The German Health System

The German health care system has the reputation of being one of the best in the world. Medical facilities are equipped with the latest technology, an extensive network of hospitals and doctors covers even the remotest areas of Germany. In the WHO's year 2000 report for global healthcare, Germany ranked 25th out of 191 countries based on a cost/effectiveness ratio.

Federal laws covering the areas of the health care system:
  • Legislation on the statutory health insurance (Social Security Code, Book V)
  • Law on Long-Term Care Insurance (Social Security Code, Book XI)
  • Drug Law
  • Medical Devices Act
  • Training regulations for doctors, dentists, veterinarians, psychotherapists and for non-physician health care professionals
  • Hospitals Financing Act
  • Narcotics Act
  • Protection Against Infection Act
  Germany has a long tradition in medical science as well as the development and manufacturing of innovative medical technology. Germany is an attractive destination for foreigners seeking medical treatment, also. But medical costs - for doctors, hospital stays and even medicines - are high - they are among the most expensive in the world.

The aim of the new reformed German health service to share the pain of reform with Germans forced to pay more out of their own pockets for medical care and additional big changes will be needed in the coming years to stem the costs of the system as the German population ages.

The German health service is decentralized and the provision of health care in Germany is guaranteed by a large number of institutions and persons who contribute to promote, maintain and, where necessary, restore the health of the population. Each of the 16 states (Bundesländer) share responsibility with the central government for the hospitals and clinics, while the state-regulated health insurance providers exert some control over running costs. There are numerous non-profit-organizations involved in providing health care, including, in particular, voluntary welfare organizations such as the Arbeiterwohlfahrt (National Association for Workers' Welfare), Caritas, the Deutscher Paritätischer Wohlfahrtsverband (German Non-Denominational Welfare Association), the German Red Cross, Diakonisches Werk (Service Agency of the Protestant Church in Germany) etc. At federal level, various ministries and agencies (in addition to the Federal Ministry for Health) are also responsible for health issues (Governmental Links).

In Germany there are numerous types of doctors, from general practitioners to specialists. Doctors work either in hospitals or in private practice. According to the World Health Organization (WHO) statistics, Germany has an average of 358.40 physicians per 100 000 inhabitants.
Public Medical Services:
  • Public Information about health matters, health education and counselling
  • Youth and school health services
  • Care for the disabled and socio-psychiatric services
  • Health-promotion
  • Prevention and control of communicable diseases, monitoring the quality of food and drinking water, health-related protection of the environment
  • Mother and child counselling services
  • Supervision of health care facilities such as: hospitals, doctors, dentists or alternative medical practitioners, practices, pharmacies, blood donor centers, dialysis centers, emergency and ambulance services
  • Surveillance of public facilities such as: leisure and recreation facilities, bathing facilities, sports facilities, airports, harbours, railway stations
  • Supervision of employees in the health professions
  • Drawing up of expert opinions
  • Compilation and evaluation of important public health data

You can go straight to a specialist in Germany, but sometimes it is better to first see your GP first as they normally have a stable of specialists they work with. All surgeries will have set hours for visiting (Sprechstunde). It is recommended to make an appointment (Termin) as waiting times can be long, but you may go without an appointment during office hours if you need urgent help. If you have any major dental work to be done you should first ask your dentist for a quote and then check it out with your insurer.

Either way, you should always take your health insurance card with you, including if you have to go the hospital. Members of the statutory insurance have to pay 10 euros per quarter to see a general practitioner since 1 January 2004. They must contribute towards the cost of prescription drugs, wound dressings and bandages.

Payments using credit cards for medical services is very rare in Germany. In general, bills are sent to your home address and paid via bank account. You must keep a copy of all doctors bills (both visits to the doctors and prescriptions) for sending on to your health insurer.

FR, 2005/11/04

Read more:
World Health Organization (WHO) statistics
Commonwealth Fund survey: Germany exhibit some disturbing trends when it comes to patient safety and quality of care.

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