German Health System Overview
Health System Rankings
Health System Outcomes
Health System Coverage
Costs for Consumers
Health System Expenditures
Germany’s COVID-19 National Strategy
Population, Mid-Year 2019: 83,517,000
Projected Population Mid-Year 2030: 83,136,000
Percentage of Population Under Age 25 Years, Mid-Year 2019: 24%
Percentage of Population 65 Years Or Over, Mid-Year 2019: 22%
Source: United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Prospects 2019: Data Booklet (ST/ESA/SER.A/424).
https://population.un.org/wpp/Publications/Files/WPP2019_DataBooklet.pdf
https://population.un.org/wpp/
Percent of Adults Aged 65 Years and Over Reporting To Be In Good Or Very Good Health (2015): 41.4%
People With Dementia Per 1,000 Population (2017): 20.1
Projected Number of People With Dementia Per 1,000 Population in 2037: 28.8
Long-Term Care Workers Per 100 People Aged 65 And Over (2015): 5
Long-Term Care Beds In Institutions and Hospitals Per 1,000 Population Aged 65 And Over (2015): 54.4
Long-Term Care Expenditure (Health and Social Components) By Government and Compulsory Insurance Schemes, as a Share of GDP (%) (2015): 1.3%
Source: OECD (2017), Health at a Glance 2017: OECD Indicators, OECD Publishing, Paris. http://dx.doi.org/10.1787/health_glance-2017-en
https://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm
Formal Long-Term Care Workers At Home (FTE) (2017): 240,061
Formal Long-Term Care Workers In Institutions (FTE) (2017): 418,500
Long-Term Care Recipients In Institutions Other Than Hospitals (Aged 65 Years and Older) (2017): 724,118
Long-Term Care Recipients At Home (Aged 65 Years and Older) (2017): 2,014,278
Source: Organization for Economic Cooperation and Development. OECD.Stat. Last accessed Oct. 15, 2019.
https://stats.oecd.org/Index.aspx?ThemeTreeId=9#
“On a per capita basis, all categories of health spending are above the respective EU averages (Figure 8), with spending on pharmaceuticals and medical devices almost 60 % higher than average. Over recent years, long-term care (LTC) spending has grown more strongly than all other expenditure categories.
“The recent LTC reform is likely to further increase expenditures because the benefit basket and eligibility criteria have been expanded and demand for services has increased (Section 5.3). Furthermore, spending on prevention has increased since 2015 due to the legal obligation for sickness funds and long-term care funds to invest more in health promotion and prevention.”
Source: OECD/European Observatory on Health Systems and Policies (2019), Germany: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
https://ec.europa.eu/health/state/country_profiles_en
https://ec.europa.eu/health/sites/health/files/state/docs/2019_chp_de_english.pdf
“Starting in 1995, all members of statutory sickness funds (including pensioners and the unemployed) as well as all people with full-cover PHI [Private Health Insurance] were declared mandatory members. This was the first introduction of mandatory membership for PHI – making it the first statutory insurance with nearly population-wide membership. In 2013, 69.9 million (87%) were covered by mandatory statutory long-term care insurance and about 9.5 million (11.5%) by mandatory private long-term care insurance (Bundesministerium für Gesundheit, 2013c).
“The requirement to pay contributions began in January 1995 with ambulatory benefits available from April of that year. Benefits for care in institutions were available from July 1996. According to the SHI [Statutory Health Insurance] principles, members and their employers jointly contribute 1.95% of monthly gross income: that is, 0.975% each. In order to compensate the employers for the additional costs, a public holiday was turned into a working day. Since 2004, pensioners have to contribute the entire 1.95% from their pension. As a result of the Child Bonus Act (Kinder-Berücksichtigungsgesetz), childless SHI members who are 23 years and older pay a 0.25 percentage point increased contribution rate (a total contribution of 2.2%).”
Source: Busse R, Blümel M. Germany: health system review. Health Systems in Transition, 2014, 16(2):1–296.
https://apps.who.int/iris/handle/10665/130246
“In contrast to SHI [Statutory Health Insurance], benefits in statutory long-term care insurance are only available upon application. The Medical Review Board (operated jointly by sickness funds and long-term care funds) evaluates the applicants and places them into one of the three categories (or denies care). Most of the private health insurers purchase this service from them. Entitlement to insurance benefits is given when care is expected to be necessary for at least six months (hence “long-term” care), while short-term nursing care continues to be funded by the sickness funds, and private insurers if included in the package. Beneficiaries with a care dependency then have a choice of receiving monetary benefits or professional nursing care while staying at home or to receive professional nursing services in nursing homes.”
Source: Busse R, Blümel M. Germany: health system review. Health Systems in Transition, 2014, 16(2):1–296.
https://apps.who.int/iris/handle/10665/130246
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Page last updated Dec. 2, 2020 by Doug McVay, Editor.