Comparing Medical Freedom: Germany vs. Japan vs. the United States

The Need to Expand Medical Freedom for Americans

Recently, while promoting my intratumoral chlorine dioxide injection therapy, I noticed that the clinics willing to collaborate with me are mostly located in countries with high levels of medical freedom. These include less developed countries, such as Mexico, Brazil, and the Philippines, where the high degree of medical freedom may stem from the limited capacity of their healthcare systems, allowing residents to make medical choices that exceed the system's capabilities. There are also developed countries, such as Germany and Japan, where medical freedom is similarly high.

Similarities Between Germany’s Healthcare System and Japan’s

Germany’s healthcare system is in many ways similar to Japan’s, particularly in allowing patients the freedom to choose unapproved or experimental therapies. While Germany also has strict regulations, the overall system provides greater flexibility for patients to voluntarily pursue certain unapproved or alternative treatments (provided informed consent is given). Below is a detailed analysis of the similarities between Germany and Japan, as well as the differences with the U.S.

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I. Key Characteristics of Germany’s Healthcare System

1. Germany’s Universal Healthcare System

• Germany has a universal healthcare system (Gesetzliche Krankenversicherung, GKV) that covers the vast majority of its residents.

• Similar to Japan, Germany’s public insurance system includes coverage for most standard medical services, while additional out-of-pocket services can be accessed through optional private healthcare choices.

• Germany allows private insurance (Private Krankenversicherung, PKV) as an option for high-income individuals or those seeking premium services.

2. Legal Self-Paid Healthcare and Alternative Medicine

• In Germany, patients can opt for additional out-of-pocket healthcare services outside the standard coverage of public insurance, known as Individuelle Gesundheitsleistungen (IGeL), which may include non-standard or alternative medicine.

• Medical institutions may provide experimental or unapproved therapies (such as homeopathy or alternative treatments) as long as the patient gives informed consent.

• This flexibility aligns closely with Japan’s concept of "自由診療" (free medical care or self-paid medical care).

3. Emphasis on Patient's Autonomy

• Germany’s healthcare standards place a strong emphasis on patient autonomy(Patientenautonomie), where laws explicitly protect the right of patients to make choices about their own medical care.

• Physicians are required to provide patients with comprehensive and transparent information so that they can make an informed decision. As long as a therapy follows legal and ethical codes, patients are allowed to pursue that treatment.

4. High Acceptance of Alternative and Experimental Therapies

• Germany is known for its openness to alternative medicine (such as homeopathy, traditional Chinese medicine, and herbal treatments), with many clinics and private medical institutions offering such services.

• For experimental therapies or unapproved treatments, they can often be provided as long as the patient is fully informed of the risks and gives explicit consent.

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II. Germany vs. Japan: Similarities in Their Healthcare Systems

1. Both Have Universal Healthcare Systems

• Both Germany and Japan operate universal healthcare systems that ensure accessibility to healthcare services at relatively low costs.

• In both countries, patients have the option to pay out of pocket for additional medical services that are not covered by public insurance.

2. Self-Paid Medical Services Are Available in Both Systems

• In Japan, patients can opt for "自由診療" (free medical care), paying for treatments not covered by public insurance.

• In Germany, patients can access non-insured services through the IGeL system or private insurance, which often includes alternative or experimental treatments.

3. Emphasis on Patient’s Medical Choice

• Japan's Constitution Article 13 guarantees “the rights to life, liberty, and the pursuit of happiness,” and this has been interpreted to include the right to medical freedom.

• Similarly, Germany’s Patients’ Rights Law (Patientenrechtegesetz) and its Basic Law (Grundgesetz) safeguard patients’ autonomy, enabling them to make informed decisions regarding their treatment.

4. Both Allow Space for Unapproved Therapies

• Japan allows unapproved therapies through its framework of "free medical care" or special clinical research, provided regulatory and ethical requirements are followed.

• Germany permits experimental therapies or treatments not yet universally approved if patients give informed consent in accordance with laws and ethics.

III. Germany vs. the United States: Differences in Healthcare Systems

IV. Germany’s Position on Unapproved Therapies

1. Legitimacy of Alternative Medicine

• Germany has a high level of acceptance for alternative medicine (such as homeopathy, herbal medicine, and traditional Chinese treatments). Many clinics and private institutions actively offer such therapies.

• In some cases, alternative treatments may even be partially reimbursed under public insurance.

2. Providing Experimental Therapies

• Physicians in Germany may offer unapproved or experimental treatments if patients are fully aware of the risks, are given transparent information, and provide informed consent.

• For example, cancer patients in Germany may access experimental therapies or participate in specialized care programs offered by hospitals.

3. Legal and Ethical Boundaries

• Germany’s Patients’ Rights Law requires that informed consent must be secured for any medical treatment, particularly experimental or unapproved therapies.

• Physicians must ensure that treatments do not pose excessive risks to the patient and must comply with medical and ethical standards.

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V. Medical Freedom: Germany vs. Japan vs. the U.S.

Conclusion: Is Germany Like Japan?

Yes, Germany’s healthcare system shares many similarities with Japan’s, especially in terms of medical freedom.

1. Similarities Between Germany and Japan

• Both countries boast universal healthcare systems offering comprehensive coverage, while also enabling patients to access supplemental or experimental services outside the standard framework.

• Informed consent is a critical part of both systems, allowing unapproved therapies to be provided legally under specific conditions.

2. Differences From the U.S.

• Unlike in the U.S., where the FDA’s strict regulations drastically limit access to unapproved therapies, Germany and Japan adopt relatively flexible approaches toward experimental and alternative treatments.

• Patients in Germany and Japan enjoy broader freedom to choose alternative medicine or experimental therapies, especially in out-of-pocket arrangements, compared to the heavily regulated U.S. system.

From the perspective of medical choice freedom, Germany aligns more closely with Japan, while the United States appears more restrictive due to FDA oversight.