Today in History
Travel to Germany
Facts About Germany
Thirty Years' War
German Chocolate Cake
How To in Germany
Current Health Care Issues and Outlook
for the Future in Germany
German health care has long overemphasized curative medicine and neglected
preventive medicine and health promotion. In 1994 the Advisory Council
for the Concerted Action in Health Care recognized this imbalance and
recommended improving prenatal and postnatal care, providing more vaccinations
for young children, and better educating the public about the dangers
of alcohol consumption and smoking both during pregnancy and at other
times. The council also found that schoolchildren need more sports, dental
care, and sex education, and that they should be taught better dietary
habits. Adolescents require better information about the dangers of drug
abuse, sexually transmitted diseases, and obesity. All adults should exercise
more and make better use of available cancer and dental screening. The
council further recommended that fewer prescription drugs be taken (the
cost for prescription drugs for the elderly is almost one-third higher
than the cost of physician visits). Improving the control of blood pressure,
counseling diabetics, eliminating occupational hazards, and promoting
self-help groups are other goals.
The council also found that many older Germans have bad dietary habits.
Although eating habits have improved in recent decades, the German diet
is rich in fats, carbohydrates, and sugar and is deficient in fruits and
vegetables. In addition, the consumption of tobacco and alcohol is high,
although it decreased between 1980 and 1990 among both men and women.
Because of these factors, specialists estimate that 30 to 40 percent of
the population has health problems related to diet.
Cardiovascular diseases are the cause of about half of all deaths, followed
by cancer, which accounts for about one-quarter of deaths (see table 10,
Appendix). Modern medicine has largely eradicated traditional threats
to health such as tuberculosis, diphtheria, and pneumonia. Marked improvements
are also seen in other areas, such as infant and maternal mortality rates.
In 1970 infant mortality rates (defined as deaths under one year of age
per 1,000 live births) were 18.5 in the former East Germany and 23.4 in
the former West Germany, compared with an estimated 6.3 in united Germany
by 1995. Maternal deaths fell from 140 per 100,000 live births in the
mid-1950s to fewer than ten per 100,000 by 1989 in the former West Germany.
A similar improvement was measured in the former East Germany.
A new health problem is acquired immune deficiency syndrome (AIDS). By
late 1994, a total of 11,854 AIDS cases had been reported in Germany.
Another institutional challenge is extending the old Länder health
care system based on statutory health insurance to the new Länder.
Achieving this goal has meant a complete overhaul of the GDR's state-run
and highly centralized system; the introduction of insurance funds, private
insurance, and voluntary organizations; and the training of physicians
to become fee-for-service entrepreneurs, rather than salaried state employees
as they were under the old system. The Treaty on Monetary, Economic, and
Social Union of May 18, 1990, also set the goal of bringing hospitals
in the former GDR up to the standards of those in the West. An ambitious
program to invest about US$1 billion per year beginning in 1995 will be
aimed at this last goal, with about 40 percent of funds coming from the
federal government, another 40 percent from the new Länder, and 20
percent from public and private insurance carriers. It is expected that
realization of the full integration of the two health systems will take
many years, however.
* Development of
the Health Care System
* Health Insurance
* Health Care Providers
of Health Care Providers
* Current Health Care
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