The passage of war, the misery, the termination and the consequences of the First World War were very dissimilar for Germany, Belgium and the Netherlands. Germany, one of the most powerful countries of Europe in 1914, emerged from the war as an economically broken and humiliated land and would be politically frustrated for years to come in its search for a new path. Belgium, as a neutral country, was swept into the war by the German invasion of 4 August 1914. For four years, most of the country was occupied by German troops, administered as a war zone and ransacked by the occupier. The Netherlands managed to preserve its neutrality and came out of the European power struggle materially unscathed. These were economically difficult years to be sure, in which the standard of living declined dramatically due to shattered trade relations. Compared with the misery of the war as experienced by its neighbours, however, the Dutch population and its business community really couldn't complain.

Germany from crisis to crisis

Germany underwent an especially pernicious period in both political and economic terms between 1914 and 1945. War, defeat, monetary upheaval, difficult recovery, economic depression, the Nazi regime and another war followed closely on each other's heels.

a. War

The full application of the Reichsversicherungsordnung (RVO) of 1911 for healthcare insurance was quickly thrown out of gear by the outbreak of the First World War. After years of bruising battles, the German army surrendered and the bloody war ended with a domestic uprising of soldiers and civilians, the fl ight of the German Kaiser to the Netherlands, the German capitulation and the armistice of 11 November 1918. The German monarchy, with its centuries-old Hohenzollern dynasty, made way for the Weimar Republic.

German social security in general and compulsory healthcare insurance in particular emerged surprisingly intact from the long war which had brought all the great nations of Europe to the brink of economic and political bankruptcy. Soon after the war broke out, the national government had taken steps to keep the costs of healthcare insurance within reasonable limits. During the war, health-insurance funds were permitted to pay only their members’ basic benefits provided by law.