Summary
Germany has developed a model of social health insurance for financing healthcare. The basic characteristics of this model are compulsory membership, income-dependent contributions paid by employers and employees, a comprehensive package of healthcare entitlements, stringent government regulation and implementation by not-for-profit health insurers — the sickness funds — which operate under public law.
Since the mid-1970s, when health care cost containment gradually evolved as a new issue in German healthcare policy-making, a long series of reform programmes have been initiated. Two recent development can be noted: the introduction of market competition in health insurance and the introduction of fixed budgets. Market competition in health insurance is now an explicit policy tool in Germany.
This article analyses the German healthcare system, the history of healthcare reforms and the current healthcare acts. Special emphasis is given to the German drug market and its regulation. The paper describes the present cost-containment policy for pharmaceutical products, especially the global budget concept which was introduced for medicines and patients’ copayments.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Graf von der Schulenburg J-M. Solidarity at a price. J Health Polit Policy Law 1992; 17: 715–738
Der Bundesminister für Arbeit und Sozialordnung. Übersicht über die soziale Sicherheit. Bonn: Der Bundesminister für Arbeit und Sozialordnung, 1991
Statistisches Bundesamt. Statistisches Jahrbuch. Wiesbaden: Statistisches Bundesamt, 1995
Statistisches Bundesamt. Gesundheitswesen Reihe 2, Fachserie 12, Ausgaben für Gesundheit. Wiesbaden: Statistisches Bundesamt, 1996
Sachverständigenrat für die konzertierte Aktion im Gesundheitswesen. Gesundheitsversorgung und Krankenversiche-rung. Baden-Baden: Nomos-Verlag, 1994
Uber A. The socioeconomic profile of patients treated by phlebotropic drugs in Germany. Angiol 1997; 48 (7): 595–607
Schöffski O. Consequences of implementing a drug budget for office-based physicians in Germany. Pharmacoeconomics 1996; 10 Suppl. 2: 37–47
Schwabe U, Paffrath D. Arzneiverordnungsreport’ 95. Stuttgart: Gustav Fischer Verlag, 1995
Greiner W. Is it necessary to regulate drug pricing and reimbursement? The German Perspective. Hannover: University of Hannover, 1994. Discussion paper no.: 38
Graf von der Schulenburg J-M. Selbstbeteiligung. Tubingen: J.B.C. Mohr, 1987
Breyer F, Zweifel P. Gesundheitsökonomie. Berlin: Springer, 1992
Graf von der Schulenburg J-M, Uber A. Socio-economic aspects of venous insufficiency: a report on a survey conducted in the Federal Republic of Germany. In: Enjeux médico-sociaux et economiques d’une Pathologic Bruxelles: Université Libre de Bruxelles, 1993
Bundesverband der Pharmazeutischen Industrie e.V. Pharma Daten’ 95. Frankfürt, 1995
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Graf von der Schulenburg, JM., Uber, A. Current Issues in German Healthcare. Pharmacoeconomics 12, 517–523 (1997). https://doi.org/10.2165/00019053-199712050-00002
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-199712050-00002