, Volume 12, Issue 5, pp 517–523 | Cite as

Current Issues in German Healthcare

  • Johann-Matthias Graf von der Schulenburg
  • Andrea Uber
Leading Article


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.


Adis International Limited Gross Domestic Product Health Insurance Scheme Sickness Fund Statutory Health Insurance 
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  1. 1.
    Graf von der Schulenburg J-M. Solidarity at a price. J Health Polit Policy Law 1992; 17: 715–738CrossRefGoogle Scholar
  2. 2.
    Der Bundesminister für Arbeit und Sozialordnung. Übersicht über die soziale Sicherheit. Bonn: Der Bundesminister für Arbeit und Sozialordnung, 1991Google Scholar
  3. 3.
    Statistisches Bundesamt. Statistisches Jahrbuch. Wiesbaden: Statistisches Bundesamt, 1995Google Scholar
  4. 4.
    Statistisches Bundesamt. Gesundheitswesen Reihe 2, Fachserie 12, Ausgaben für Gesundheit. Wiesbaden: Statistisches Bundesamt, 1996Google Scholar
  5. 5.
    Sachverständigenrat für die konzertierte Aktion im Gesundheitswesen. Gesundheitsversorgung und Krankenversiche-rung. Baden-Baden: Nomos-Verlag, 1994Google Scholar
  6. 6.
    Uber A. The socioeconomic profile of patients treated by phlebotropic drugs in Germany. Angiol 1997; 48 (7): 595–607CrossRefGoogle Scholar
  7. 7.
    Schöffski O. Consequences of implementing a drug budget for office-based physicians in Germany. Pharmacoeconomics 1996; 10 Suppl. 2: 37–47PubMedCrossRefGoogle Scholar
  8. 8.
    Schwabe U, Paffrath D. Arzneiverordnungsreport’ 95. Stuttgart: Gustav Fischer Verlag, 1995Google Scholar
  9. 9.
    Greiner W. Is it necessary to regulate drug pricing and reimbursement? The German Perspective. Hannover: University of Hannover, 1994. Discussion paper no.: 38Google Scholar
  10. 10.
    Graf von der Schulenburg J-M. Selbstbeteiligung. Tubingen: J.B.C. Mohr, 1987Google Scholar
  11. 11.
    Breyer F, Zweifel P. Gesundheitsökonomie. Berlin: Springer, 1992Google Scholar
  12. 12.
    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, 1993Google Scholar
  13. 13.
    Bundesverband der Pharmazeutischen Industrie e.V. Pharma Daten’ 95. Frankfürt, 1995Google Scholar

Copyright information

© Adis Data Information BV 1997

Authors and Affiliations

  • Johann-Matthias Graf von der Schulenburg
    • 1
    • 2
  • Andrea Uber
    • 1
    • 2
  1. 1.Institute for Insurance Economics (Institut für Versicherungsbetriebslehre)University of HannoverHannoverGermany
  2. 2.North German Center for Health Services ResearchUniversity of HannoverHannoverGermany

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