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Healthcare in Germany

Germany has a universal[1] multi-payer health care system paid for by a combination of statutory health insurance (Gesetzliche Krankenversicherung) and private health insurance (Private Krankenversicherung).[2][3][4][5][6]

The turnover of the national health sector was about US$368.78 billion (€287.3 billion) in 2010, equivalent to 11.6 percent of gross domestic product (GDP) and about US$4,505 (€3,510) per capita.[7] According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004.[8] In 2004 Germany ranked thirtieth in the world in life expectancy (78 years for men). Physician density in Germany is 4.5 physicians per 1000 inhabitants as of 2021. It was 4.4 physicians per 1000 inhabitants in 2019. [9] It also had very low infant mortality rate (4.7 per 1,000 live births).[note 1][10] In 2001 total spending on health amounted to 10.8 percent of gross domestic product.[11]


According to the Euro health consumer index, which placed it in seventh position in its 2015 survey, Germany has long had the most restriction-free and consumer-oriented healthcare system in Europe. Patients are allowed to seek almost any type of care they wish whenever they want it.[12] In 2017, the government health system in Germany kept a record reserve of more than €18 billion which made it one of the healthiest healthcare systems in the world at the time.[13]

is set by the based on a fixed set of covered services as described in the German Social Law (SozialgesetzbuchSGB), which limits those services to "economically viable, sufficient, necessary and meaningful services";

Federal Ministry of Health

is not dependent on an individual's health condition, but a percentage (currently 14.6%, half of which is covered by the employer) of salaried income under €64,350 per year (in 2021). Additionally, each public health insurance provider charges an additional contribution rate, which is 1.3% on average (2021),[22] but goes up to 2.7%;[58][59]

[57]

includes family members of any family members, or "registered member" (Familienversicherung – i.e., husband/wife and children are free);

[22]

is a "pay as you go" system – there is no saving for an individual's higher health costs with rising age or existing conditions. Instead, the solidarity principle applies in which the current active generation pays forward for the costs of the current retired generation.

[60]

Public hospitals (öffentliche Krankenhäuser).

Charitable hospitals (frei gemeinnützige Krankenhäuser).

Private hospitals (Privatkrankenhäuser).

Waiting times and capacity[edit]

In 1992, a study by Fleming et al. 19.4% of German respondents said they had waited more than 12 weeks for their surgery. (cited in Siciliani & Hurst, 2003, p. 8),[85]


In the Commonwealth Fund 2010 Health Policy Survey in 11 countries, Germany reported some of the lowest waiting times. Germans had the highest percentage of patients reporting their last specialist appointment took less than 4 weeks (83%, vs. 80% for the U.S.), and the second-lowest reporting it took 2 months or more (7%, vs. 5% for Switzerland and 9% for the U.S.). 70% of Germans reported that they waited less than 1 month for elective surgery, the highest percentage, and the lowest percentage (0%) reporting it took 4 months or more.[86] Waits can also vary somewhat by region. Waits were longer in eastern Germany according to the KBV (KBV, 2010), as cited in "Health at a Glance 2011: OECD Indicators".[87]


As of 2015, waiting times in Germany were reported to be low for appointments and surgery, although a minority of elective surgery patients face longer waits.[88][89]


According to the National Association of Statutory Health Insurance Physicians in 2016,(KBV, Kassenärztliche Bundesvereinigung), the body representing contract physicians and contract psychotherapists at federal level, 56% of Social Health Insurance patients waited 1 week or less, while only 13% waited longer than 3 weeks for a doctor's appointment. 67% of privately insured patients waited 1 week or less, while 7% waited longer than 3 weeks. The KBV reported that both Social Health Insurance and privately insured patient experienced low waits, but privately insured patients' waits were even lower. [90]


As of 2022, Germany had a large hospital sector capacity measured in beds with the highest rate of intensive care beds among high income countries and the highest rate of overall hospital capacity in Europe.[91] High capacity on top of significant day surgery outside of hospitals (especially for ophthalmology and orthopaedic surgery) with doctors paid fee-for-service for activity performed are likely factors preventing long waits, despite hospital budget limitations.[85] Activity-based payment for hospitals also is linked to low waiting times (Siciliani & Hurst, 2003, 33–34, 70).[85] As of 2014, Germany had introduced Diagnosis-related group activity-based payment for hospitals with a soft cap budget limit.[92]

Arzneimittelmarkt-Neuordnungsgesetz

Health in Germany

Health care compared

Health care system of the elderly in Germany

Reformhaus

Universal health care