Germany has the world’s oldest national social health insurance system, with origins dating back to Otto von Bismarck‘s social legislation in the 1880s.
Bismarck stressed the importance of three key principles:
- solidarity – the government is responsible for ensuring access by those who need it,
- subsidiarity – policies are implemented with smallest no political and administrative influence,
- corporatism – the government representative bodies in health care professions set out procedures they deem feasible.
Germany’s health care system provides its residents with nearly universal access to comprehensive high-quality medical care and a choice of physicians. Over 90 percent of the population receives health care through the country’s statutory health care insurance program. Membership in this program is compulsory for all those earning less than a periodically revised income ceiling. Nearly all of the remainder of the population receives health care via private for-profit insurance companies. Everyone uses the same health care facilities.
Although the federal government has an important role in specifying national health care policies and although the Länder control the hospital sector, the country’s health care system is not government run. Instead, it is administered by national and regional self-governing associations of payers and providers. These associations play key roles in specifying the details of national health policy and negotiate with one another about financing and providing health care. In addition, instead of being paid for by taxes, the system is financed mostly by health care insurance premiums, both compulsory and voluntary.
In early 1993, the Health Care Structural Reform Act (Gesundheitsstrukturgesetz–GSG) came into effect, marking the end of a more than a century-long period in which benefits and services under statutory public health insurance had been extended to ever larger segments of the population. Rising health expenditures may prompt policy makers to impose further restrictions on providers and consumers of health care. These high expenditures have been caused by a rapidly aging population (retirees’ costs rose by 962 percent between 1972 and 1992), the intensive and costly use of advanced-technology medical procedures, and other economic and budgetary pressures.
The healthcare system in Germany is funded by statutory contributions ensuring free healthcare for all. You can also take out private health insurance (Private Krankenversicherung or PKV) to replace or top up GKV cover. There are strict conditions, however, about who must register for mandatory state health insurance, and who can opt out in favour of private health insurance.
Travellers who have a foreign health insurance policy can use it during temporary visits to Germany, but will typically be asked to pay in cash at the end of their visit and claim a reimbursement later.
- I need an ambulance – Ich brauche einen Krankenwagen.
- Heart attack – Herzinfarkt
- I need a doctor – Ich brauche einen Arzt.
- I need a hospital – Ich brauche ein Krankenhaus.
- There’s been an accident – Es gab einen Unfall.
- I am allergic to… – Ich bin alergisch gegen…
- Hospital – Krankenhaus
- Patient – Patient
- Sick – Krank
Health Care Providers in Germany
Development of the Health Care System in Germany
Structure of German Society
Women In German Society
Marriage and Family in Germany
Fertility in Germany
Mortality in Germany
Religion in Germany
Population Distribution and Urbanization in Germany