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Cost-sharing in the German health care system

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  • Gericke, Christian A.
  • Wismar, Matthias
  • Busse, Reinhard

Abstract

In Germany, cost-sharing for health care has been used as a financing mechanism since 1923. In this article, the historical development of user charges in Germany since the 1980s is presented in more detail by type of private expenditure, including direct payments, cost-sharing measures, and voluntary health insurance. This is followed by a mapping of current cost-sharing measures including a discussion of protection mechanisms and responsibility for decision-making on cost-sharing measures and a summary of national policy debates. In the final section, the results of a systematic review of the literature on the impact of cost-sharing on equity, efficiency and health outcomes in Germany are presented.

Suggested Citation

  • Gericke, Christian A. & Wismar, Matthias & Busse, Reinhard, 2004. "Cost-sharing in the German health care system," Discussion Papers 2004/4, Technische Universität Berlin, School of Economics and Management.
    • Handle: RePEc:zbw:tubsem:20044
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    File URL: https://www.econstor.eu/bitstream/10419/36425/1/384759017.pdf
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    Cited by:

    1. Wörz, Markus, 2011. "Financial consequences of falling ill: Changes in the German health insurance system since the 1980s," Discussion Papers, Research Unit: Inequality and Social Integration SP I 2011-209, WZB Berlin Social Science Center.
    2. Pablo Gottret & George Schieber, 2006. "Health Financing Revisited : A Practitioner's Guide," World Bank Publications - Books, The World Bank Group, number 7094, December.
    3. Hossein, Zare & Gerard, Anderson, 2013. "Trends in cost sharing among selected high income countries—2000–2010," Health Policy, Elsevier, vol. 112(1), pages 35-44.

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