The number of documents available on the P4H Network’s digital platform reflects the network’s scope of work. The majority of documents are primary source materials created by country nationals or resources produced by organizations working in social health protection (SHP) and/or health financing (HF).
Is a Spending Freeze Sufficient to Stabilise the Contribution Rate in Germany’s Statutory Health Insurance? A Counterfactual Simulation
Germany's statutory health insurance expenditure has consistently outpaced member contribution revenues by about 1% annually for nearly 25 years, necessitating further contribution rate increases unless policy changes occur. A proposed spending moratorium aims to...
Germany’s social health protection reforms: main legislation
This document complements the timeline of Germany’s social health protection (SHP) reforms from 1883 to 2025 on the Germany country page. It provides key dates of German SHP acts and, for each of them, a snapshot explanation, extracted from a selected source.
Public Vs. Private Health Insurance in Germany
In Germany, every resident must have health insurance, choosing between public statutory insurance, which is income-based, covers essential care, and includes dependents at no extra cost, or private insurance, which offers modular plans with potentially faster access...
Statutory Health Insurance Modernization Act 2003
The following extract, written in German and translated into English using Google Translate, from the website of AOK, the German public health insurance provider, provides some details about the Statutory Health Insurance Modernization Act of 2003. With the GKV...
SHI Competition Strengthening Act 2007
The following extract from the CESifo Dice Report: Journal for Institutional Comparisons describes the Social Health Insurance Pro Competition Act of 2007. On 1 April 2007 an act became effective which will radically change the German system of health care: the...
The ethics of behaviour-based insurance models: Solidarity-based concerns in Germany’s statutory health insurance
Sickness funds are starting to use digital behavioral data to encourage physical activity among their members, but the ethical and societal implications, especially in solidarity-based insurance systems, are not well understood. While these programs may foster new...
Attitudes towards the dual health insurance system and inequalities in health care in Germany – results of a population survey
A survey of 2,201 adults in Germany found that while about 77% believe all insured individuals have equal access to necessary medical care, only around 20% think the quality of care is the same between statutory and private insurance holders. Nearly 80% support...
Forgone Care of doctor’s visits in Germany – Results from three cross-sectional surveys
A study analyzing data from German representative surveys found that 21% of participants reported forgone care in the past year, with higher rates in women and younger adults. The main barriers to accessing care were categorized as systemic, psychological, and...
Using income-based caps to protect people from user charges for health care
User charges for health care—such as co-payments for doctor visits, hospital stays, or medicines—can create significant barriers to accessing necessary services, particularly for people with low incomes. To mitigate this, some countries in Europe have adopted...
Public health in Germany: structures, dynamics, and ways forward
Germany faces challenges in public health despite its strong economy and social welfare system, with health indicators lagging behind other European nations. Key issues include the lack of a central public health authority, insufficient funding for prevention, and...
The other health care system in Germany: care for people without health insurance
A study identified 128 institutions in Germany providing healthcare to uninsured individuals. The care offered was varied and often reliant on private donations, with specialties including general medicine, gynecology, and psychiatry, but overall access was uneven and...
Germany: health system summary 2024
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...
Germany: Hospital Care Improvement Act
The federal government is undertaking a significant hospital reform to address the threat of clinic insolvencies, inadequate treatment, and increased travel distances for patients if current inpatient care structures remain unchanged. The reform aims to ensure...
Financing universal health care: Premiums or payroll taxes?
This paper evaluates the transition of Germany's hybrid health insurance system to a uniform system, which could be financed through funded or unfunded premiums or payroll taxes. The findings reveal that while payroll taxes offer good insurance properties, they also...
Statutory Health Insurance Financial Stabilization Act 2022
This paper critically analyzes the implications of the 2022 National Association of Statutory Health Insurance Funds Financial Stabilization Act (GKV-FinStG) on pharmaceutical dynamics in Germany.