McCare Model

For years, illegal workers from eastern Europe have filled a gaping hole in Germany's under-funded and overstretched health-care system by providing extensive care at home for the country's old and ailing.

Some 4.5 million households in Germany are estimated to have patients in need of care at home -- twice the amount that is officially registered for nursing insurance coverage.

But given the scarce and expensive nature of nursing personnel in Germany, who usually stay with patients at home for a couple of hours a day at most, it's cheaper workers from eastern Europe who do the rest. That includes shopping, cooking, administering medication and generally providing time and company.

An estimated 100,000 Bulgarians, Czechs, Hungarians and Poles work illegally in the health-care sector in Germany.

Care for two euros an hour

Sensing a business opportunity, a Bremen-based nursing company called "McPflege," or "McCare," now plans to use cheap labor from eastern European nations, legalize them and offer 24-hour personal nursing care for just two euros ($2.77) an hour. True to its name, the company intends to establish branches all over Germany within the next year.

Depending on the kind of care needed, patients would shell out between 1,500 and 1,700 euros a month, company CEO Norbert Meiners said last week. In comparison, a typical German health-care provider costs up to 5,000 euros a month for the same service.

In addition, the company said it would get a yearly cut of 570 euros from each patient for providing qualified, legal and German-speaking nursing personnel from eastern Europe.

According to EU service sector regulations, only German nursing providers are allowed to offer actual care for patients; foreign nurses can only provide additional services.

In accordance with the laws, the company would not pose competition to domestic nursing care providers, Meiners said, but rather take over nursing between visits by German care personnel. That would not just help patients but also the German nursing care providers, since patients could then stay at home longer, he said.

"People don't want to go into nursing homes and this way the [German] nursing services don't lose their patients," Meiners said.

Critics slam "fast care" model

But the plans have sparked a furor in Germany, with critics slamming the company's aggressive pricing strategy and business model.

Ralf Krüger from the Verdi services-sector labor union said the company name alone made one think about fast food and suggested "fast care."

"We don't think the quality that's needed in nursing care can be achieved by McPflege," Krüger told news agency AP.

"This is only about avoiding being alone," said Holger Knörr, head of the German nursing care association DBfA. "Professional care is something else."

Others have accused the company of driving down wages to unrealistic levels and questioned the legality of the company's business model.

"For us, it's modern slavery," Bernd Tews, head of the association of private social services providers (BPA) said in a statement. "An hourly wage of two euros for nurses is considered immoral by German work standards."

A hypocritical debate?

Experts, however, point out that even if German nursing care providers may be right about some of their criticism, they have no solutions to resolve the problem.

Competition is intense between the estimated 10,000 German nursing care service providers who, whether they are private or state-funded, are overstretched and under pressure to take care of as many patients as possible in a short time.

Nursing care expert Claus Fussek said the whole debate was hypocritical.

"When a 75-year-old woman takes care of her 80-year-old husband day and night, nobody asks whether she can manage it or is qualified for it," Fussek told Berlin daily taz.

The McPflege-type care is a meaningful addition, Fussek said, adding that it provided overburdened relatives with quick aid at affordable prices.