Health Insurance in Germany

Abstract

In this chapter, we discuss the current German health insurance system, in which statutory health plans coexist with a smaller private system. Germany’s insurance system has produced nearly universal coverage and has many strengths compared to other countries, including one of the most comprehensive risk-adjustment systems to mitigate zero-sum cost shifting among plans. However, insurance competition is still not fully aligned with value for patients, and ermany faces important choices such as the number and viability of health plans and the appropriate relationship between the statutory and private insurance systems. In this chapter, we address insurance access and competition, the focus of most discussions on health care reform in Germany and other countries. In Chapter 8, we will explore the role of health insurance plans in health care delivery. While historically German health plans have assumed a passive role with respect to involvement in the delivery of care, there is an opportunity to transform the role of plans in improving patient value.