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Health Care Reform in Germany

Author: THOMAS GERLINGER
Published in GPS, Vol. 6 No. 1

German health care policy is characterized by a paradigm shift initiated by the enactment of the Health Care Structure Act in 1992. This fundamental change is both affecting in its care structures and its financial and regulatory mechanisms. This transformation is an expression of a paradigm change in health policy initiated during the first half of the 1990s. This paradigm change in health policy increasingly favours the goal of adapting the health care system to the perceived requirements of a globalised economy at the expense of the aim of covering the social life-risk of ‗sickness‘. Since it be-gan, health policy has proceeded down that chosen development path, gen-erally by means of incremental reforms. In terms of care structures the paradigm change involves modernization and rationalization of the provi-sion of medical care. In financing it is characterised by a new welfare mix where the financial burden shifts from collective solidarity to individual patients and fund members – while at the same time the employers‘ share is reduced. In terms of regulation the paradigm change is characterised by the implementation of competition-centred structural reforms.

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