{"id":987501928,"date":"2023-02-03T08:18:54","date_gmt":"2023-02-03T07:18:54","guid":{"rendered":"https:\/\/p4h.world\/country\/germany\/"},"modified":"2025-10-30T13:49:06","modified_gmt":"2025-10-30T12:49:06","slug":"germany","status":"publish","type":"country","link":"https:\/\/p4h.world\/en\/countries\/germany\/","title":{"rendered":"Germany"},"content":{"rendered":"

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Germany has one of the lowest rates of unmet needs in Europe<\/a>, with the difference in insurance coverage between income groups being less than one-fourth of a percentage point. Government health expenditures represent more than 20% of government expenditures, which is the fourth highest in the so-called WHO Europe Region in 2022.[1]<\/a><\/sup><\/p>\n

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Germany\u2019s health financing (HF) system, which is largely based on its mandatory health insurance system, comprises both statutory health insurance (SHI) and private health insurance (PHI).[2]<\/a><\/sup> It is built on the social insurance model established in 1883 under Otto von Bismarck[3]<\/a><\/sup> (chancellor of Germany at that time) that still stands today as a model of an insurance-based system advancing universal health coverage.<\/p>\n

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SHI covers about 89% of the population.[4]<\/a><\/sup> The following extract from Germany: Health Care & Long-Term Care Systems<\/a>, published by the European Commission, lists the services covered by SHI.<\/p>\n

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SHI covers preventive services, inpatient and outpatient hospital care, physician services, mental health care, dental care, optometry, physical therapy, prescription drugs, medical aids, rehabilitation, hospice and palliative care, pregnancy care, maternal leave and sick leave compensation.<\/p>\n<\/blockquote>\n

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SHI operates with self-governing sickness funds (96 in 2023)<\/a>. The sickness funds collect contributions and send them to a central \u201creallocation pool\u201d, the Gesundheitsfonds (in English, Health Fund), which reallocates the funds back, based on risk-adjusted criteria.[5]<\/sup> SHI contributions are calculated as a percentage of income, with supplementary premiums added by individual sickness funds when necessary.[6]<\/sup><\/p>\n

[\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 5″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||||false|false” global_colors_info=”{}”]The 11% or so of the population not covered by SHI are covered by PHI. This smaller percentage of the population mainly comprises individuals with high incomes, the self-employed and civil servants. PHI charges premiums based on age and health risks.[7]<\/a><\/sup>[\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 6″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||||false|false” global_colors_info=”{}”]<\/p>\n

The following excerpt from Germany: Health System Summary 2022<\/em><\/a>, published by the European Observatory on Health Systems and Policies, explains Germany\u2019s health system governance.<\/p>\n

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Health system governance in the country is complex and decentralized: it is divided between the federal and state levels, and corporatist bodies of self-governance. While the federal level sets the overall legal framework, state governments are responsible for hospital planning and public health services, and for example, took leading roles in implementing measures to respond to the COVID-19 pandemic. However, most decision-making power within the SHI system is delegated to corporatist bodies (such as associations of providers and sickness funds). The public health, ambulatory and inpatient, and long-term care sectors in the health care system are subject to different legislation and thus are separated in terms of organization, financing and reimbursement.<\/p>\n<\/blockquote>\n

[\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 9 – Footnotes” _builder_version=”4.21.0″ _module_preset=”default” text_font_size=”13px” custom_margin=”20px||||false|false” custom_padding=”||||false|false” global_colors_info=”{}”]References<\/strong><\/p>\n

[1]<\/span> Global Health Expenditure Database<\/a>, World Health Organization (choose country)<\/p>\n

[2]<\/span> Bl\u00fcmel, Miriam, et al. “Germany: Health System Review<\/a><\/em>” Health Systems in Transition<\/em>, vol. 22, no. 6, 2020, p. xxii.<\/p>\n

[3]<\/span> Ibid<\/a>, p. 14.<\/em><\/p>\n

[4]<\/span> Bl\u00fcmel, Miriam, et al. “Germany: Health System Summary 2024<\/a><\/em>” European Observatory on Health Systems and Policy, 2024, p. 5.<\/p>\n

[5]<\/span> Bl\u00fcmel, Miriam, et al. “Germany: Health System Summary 2022<\/a><\/em>” European Observatory on Health Systems and Policies, 2022, p. 4.<\/p>\n

[6]<\/span> Bl\u00fcmel, Miriam, et al. “Germany: Health System Review<\/a><\/em>” .” Health Systems in Transition, vol. 22, no. 6, 2020, p. xxiv.<\/p>\n

[7]<\/span> Ibid<\/a><\/em> pp. xxiii-xxiv.<\/p>\n

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Key features of the German social health protection and health financing systems<\/h3>\n

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For more details about the reforms from 1883 to 2025, please see the document<\/h4>\n

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Germany has one of the lowest rates of unmet needs in Europe, with the difference in insurance coverage between income groups being less than one-fourth of a percentage point. Government health expenditures represent more than 20% of government expenditures, which is the fourth highest in the so-called WHO Europe Region in 2022.[1]Germany\u2019s health financing (HF)…<\/p>\n","protected":false},"author":1,"featured_media":987786411,"template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":""},"acf":[],"_links":{"self":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country\/987501928"}],"collection":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country"}],"about":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/types\/country"}],"author":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":54,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country\/987501928\/revisions"}],"predecessor-version":[{"id":987789832,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/country\/987501928\/revisions\/987789832"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media\/987786411"}],"wp:attachment":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media?parent=987501928"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}