Health insurance and health policy in the Federal Republic of Germany. 1981

U E Reinhardt

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.

UI MeSH Term Description Entries
D007348 Insurance, Health Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading. Group Health Insurance,Health Insurance,Health Insurance, Voluntary,Health Insurance, Group,Health Insurances,Insurance, Group Health,Insurance, Voluntary Health,Insurances, Health,Voluntary Health Insurance
D009313 National Health Programs Components of a national health care system which administer specific services, e.g., national health insurance. National Health Insurance, Non-U.S.,Health Services, National,National Health Insurance,National Health Insurance, Non U.S.,National Health Services,Services, National Health,Health Insurance, National,Health Program, National,Health Programs, National,Health Service, National,Insurance, National Health,National Health Program,National Health Service,Program, National Health,Programs, National Health,Service, National Health
D005102 Health Expenditures The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers. Expenditure,Expenditures, Health,Health Expenditure,Out Of Pocket Expenditure,Out-of-Pocket Cost,Out-of-Pocket Expense,Out-of-Pocket Payment,Expenditures,Expenditures, Direct,Expenditures, Indirect,Expenditures, Out-of-Pocket,Out-of Pocket Expenditures,Out-of-Pocket Costs,Out-of-Pocket Expenses,Out-of-Pocket Payments,Out-of-Pocket Spending,Cost, Out-of-Pocket,Costs, Out-of-Pocket,Direct Expenditure,Direct Expenditures,Expenditure, Direct,Expenditure, Health,Expenditure, Indirect,Expenditure, Out-of Pocket,Expenditure, Out-of-Pocket,Expenditures, Out of Pocket,Expenditures, Out-of Pocket,Expense, Out-of-Pocket,Expenses, Out-of-Pocket,Indirect Expenditure,Indirect Expenditures,Out of Pocket Cost,Out of Pocket Costs,Out of Pocket Expenditures,Out of Pocket Expense,Out of Pocket Expenses,Out of Pocket Payment,Out of Pocket Payments,Out of Pocket Spending,Out-of Pocket Expenditure,Out-of-Pocket Expenditure,Out-of-Pocket Expenditures,Payment, Out-of-Pocket,Payments, Out-of-Pocket,Spending, Out-of-Pocket
D005860 Germany, West The former Federal Republic of Germany which was reunified with the former German Democratic Republic in 1990. Federal Republic of Germany,Germany, Federal Republic of

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