Skip to main content

Germany: Where Have We Been?

  • Chapter
  • First Online:
ICU Resource Allocation in the New Millennium

Abstract

Germany’s health system organization is based on three major principles: compulsory insurance, compulsory contributions from both employers and employees and solidarity. A vast majority of German citizens follow the idea that health risks should be shared collectively by the community of all insured persons [9]. Irrespective of the amount each person had paid into the social system, all have access to comprehensive coverage. In order to understand Germany’s peculiarities in health policy, this chapter provides an introduction into Germany’s model of health care and then discusses which kinds of resource allocation strategies already have evolved. The second chapter deals with prospects for Germany’s health care system in the near future and future. Both chapters do not discuss future developments in the area of medical technology.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Boldt J, Schollhorn T. Ethics and monetary values. Influence of economical aspects on decision-making in intensive care. Anaesthesist. 2008;57:1075–82. quiz 1083.

    Article  PubMed  CAS  Google Scholar 

  2. Bundesministerium der Justiz. Sozialgesetzbuch V, § 72. In: Bundesministerium der Justiz, 2010. http://bundesrecht.juris.de/sgb_5/__72.html.

  3. Hoppe Joerg-Dietrich. Equitable distribution through prioritization – patient welfare in times of shortage. Presented at German Medical Assembly, Mainz; 2009.

    Google Scholar 

  4. Hurst SA, Slowther AM, Forde R, Pegoraro R, Reiter-Theil S, Perrier A, Garrett-Mayer E, Danis M. Prevalence and determinants of physician bedside rationing: data from Europe. J Gen Intern Med. 2006;21:1138–43.

    Article  PubMed  Google Scholar 

  5. Jaeger M, Schuhmann MU, Samii M, Rickels E. Neurosurgical emergencies and missing ­neurosurgical intensive care unit capacity: is “operate-and-return” a sound policy? Eur J Emerg Med. 2002;9:334–8.

    Article  PubMed  Google Scholar 

  6. Kassenärztliche Bundesvereinigung. Grunddaten zur vertragsärztlichen Versorgung in Deutschland 2009. Berlin; 2009. Accessed 6 June 2012.

    Google Scholar 

  7. Kern A, Beske F, Lescow H. Leistungseinschränkung oder Rationierung im Gesundheitswesen? Deutsches Ärzteblatt. 1999;96:A-113–116.

    Google Scholar 

  8. Marstedt G. Solidarität und Wahlfreiheit in der GKV. In: Böcken J, Braun B, Schnee M, editors. Gesundheitsmonitor 2002: Die ambulante Versorgung aus Sicht von Bevölkerung und Ärzteschaft. Gütersloh: Verlag Bertelsmann Stiftung; 2002. p. 112–29.

    Google Scholar 

  9. Moerer O, Plock E, Mgbor U, Schmid A, Schneider H, Wischnewsky MB, Burchardi H. A German national prevalence study on the cost of intensive care: an evaluation from 51 intensive care units. Crit Care. 2007;11:R69.

    Article  PubMed  Google Scholar 

  10. Müller-Jung Joachim. Der Gesundheitsminister pfeift auf die Zukunft. In: FAZ.NET; 2010. http://www.faz.net/s/Rub7F74ED2FDF2B439794CC2D664921E7FF/Doc∼EF009E5068D8842739403500DE5FCC473∼ATpl∼Ecommon∼Scontent.html. Accessed 6 June 2012.

  11. Statistisches Bundesamt. Gesundheitsberichterstattung des Bundes. In: Bonn; 2009.http://www.gbe-bund.de/oowa921-install/servlet/oowa/aw92/WS0100/_XWD_FORMPROC?TARGET=&PAGE=_XWD_98&OPINDEX=4&HANDLER=_XWD_CUBE.SETPGS&DATACUBE=_XWD_124&D.000=3730&D.001=1000001&D.935=12147. Accessed 9 September 2010.

  12. Statistisches Bundesamt. Pressemitteilung Nr.429 vom 12.11.2009. In: 2009.http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Presse/pm/2009/11/PD09__429__231,templateId=renderPrint.psml. Acessed 9 september 2010.

  13. Statistisches Bundesamt. Gesundheitsausgaben. In: 2010.http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Navigation/Statistiken/Gesundheit/Gesundheitsausgaben/Gesundheitsausgaben.psml. Accessed 9 September 2010.

  14. Strech D, Danis M, Lob M, Marckmann G. Extent and impact of bedside rationing in German hospitals: results of a representative survey among physicians. Dtsch Med Wochenschr. 2009;134:1261–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thomas Kerz M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kerz, T. (2013). Germany: Where Have We Been?. In: Crippen, D. (eds) ICU Resource Allocation in the New Millennium. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3866-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-3866-3_4

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-3865-6

  • Online ISBN: 978-1-4614-3866-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics