Health Care in Germany

Christa Altenstetter
Content Type
Working Paper
European Union Studies Center
The question of whether the introduction of competition and managed care in the German health care system means a "new paradigm" or simply a "stalemated strategy" was raised in a 1999 issue of Health Affairs by Lawrence Brown and Volker F. Amelung (1999). In that same issue, Uwe E. Reinhard (1999) responded with a question of his own: "Why would Germany wish to emulate the US style of managed care, with its as yet unproven effect on quality and outcomes?" The core of their disagreement seems to center around two issues. First, can competition and managed care flourish in a political culture and healthcare system where central policy-making and enforcement arrangements are embedded? The distinct political economy and history of Germany may create conditions that are not conducive to competition and managed care, unlike the US. The second issue that leads to the different interpretations above is the elusive concept of quality in health care, especially how to measure and achieve it.
Government, Human Welfare, Political Economy
Political Geography