Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. The difference is partly driven by the fact that hospital reimbursement is chiefly a function of the number of hospital days as opposed to procedures or the patient's diagnosis. The average length of hospital stay in Germany has decreased in recent years from 14 days to 9 days, still considerably longer than average stays in the U.S. Ĭopayments were introduced in the 1980s in an attempt to prevent overutilization and control costs. health maintenance organizations, has been considered as a cost-containment mechanism but would require consent of regional medical associations, and has not materialized. Capitated care, such as that provided by U.S. Although reimbursement of providers is on a fee-for-service basis the amount to be reimbursed for each service is determined retrospectively to ensure that spending targets are not exceeded. In 1986 expenditure caps were implemented and were tied to the age of the local population as well as the overall wage increases. ![]() The commission takes into account government policies and makes recommendations to regional associations with respect to overall expenditure targets. Since 1976 the government has convened an annual commission, composed of representatives of business, labor, physicians, hospitals, and insurance and pharmaceutical industries. Long-term care insurance ( Pflegeversicherung) was introduced in 1995. Between 19 several cost laws were enacted. In 1974 SHI covered students, artists, farmers and disabled living shelters. New laws came in effect in 1972 to help finance and manage hospitals. In 1956, Laws on Statutory health insurance (SHI) for pensioners come into effect. 1935, Gerhard Domagk discovers sulfonamides. In 1932, Berlin treaty (1926) expired and Germany's modern healthcare system started shortly after the expiration of Berlin Treaty. Unemployment insurance was introduced in 1927. Mandatory health insurance originally applied only to low-income workers and certain government employees, but has gradually expanded to cover the great majority of the population. 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 the smallest political and administrative influence, and corporatism, the government representative bodies in health care professions set out procedures they deem feasible. Germany has the world's oldest national social health insurance system, with origins dating back to Otto von Bismarck's social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. 3.5 Self-payment (international patients without any national insurance coverage).In 2017, the governmental 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. Patients are allowed to seek almost any type of care they wish whenever they want it. ![]() ![]() Īccording 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. ![]() In 2001 total spending on health amounted to 10.8 percent of gross domestic product. It also had very low infant mortality rate (4.7 per 1,000 live births). It was tied for eighth place in the number of practicing physicians, at 3.3 per 1,000 persons. In 2004 Germany ranked thirtieth in the world in life expectancy (78 years for men). According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004. The turnover of the 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. Germany has a universal multi-payer health care system paid for by a combination of statutory health insurance ( Gesetzliche Krankenversicherung) and private health insurance ( Private Krankenversicherung).
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