Germany 'exporting' old and sick to foreign care homes

[Magda Hassan]

Germany 'exporting' old and sick to foreign care homes

Pensioners are being sent to care homes in eastern Europe and Asia in an austerity move dismissed as 'inhumane deportation'

• Kate Connolly in Berlin
  
• guardian.co.uk, Wednesday 26 December 2012 16.37 GMT
  

German pensioners in Berlin. Many elderly Germans are increasingly being sent to cheaper retirement and long-term care accommodation in eastern Europe and Asia. Photograph: Sean Gallup/Getty Images

Growing numbers of elderly and sick Germans are being sent overseas for long-term care in retirement and rehabilitation centres because of rising costs and falling standards in Germany.
The move, which has seen thousands of retired Germans rehoused in homes in eastern Europe and Asia, has been severely criticised by socialwelfare organisations who have called it "inhumane deportation".
But with increasing numbers of Germans unable to afford the growing costs of retirement homes, and an ageing and shrinking population, the number expected to be sent abroad in the next few years is only likely to rise. Experts describe it as a "time bomb".
Germany's chronic care crisis the care industry suffers from lack of workers and soaring costs has for years been mitigated by eastern Europeans migrating to Germany in growing numbers to care for the country's elderly.
But the transfer of old people to eastern Europe is being seen as a new and desperate departure, indicating that even with imported, cheaper workers, the system is unworkable.
Germany has one of the fastest-ageing populations in the world, and the movement here has implications for other western countries, including Britain, particularly amid fears that austerity measures and rising care costs are potentially undermining standards of residential care.
The Sozialverband Deutschland (VdK), a German socio-political advisory group, said the fact that growing numbers of Germans were unable to afford the costs of a retirement home in their own country sent a huge "alarm signal". It has called for political intervention.
"We simply cannot let those people who built Germany up to be what it is, who put their backbones into it all their lives, be deported," said VdK's president, Ulrike Mascher. "It is inhumane."
Researchers found an estimated 7,146 German pensioners living in retirement homes in Hungary in 2011. More than 3,000 had been sent to homes in the Czech Republic, and there were more than 600 in Slovakia. There are also unknown numbers in Spain, Greece and Ukraine. Thailand and the Philippines are also attracting increasing numbers.
The Guardian spoke to retired Germans and people needing long-term care living in homes in Hungary, Thailand and Greece, some of whom said that they were there out of choice, because the costs were lower on average between a third and two-thirds of the price in Germany and because of what they perceived as better standards of care.
But others were evidently there reluctantly.
The Guardian also found a variety of healthcare providers were in the process of building or just about to open homes overseas dedicated to the care of elderly Germans in what is clearly perceived in the industry to be a growing and highly profitable market.
According to Germany's federal bureau of statistics, more than 400,000 senior citizens are currently unable to afford a German retirement home, a figure that is growing by around 5% a year.
The reasons are rising care home costs which average between €2,900 and €3,400 (£2,700) a month, stagnating pensions, and the fact that people are more likely to need care as they get older.
As a result, the Krankenkassen or statutory insurers that make up Germany's state insurance system are openly discussing how to make care in foreign retirement homes into a long-term workable financial model.
In Asia, and eastern and southern Europe, care workers' pay and other expenses such as laundry, maintenance and not least land and building costs, are often much lower.
Today, European Union law prevents state insurers from signing contracts directly with overseas homes, but that is likely to change as legislators are forced to find ways to respond to Europe's ageing population.
The lack of legislation has not stopped retired people or their families from opting for foreign homes if their pensions could cover the costs.
But critics of the move have voiced particular worries about patients with dementia, amid concern that they are being sent abroad on the basis that they will not know the difference.
Sabine Jansen, head of Germany's Alzheimer Society, said that surroundings and language were often of paramount importance to those with dementia looking to cling to their identity.
"In particular, people with dementia can find it difficult to orientate themselves in a wholly other culture with a completely different language, because they're very much living in an old world consisting of their earlier memories," she said.
With Germany's population expected to shrink from almost 82 million to about 69 million by 2050, one in every 15 about 4.7 million people are expected to be in need of care, meaning the problem of provision is only likely to worsen.
Willi Zylajew, an MP with the conservative Christian Democrats and a care service specialist, said it would be increasingly necessary to consider foreign care.
"Considering the imminent crisis, it would be judicious to at least start thinking about alternative forms of care for the elderly," he said.
Christel Bienstein, a nursing scientist from the University of Witten/Herdecke, said many German care homes had reached breaking point due to lack of staff, and that care standards had dropped as a result.
"On average each patient is given only around 53 minutes of individual care every day, including feeding them," she said. "Often there are 40 to 60 residents being looked after by just one carer."
Artur Frank, the owner of Senior Palace, which finds care homes for Germans in Slovakia, said that was why it was wrong to suggest senior citizens were being "deported" abroad, as the VdK described it.
"They are not being deported or expelled," he said. "Many are here of their own free will, and these are the results of sensible decisions by their families who know they will be better off."
He said he had seen "plenty of examples of bad care" in German homes among the 50 pensioners for whom he had already found homes in Slovakia.
"There was one woman who had hardly been given anything to eat or drink, and in Slovakia they had to teach her how to swallow again," he said.
German politicians have shied away from dealing with the subject, largely due to fears of a voter backlash if Germany's state insurers are seen to be financing care workers abroad to the detriment of the domestic care industry.
http://www.guardian.co.uk/world/2012/dec...care-homes

[Peter Lemkin]

How sick.....the article mentioned most of the wrongs, but forgot that they would also be far from and deprived of friends and family, not just familiar culture, language and surroundings...even food. Yes, Europe is collapsing too.....just a few steps behind the USA.

[Jan Klimkowski]

Growing numbers of elderly and sick Germans are being sent overseas for long-term care in retirement and rehabilitation centres because of rising costs and falling standards in Germany.
The move, which has seen thousands of retired Germans rehoused in homes in eastern Europe and Asia, has been severely criticised by socialwelfare organisations who have called it "inhumane deportation".
But with increasing numbers of Germans unable to afford the growing costs of retirement homes, and an ageing and shrinking population, the number expected to be sent abroad in the next few years is only likely to rise. Experts describe it as a "time bomb".

This is the logic of capitalist, profit-driven, health care.

First we had doctors and nurses trained in eastern Europe, India, Pakistan, Africa etc lured from the country that had educated them to western Europe by higher wages, to care for the sick and elderly in the UK, Germany, France, Scandanavia etc.

Now, the Germans have started sending the elderly to these countries where wages and costs are lower.

And this is in the strongest economy in Europe.

I heard a radio interview with a Greek doctor, in his 40s, who said his medical qualifications enabled him to work anywhere in Europe and he was currently earning 1200 Euros a month in Greece, living on his rapidly diminishing savings. So, soon, not only will ordinary Greek people not be able to afford drugs or treatment, but there won't be any doctors and nurses left to care for them.

Meanwhile, as bankers continue to make fortunes from central bank scams, MSM tells us there's nothing to worry about.....

Then there's this:

Counterfeit medicine from Asia threatens lives in Africa

Malaria is one of the diseases affected by unscrupulous traders in fake and substandard drugs

Kathleen E McLaughlin

The Guardian, Sunday 23 December 2012 16.33 GMT

International health experts are warning of a mounting health crisis in parts of Africa because of an influx of counterfeit medicine from Asia that is playing havoc with the treatment of diseases such as malaria. Porous borders in Africa coupled with indifferent oversight in China are combining to turn the continent and its pressing health problems into a free-for-all for maverick manufacturers, some of whom are producing pills with no active ingredients at all.

Precise data is hard to track down because of the informal nature of African health systems. But several recent studies warn that as many as one-third of malaria drugs in Uganda and Tanzania are fake or substandard, with most believed to originate in China or India.

Apart from the lives lost, there are additional concerns about drug resistance building in east Africa, experts say. "It's a crisis any time someone dies," Nick White, who chairs the Wellcome Trust's south-east Asia major overseas programmes and the WorldWide Antimalarial Resistance Network (Wwarn). "It's a massive problem that people have simply ignored. It's not like a boil that's beginning to burst because it's been a problem for a long time. What has happened is we are beginning to recognise it more."

Laurie Garett, senior fellow for global health at the US Council on Foreign Relations, said: "Nobody has a head count or a body count on numbers of Africans that have died as a result. But China's role certainly has been dreadful."

David Nahamya, chief drug inspector for the Ugandan national drug authority, said: "What we are told is this, if someone wants to counterfeit a drug, they just take the package to China and they can make it in thousands. You have seen how they make it there. They can copy anything."

An increasing list of studies and surveys about fake, counterfeit and substandard drugs has emerged in recent years, but because of deeply entrenched interests from all sides governments, NGOs and pharmaceutical companies there has been great reluctance to call the scourge of killer medications in Africa and elsewhere a crisis.

This is despite the fact that everything from life-saving Aids medication to emergency contraception are being copied, faked and made with shoddy components on a huge scale.

Patrick Lukulay, vice president of the US Pharmacopeial Convention's global health impact programmes, said it was no secret that the majority of dangerous medications came from China and India, as those countries had the world's largest production bases for both active ingredients and finished drugs.

While India has stepped up oversight, "China is only now just catching on", he added.

Though it may seem like an immense amount of trouble to counterfeit a £3 packet of malaria pills, Lulukay noted that the global trade was estimated at £46bn a year. Counterfeiters know their markets well and target medications accordingly. Efforts to combat the activity are in their infancy.

"If you want to be efficient in fighting it, you have to have a very strong regulatory authority, very strong collaborations, very good distribution networks and good co-operation between governments," said Sabine Kopp, who manages the anti-counterfeiting and medicines quality assurance programmes at the World Health Organisation.

As yet, none of those components are in place and counterfeiters, apparently unconcerned with harming sick people in developing countries, continue making huge profits.

It is a loss to global aid organisations, as well, said Dr Nick White. "Think of the hundreds of millions, if not billions, you spend on pills to help people in poor countries," he said. "It's bonkers not to make sure they're authentic and instead people are ending up with shoddy pills from China."

This work was funded in part by a grant from the Pulitzer Center on Crisis Reporting

[Greg Burnham]

Thanks for sharing this, Jan. I have long believed that there exists certain "businesses" or perhaps "industries" that need not be allowed to
"go public" and sell shares of company stock. In the States there is a requirement that "publicly held" companies must strive at all times to
return a profit on investment to the shareholders. While this may, on the surface, appear to be in the best interest of the shareholders and
serve to prevent those tasked with guardianship over shareholder investment funds from failing to keep their proverbial eye on the ball, there
is more to it than that. When the actual Products and Services offered by these companies to consumers are of a crucial nature, such as, health
care, then the profit to shareholders must take a back seat to greater Hippocratic Principles. So, until an exception is made to the "return on
investment" fiduciary responsibility of these Health Care Companies to their shareholders (not likely to happen) or alternately a restriction is put
in place that prohibits Health Care companies from selling stock to the public in order to avoid a conflict of interest that inevitably results in
the company being between a rock and a hard place, we will continue to have a health care mess. Choosing between providing "great health
care" --OR-- "providing the highest return on shareholder investments" is no way to run a company and certainly is no way to provide health care.
The conflict is much too deep given the laws in existence today.

Of course, it should go without saying that patient care MUST take precedence over shareholder ROI. But, until the laws are amended that is
not likely to become a reality. Moreover, what of those who are heavily invested in health care? How do we amend the system (which certainly
needs amending) without damaging the interests of honest folks whose retirement funds are heavily invested in health care industries? These
are very challenging considerations, indeed. It is easier to make laws going forward BEFORE anyone is heavily invested, much more difficult is
it to protect those already invested.

While I agree that capitalistically driven health care is a recipe for disaster, still... free markets tend to bring costs down, but only if they are truly
free. I believe that a restriction from trading stock for certain, select industries is a necessary and sensible regulation that should have already
been implemented.

I just wonder: How did "they" miss this conflict to begin with? Answer: We give "them" way too much credit (no pun intended).


.

[Jan Klimkowski]

Greg - I agree.

Some "industries" should not be driven by the profit motive.

Here in the UK, we're beginning to be infected by some of the private healthcare distortions, such as GPs (neighbourhood clinic doctors) being financially incentivized (often covertly) to send patients to particular hospitals for treatment or to prescribe expensive Big Pharma drugs.

Some thirty-odd years ago, my 23-year-old cousin defected from Cold War Poland to the UK, by marrying a British citizen for his passport, having just completed her medical studies. Poland lost a doctor. My cousin is bright and tenacious, and quickly learnt English and passed the exams to requalify in Britain.

As my mother had "sponsored" my cousin's holiday from Poland to London, as was mandatory during the Cold War, the Polish secret police held my parents responsbile for their losing a doctor trained and educated entirely at the cost of the Polish state.

Britain gained a talented doctor for free.

This small anecdote has been writ large as the rich west has literally stolen doctors and nurses from Africa, Asia and eastern Europe.

MSM paints Castro as a communist dictator oppressing the people. It rarely mentions the fact that Fidel and the Cuban state trained tens of thousands of doctors and sent them out across central and south America to treat, ahem, the oppressed......

Medicine is too important to be governed by the profit motive.

[Greg Burnham]

Medicine is too important to be governed by the profit motive.

Indeed.