healthcare brings OVERALL cost down. It makes private treatment cheaper. A crown and root canal costs about $2k in the US. Plus, it is nearly impossible to find cost of a procedure prior to it. It is fking weird.
For comparison, with insurance in the US my root canal cost about $250 out of pocket.
For instance Internet connectivity is not "catastrophically" bad, (could indeed be better, though).
An overlooked trend that has has changed communication patterns with patients for the worse is a trend towards larger joint practices with doctors as employees often not working fulltime. Joint practices tend to have larger, fuller waiting rooms, and which necessarily results in (in my experience) a more stressful doctor-visiting atmosphere.
Moreover, paperwork has become more complex also for patients, e.g. when agreements and waivers (for operations) have to be signed, nobody has the time to explain these. Nobody can explain finer points of medicine prescriptions, and usage of technical helping equipments (e.g. hearing aids). The staff at the front desk can't explain this, and the doctors do not have the time to either.
These are all general problems, not Germany-specific.
However, I heavily disagree about Internet connectivity. In cities like BER, HAM or MUC it is "meh". On the country-side and in smaller towns it is catastrophically bad for the 4th largest economy on the planet.
This is Deutsche Telekom's fiber network in Hamburg, today: https://i.redd.it/r4a07co2x4y11.png
I asked a handyman community the other day if my furnace running 22 hours a day during the winter is normal and how furnaces work.
I got about a dozen "it depends..." answers that enumerated all the factors involving a house heating and cooling until someone basically said, "no it doesn't really depend. That's very much not normal regardless of any factors. You'd have to be in a really unusual situation for this to be normal and not warrant further investigation."
See, this is the problem with you not being an expert in the field.
For example, if your house had terrible insulation and it was -10 out. Yea, that thing is going to run all day. If you had a new house, but left all your windows open, yea it will run all day too. So, yea, "it depends' is a perfectly cromulent answer without you giving lots of information.
People that don't have much experience are the ones that will say "yep, it's broke" right off the bat. When I was younger and you asked "Can you make my software stack faster", I'd have answered yes. These days "It depends", probably followed by "How much money do you want to spend".
TL:DR; The complexity of reality doesn't give a damn how simple you want your problem to be.
As a non expert I wouldn't have been surprised if someone said, "yeah it's pretty common for furnaces to run non stop in cold winters. That's their design."
This was not uncommon in rich (big houses) older (built up before WW2) towns in MA because the houses are big and old and state law regarding who can perform plumbing/electrical/hvac work greatly drive up costs and are a massive incentive to always minimum amount of work possible so tons of people would have poorly insulated houses with smaller than ideal heating systems. For the coldest days in the winter many people's furnaces would run all day to keep the house warm (whereas poor people just turn down the heat).
This has changed recently because the state is pumping a ton of money into incentives for people to make their homes energy efficient now basically every old house has had insulation blown in everywhere because with state subsidies the cost to do so is now justifiable in the overwhelming majority of use cases.
Importantly in this case, the outside temperature at which your heat or AC runs constantly is the maximum where your house will maintain temperature. So, because of the different tradeoffs of oversizing heat vs AC, normal practice is to put in enough AC for a typical summer (and just let the house get a little warmer during a heat wave) so that dehumidification remains optimal, and to put in enough heating for a worst-case cold snap because, well, it doesn't hurt much and people REALLY complain when their house gets cold in the winter.
"The further you are from mainstream medicine, the greater the confidence signaling. Doctors tend to express the least confidence, and crackpots the most. This is why alternative medicine thrives."
I have a relative that was diagnosed with EDS, it is a very serious disease with no cure. This relative has spent $20k+ on prolotherapy. There is 0 scientific evidence that prolo works, and 0 evidence that it works on this specific disease. Those doctors just make up claims and for sources link to their site. But what they sell is hope, which is really saddening considering that person will be unable to afford housing/food soon. Just thinking about it makes me angry that people like that exist.
People simply have a hard time accepting their fate. REAL doctor will tell you what you don't want to hear, a doctor that sells snake oil will promise BENEFICIAL treatments based on bs.