Health Care in Germany

Germany has Europe's oldest system of universal health care, whose origins date back to Otto von Bismarck's social legislation, which included the bill on health insurance in 1883, accident insurance project Act of 1884, and Old Age and Disability Insurance Bill of 1889. As the compulsory health insurance, these bills originally applied only to workers with low income and certain government employees and their coverage, and that subsequent legislation gradually expanded to cover almost the entire population [44].

Currently, 85% of the population is covered by a health insurance plan provided by the Basic Law, which provides a standard level of coverage. The rest opt for citing health [private insurance needed], which often offer additional benefits. According to the World Health Organization, the health care system in Germany was 77% government funded and 23% private funds from 2004 [31].

The government partially reimburses the costs for low-wage workers, whose premiums are capped at a predetermined value. wage workers pay a higher premium based on their salary. They can also opt for private insurance, which is generally more expensive, but the price may vary depending on the health of the individual [45].

The reimbursement is a fee for service, but the number of licensed physicians to accept the statutory health insurance in a given location is regulated by the government and professional societies.

Co payments were introduced in the 1980s in an attempt to prevent overuse. The average length of hospital stay in Germany has declined in recent years from 14 days to nine days, much longer than the average stay in the U.S. (5-6 days). [46] [47] Part of the difference is that the main consideration for hospital reimbursement is the number of hospital days as opposed to diagnostic procedures. Drug costs have risen dramatically, from nearly 60% from 1991 to 2005. Despite attempts to contain costs, total health expenditure rose to 10.7% of GDP in 2005, as compared to other Western European countries, but significantly lower than that spent in the U.S. (nearly 16 % of GDP) [48].