Health insurance and health policy in the Federal Republic of Germany.
Reinhardt, Uwe E
Date of Pub
This paper presents a structured survey of the West German health care and health insurance system. The West German health
insurance system is very comprehensive and generous. The scheme provides full coverage for all medically necessary services,
including ambulatory and inpatient care, prescription drugs, dental care, medical appliances and even prolonged rehabilitation
in the so called Kurorten (localities with health spas). Typically, patients do not bear any copayment at the point of service,
or only very modest ones. Physicians are paid on a fee-for-service basis (according to negotiated fee schedules), hospitals
are reimbursed on the basis of prospectively negotiated per diems, and the suppliers of drugs and appliances are reimbursed
at what is referred to as "market prices" (that is, at prices set by suppliers with only mild indirect control from the public
sector or third-party payors). This extraordinarily liberal insurance system causes West Germany to devote no greater a proportion
of their Gross National Product (GNP) to health care than does the United States. Using the American definition of "national
health care expenditures," both nations currently devote about 9.4 percent of their GNP to health care.
Comparative Study : Germany, West : Health Expenditures/trends : Insurance, Health/utilization : National Health Programs/organization
& administration : Support, U.S. Gov't, P.H.S.