Published 7 November 2008, doi:10.1136/bmj.a1997
Cite this as: BMJ 2008;337:a1997

Analysis

Looking to Europe

German health care: a bit of Bismarck plus more science

Peter T Sawicki, institute director, Hilda Bastian, head of health information department

1 German Institute for Quality and Efficiency in Health Care, Dillenburger Strasse 27, Cologne 51105, Germany

Correspondence to: H Bastian hilda.bastian@iqwig.de

Analysis, doi:10.1136/bmj.39451.406123.AD

Germany’s health system provides good access to care for all patients. But, as Peter Sawicki and Hilda Bastian explain, it is increasingly turning to science to determine what is good value

The first 150 words of the full text of this article appear below.

Germany was the first country to develop a national system to insure people against medical costs. It was in 1883 that one of the most conservative of politicians, Otto von Bismarck, laid down the first foundation slab for the modern European welfare state. Scientific and medical research was a pillar of Germany’s economic and industrial development strategy from that time as well. These policies and structures helped develop an advanced, highly medicalised, and technological healthcare system. In recent decades, a combination of wealth and strong social welfare infrastructure has insulated Germany from having to ask too many hard questions about the value of one of the world’s most expensive healthcare systems. This article looks at the challenges of maintaining the legacy of access to health care for all, a growing commitment to patient empowerment, and the changing role of evidence in western Europe’s most populous country.

The roots of Germany’s . . . [Full text of this article]


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This article has been cited by other articles:

  • Sawicki, P. T. (2009). Communal Responsibility for Health Care -- The Example of Benefit Assessment in Germany. NEJM 361: e42-e42 [Full text]  
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