Five years of high-level exchange visits by Minnesota and German health care policy leaders have borne more fruit than most Minnesotans know, state Rep. Joe Atkins disclosed at a debriefing Thursday at the University of Minnesota’s Center for German and European Studies (CGES).

Atkins, DFL-Inver Grove Heights, revealed that the health care policy lessons he derived from exchange visits to Germany in 2010 and 2012 inspired his decision to sponsor the 2013 bill that authorized creation of MNsure, the state’s new Obamacare-linked purchasing exchange.

“If MNsure works, we get the credit. If it doesn’t, we’re blaming the Germans!” Atkins joked – I think.

MNsure is a far cry from the German system, which might be fairly described as Medicare for all combined with an opportunity to opt for private insurance instead, as about 10 percent of Germans do. But MNsure aims to do what Germany long has done – give every citizen the benefit of health insurance.

Germans spend about half the amount per capita that Americans do on public and private health care combined. Learning how that’s done, while giving Germans a chance to borrow ideas from Minnesota, is the focus of the annual CGES exchanges, which are funded by the German government.

This year’s 21-member Minnesota delegation to Berlin, which traveled in mid-September, took note of German price controls on pharmaceuticals, government financing of medical education, and a requirement that every citizen have long-term care insurance. But the biggest difference between American and German health care is cultural, the delegation said.

“In Germany, the rich help pay for the poor. The healthy help pay for the sick. The young help pay for the old. The males help pay for the female patients. They all agree with that. That’s the culture of that country, and it’s not the same in this country,” said state Rep. Tom Huntley, DFL-Duluth.

Kevin Goodno, a former Republican legislator and state human services commissioner, added: “Germans are not more caring than we are as Americans. They’ve just been raised in a system that has the expectation that government will provide these services…. It’s not impossible for us here to have the same culture and the same expectations. It’s just that we have to go through these growing pains. I think the ACA [Obamacare] is part of that, for better or for worse.”