the German Healthcare System
12. November 2008 von Kamal Osman
The German Healthcare System
The Federal Republic of Germany is composed of sixteen states, the so-called „Bundesländer“ or “Länder”. Germany has one of the highest population density within the European Union. In December 2005 the number of doctors was 373 per 100,000 inhabitants. Healthcare is funded by a statutory contribution system that ensures free healthcare for all via sickness funds. Insurance payments are based on a percentage of income, divided between employee and employer. Healthcare insurance in Germany is divided between statutory and private schemes. The statutory health insurance, the so-called “Gesetzliche Krankenversicherung” (GKV), occupies a central position in the Healthcare system in the Federal Republic of Germany. About 90 % of the population are covered by the statutory health insurance which is compulsory for all who earn less than 3862,50 € (in 2004) before tax. Private healthcare schemes can either provide to complete health service for those who opt out for the GKV or top-up cover for those who remain within it.
In Germany, the provision of healthcare can be broadly separated into ambulatory and in patient sectors. Outpatient services supplied to the public are largely the responsibility of independent doctors practising on a freelance basis under contract to the statutory health insurance. Doctors caring for patients who have sickfunds must be registered by law by the regional association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung).
Hospitals in Germany are grouped into three main types:
- Public hospitals (Öffentliche Krankenhäuser) run by the local authorities, the towns and the “Länder”
- Voluntary non-profit making hospitals (Frei gemeinnützige Krankenhäuser) run by the churches or non-profit making organisations such as the German Red Cross
- Private Hospitals (Privatkrankenhäuser) run as free commercial enterprises
Medical Education
Medical studies take a minimum of six years. In the last year, the so-called “Praktisches Jahr”, the students work in a university hospital or a teaching hospital and have four months attachments both in medical and surgical specialities and four months in a speciality of their choice. This is followed by an examination “Zweiter Abschnitt der ärztlichen Prüfung”, formerly by an examination “Dritter Abschnitt”. After graduating the student is a doctor/physician. The doctor gets full license (Approbation) which entitles the physician to practise the medical profession. Formerly the physician got a temporary license to practise as a doctor/physician . After another 18 months of internship (Arzt im Praktikum) the physician received the definite licence to Practise (Approbation). Postgraduate training time may take four to six years depending on the speciality.
Continuing Medical Education
Continuing Medical Education is mandatory for all physicians practicing in Germany. The German Medical Association has issued a Regulation Framework for Continuing Medical Education which serves as a model regulatory procedure for all State Medical Chambers in Germany.
- The German Medical Association: The Bundesärztekammer (BÄK) is the central organisation in the system of medical self-administration in Germany
German Research Centers and Institute:مراكز البحوث
- The Federal Ministry of Education and Research (Germany)
- The Federal Ministry of Health (Germany): (in German, Bundesministerium für Gesundheit ) is a ministry of the German federal government. It is the highest German federal government department responsible for health with two offices (Bonn, Berlin).
- The Information System of the Federal Health Monitoring (Englisch / Deutsch)
- Robert Koch-Institut (RKI): The Robert Koch Institute (RKI) is the central federal institution responsible for disease control and prevention and is therefore the central federal reference institution for both applied and response-orientated research as well as for the Public Health Sector
- Max-Planck-Institut / Max Planck Society for the Advancement of Science : is an independent non-profit association of German research institutes funded by the federal and state governments.(International Max Planck Research Schools)
- Fraunhofer-Gesellschaft / The Fraunhofer Society : is a research organization with 59 institutes spread throughout Germany, each focusing on different fields of applied science (as opposed to the Max-Planck-society, which works primarily on basic science).
- PEI Paul-Ehrlich-Institut (Bundesinstitut für Impfstoffe und biomedizinische Arzneimittel : is an institution of the Federal Republic of Germany. Its research and control activities promote the quality, efficacy and safety of biological medicinal products
- The Helmholtz-Gemeinschaft The Helmholtz Association of German Research Centres (German: Helmholtz-Gemeinschaft Deutscher Forschungszentren) is the largest scientific organisation in Germany. It is a union of 16 scientifically, technically, biologically, and medically oriented research centers.
- Medical Research Networks : the Internet Portal of the Competence Networks in Medicine
- The Pharmaceuticals Initiative for Germany
- Fritz Beske Institut für Gesundheits-System-Forschung Kiel (IGSF)- WHO Collaborating Centre for Health Care Systems Research and Development (German website!)
- The Leibniz Association: The Gottfried Wilhelm Leibniz Scientific Community, is the umbrella organisation for 86 institutions conducting research or providing scientific infrastructure. Some 6,500 scientists and scholars work in the humanities and social sciences, economics, spatial and life sciences as well as in mathematics, the natural and engineering sciences and in environmental research
