Germany’s health system is decentralized, with compulsory statutory health insurance (SHI) covering 89% of the population and substitutive private health insurance (PHI) covering about 11%, offering comparable or better benefits. In 2022, Germany spent 12.7% of GDP on health—the highest in the EU—with modest out-of-pocket payments mainly for long-term care and pharmaceuticals. Recent reforms focus on modernizing hospital care, including supplementing DRG payments with flat fees and shifting appropriate inpatient treatments to day treatments to address staffing and capacity issues.
