ABSTRACT
Since the 1990s Germany’s health-care system has undergone dramatic changes as a response to spiralling health-care expenditure associated with significant demographic change, advancements in costly medical technologies and rising costs for health-care services. How immense the pressure is that has been building up on Germany’s health-care system is well illustrated by the dramatic increase in public spending on health (Figure 16.1), which has risen from 9.6 per cent of GDP (approximately €159 billion) in 1992 to 11.6 per cent (€287 billion) in 2010. Calculated as total health expenditure per capita, this translates into a nearly twofold increase from €1,970 in 1992 to €3,510 (Statistisches Bundesamt 2012). These developments are, however, not a recent phenomenon but have been building up for the past decades. In fact, the percentage of GDP for total health expenditure has increased by 78 per cent over the past 40 years and is predicted to increase to about 15.5 per cent (€453 billion) by 2020 (Treugast 2010). Annual health expenditure in Germany (1992–2010) (source: Statistisches Bundesamt 2012). https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780203079362/ab15dcbc-ef8a-4c31-9fc3-68ef43092013/content/fig16_1_B.jpg" xmlns:xlink="https://www.w3.org/1999/xlink"/>
