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]
Carrin and James have identified 1988—105 years after Bismarck's first sickness fund laws—as the date Germany achieved universal health coverage through this series of extensions to growing benefit packages and expansions of the enrolled population. Bärnighausen and Sauerborn have quantified this long-term progressive increase in the proportion of the German population covered mainly by public and to a smaller extent by private insurance. Their graph is reproduced below as Figure 1: German Population Enrolled in Health Insurance (%) 1885–1995.
Initially the health insurance law of 1883 covered blue-collar workers in selected industries, craftspeople and other selected professionals.6 It is estimated that this law brought health insurance coverage up from 5 to 10 per cent of the total population.
As Germany has the world's oldest SHI [social health insurance] system, it naturally lends itself to historical analyses
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