Among health care economists, the consumer’s free choice of any insurance plan, and the resulting competition among the insurers, is one of the most admired features of the German system. “Americans tend to think that the profit motive is the only driver of competition,” Karl Lauterbach, a German economist who won a seat in the Bundestag, the national parliament, told me. “But our Krankenkassen compete because the executives earn more money, and higher prestige, if they have a larger pool of insured members. So we have universal coverage, and nobody can be turned down because of a preexisting
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