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Published online by Cambridge University Press: 06 March 2019
How to reform the American health care system, now dominated by a decreasing number of multi-billion dollar managed care corporations, has occupied the public debate for many years. Recent news reports hefty increases in managed care premiums, benefit reductions, and an ever-growing number of managed care organizations refusing to treat Medicare patients. Numerous “patients’ bills” have been submitted in Congress, attempting to rein in some of the managed care cost containment practices. None have been adopted so far. At best, such bills would superficially treat some of the symptoms of an ill-functioning health care delivery system, poorly serving the population, insured and uninsured, and creating a plethora of ethical conflicts for providers battling to preserve an acceptable standard of care. Since the Clinton health care reform efforts failed in 1994, no one has proposed a fundamental revision of the system, and the United States remains the only industrialized nation without a universal health care system. The literature mainly reports on those – English-language – countries whose cost containment measures have resulted in overburdening the public health care system. There are, however, numerous European governments which succeed in stabilizing health care expenditures by mandating some sacrifices by all participants in the health care system while preserving universal access, comprehensive coverage, and the standard of care.
1 For Patients’ Rights, A Quiet Fadeaway. Amy Goldstein, WASHINGTON POST, Sept. 12, 2003, At A4.Google Scholar
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Cite as: Ursula Weide, Law and the German Universal Healthcare System: A Contemporary Overview, in: 6 German Law Journal 1143 (2005), at: www.germanlawjournal.com/pdf/Vol06No08/PDF_Vol_06_No_08_1143-1172_Developments_Weide.pdf Google Scholar
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26 SGB V, Art. 1) Sozialgesetzbuch – Fünftes Buch (SGB V). BGBl. 2477, 20 December 1988.Google Scholar
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35 Körperschaften des öffentlichen Rechts. Von Gierke's historical concept of “associations” was recognized under public law which endows them with normative functions. Other examples are municipalities and counties. See also, supra, note 20.Google Scholar
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38 Id. Art. 72(2) Sicherstellungsauftrag. SGBV, Art. 72. This concept has been the subject of heated public debate for several years as some have suggested to limit the mandate of adequate health care delivery to the sickness funds. This would provide them with bargaining power similar to managed care companies in the united states and eliminate most of physician influence.Google Scholar
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49 SGB V, Art. 112.Google Scholar
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51 SGB V, Art. 92. Kopfpauschale. Compensation for standard care is a flat fee per patient per quarter.Google Scholar
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54 Gemeinsamer Bundesausschuss. SGB V, Art. 91. Originally, the term denoted several committees, individually responsible for ambulatory care physicians, dentists, and hospitals. all were composed of representatives of the respective federal specialty associations and the sickness fund associations. The health care reform bill of 2004 (the GMG) merged all of these into one committee under one chairmanship, with uniform rules of procedure and independent funding.Google Scholar
55 Richtlinien der Bundesausschüsse. SGB V, Art. 92.Google Scholar
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