Health System of Germany

Health Care Systems of Germany
Name
Institution

Abstract
This essay is a presentation of the health care system in Germany. The overview covers delivery of health care in hospitals, public clinics and private clinics; acquisition of health care through private and insurance pay; funding of health care either by the employer or private pay; care for chronically ill; care for dying patients and the involvement of the patient in deciding on the treatment procedure.
Introduction
The Germany’s health care system is referred to as the Bismarck model and is the oldest model in the world. The model was established in 1883 but has been exposed to several substantial changes to date but the basic structure has been maintained. A significant reform enacted in 2007 had four target goals aimed at having in place mandatory collective health insurance coverage, modernization of sickness funds, and improvement of medical care as well as reforming health fund. The German health system is effective in that it has served its population of 82.4 million effectively in such a way that it has boosted the life expectancy to 81.9 years for women and 78.7 years in men (Schabloski, 2008). This paper is aimed at discussing in details the health care system in Germany.
Delivered of Healthcare
Germany has a universal health care system which is multi-payer. The health services are offered in private and government institutions. In 2010, the hospital sector in Germany was made up of 2,064 acute care health institutions that were roughly classified into three categories namely; private for-profit hospital which are owned by municipalities, private hospitals not-for-profit which are owned in most cases by religious organizations as well as the hospitals owned by the public. In Germany, private hospitals refer to those that are not under the ownership of any level of government; municipal, state, federal governments or even other public bodies. The private health care providers offer their services to all patients even those that are not privately insured (Roeder, 2012).
German hospitals are reimbursed for every case they handle rather than having global budgets as is the case in Canada. Hospitals often compete for patients who have the freedom to choose the health facility they wish to be served. Consequently, healthcare services in Germany are patient –oriented thus prevents the emergency of prioritization, rationing of treatments or even waiting lists. All hospitals in Germany are subjected to very strict quality assurance and transparency mechanisms. All hospital’s activities in all hospitals are included in the annual reports for every hospital and are available online and can be accessed by all citizens. In addition, the local media serves as a watchdog ever scrutinizing the degree of quality in every hospital. As a result, all hospitals are careful to ensure that their services are of high quality. However, hospital classified as for –profit –hospitals offer better quality care when compared to private-not –for –profit and the public hospitals. For instant, they have a shorter waiting time, admits patients faster, hold their inpatients for a longer period even though patients are paid for a flat sum; meaning they discharge patients when they have fully recovered (Roeder, 2012).
Acquisition of Healthcare
Health care in Germany is acquired through insurance schemes. From 2009 health insurance became mandatory for all Germany citizens as well as all permanent residents. Coverage is offered by nongovernmental health insurance funds which are not for profit and are commonly referred to as sickness funds which are under statutory health insurance scheme (SHI). Close to 86% of the Germany population receive their principal coverage through SHI (Thomson et al, 2013). The sickness fund is classified into six major groups namely; general regional funds (Allgemeine Ortskrankenkassen; AOK), company based funds (Betriebskrankenkassen; BKK), Trade guid funds (Innungskrankenkassen; IKK), Agricultural funds (Landwirtschaftliche Krankenkassen, LKK), Miners-railway-sea funds (Knappschaft-Bahn-sea) and the Substitute funds (Ersatzkassen) (Clarke & Bidgood, 2013).
Coverage is also offered by voluntary alternative private health insurance (PHI) which serves about 11% of the German population. SHI covers all employed people and pensioners who earn less than €4,350 per month as well as their dependents who are covered for free. For the individuals whose wages are higher such as the self employed and the civil servants are either covered by SHI or do purchase substitutive PHI. Unlike SHI, PHI uses actuarial calculations in determining risk equivalent premiums for every client they serve (Thomson et al, 2013).
Few people especially the young couples earning attractive income opt for the PHI which offers a bigger range of services as well as lower premiums. In addition, PHI unlike SHI plays both complementary and supplementary role that covers minor benefits such as access to better amenities as well as some copayments like dental care services. About 3% of the German populations; which include policemen and soldiers have their health care under special programs. Immigrants who are undocumented are under the cover of social security in case of acute illness, pregnancy and childbirth (Thomson et al, 2013).

Payment of Health Care
Health care system is funded from centralized national health funds known as the sickness funds which are autonomous nongovernmental bodies and not for profit. Sickness funds get their funding from compulsory contributions that are levied as a percentage of every employee’s gross wages up to ceiling. In Germany, a uniform contribution rate was set by the government and was set in the ...