THE GERMAN HEALTH-CARE SYSTEM - STRUCTURE AND CHANGES

The German health care system has often been viewed by American policy makers as a model for a system that controls costs and provides cover age to virtually all of its citizens, while maintaining a private mark et for the delivery of most services. Nevertheless, German policy make rs are as concerned as their American counterparts about the increasin g share of national income devoted to health care. To control rising h ealth care costs, the German government, after two decades of cost con trol interventions, has enacted a major health care reform aimed at re ducing structural deficits of the current system and enhancing competi tion within the system. We review the general structure of the German health care system and analyze its specific problems. We also discuss its accomplishments and present the recently enacted health care refor m.