Germany (full name of the Federal Republic of Germany) is located in central Europe and is the country with the largest number of neighbors in European countries. The combination of maritime climate and continental climate is the main feature of the German climate. The maritime climate in northwestern Germany is more obvious, and it gradually transitions to the continental climate in the east and south. By the end of 2006, Germany had a population of 82.31 million, mainly composed of Germans, and a small number of Danes and Sorbians, as well as 7.288 million foreigners, accounting for about 8.8% of the total population.
Overall, Germans are in better health, with an average life expectancy of 72.7 years for men and an average life expectancy of 79 years for women. In the cause of death, chronic diseases such as cardiovascular diseases and malignant tumors have become the leading causes of death in Germany, accounting for 50% and 25%, respectively.
Germany is the fourth largest in the world, the largest economy in Europe, and the second largest exporter in the world. Its industrial products are generally sold abroad, and nearly one-third of the employed people work in the export industry. At the same time, the German government is also committed to promoting the development of science and technology, and is the first country to develop successful magnetic levitation railway technology.
German medical care ranks in the top three in the world, second only to Switzerland and the United States, and there are many authoritative hospitals, and the medical level is also in a leading position worldwide. Germany's strength lies in otolaryngology, orthopedics, genetic testing, and tumors. The purpose of this paper is to analyze the logic behind these successes by introducing the specific medical systems and biomedical research conditions in Germany.
1. German medical system
Germany is the first country in the world to start a social health insurance system. In 1833, Germany (Imperial Period) promulgated the world's first "Sickness Insurance Law" and established the Statutory Health Insurance (SHI), marking the establishment of the German social health insurance system. The German statutory medical insurance system has become a typical representative of the social medical insurance model with its relatively sound medical system and better service level. The German medical insurance system has the following characteristics:
Wide coverage of the medical insurance system
Germany implements compulsory medical insurance, everyone must be insured, and the government subsidizes low-income people to participate in the insurance through the social assistance system. Its SHI is the most important part of the national social security system, including mandatory universal health insurance, long-term care insurance, compulsory pension insurance and mandatory industrial injury insurance.
German medical insurance covers a wide range and basically achieves universal health insurance. The 453 statutory mandatory disease foundations cover a population of 72 million, while 52 private health insurance companies cover a population of 7.1 million. That is to say, about 90% of German nationals participate in statutory insurance, and about 8% of the nationals participate. Commercial insurance, while another 2% of the population (such as military and police officers) enjoy free medical services.
Statutory insurance and private insurance are in parallel
The structure of medical insurance ownership in Germany is based on “legal medical insurance, supplemented by commercial medical insuranceâ€. This is because medical services in Germany are considered to be a public product, regardless of the individual’s ability to pay and wealth. The right to enjoy medical services. Under the guidance of this concept, Germany has formed the statutory medical insurance principle of “unity and mutual assistance, social mutual aidâ€, and also regards “social fairness†as the guiding ideology for SHI policy formulation.
German law stipulates that employees with monthly incomes below 4,050 euros must be insured with statutory health insurance, above which civil servants and freelancers can choose private health insurance. Nationals can also participate in the compensation insurance insurance provided by private insurance on the basis of participating in statutory social medical insurance. Based on the characteristics of “binary unity and structural mutual compatibilityâ€, the German medical insurance system has high stability and certain flexibility.
Convenient medical treatment, medical separation
There are 2,260 hospitals in Germany, with about 572,000 beds, reaching 6.97 beds per 1,000 people, and the use of beds is more efficient, with an average usage rate of over 80%. Among the 2030 comprehensive hospitals in Germany, there are 790 public hospitals, 820 non-profit hospitals, and 420 private hospitals. In the medical service system, Germany does not implement a medical fixed-point system. Patients can choose to go to any hospital to see a doctor. If they take medicines at any pharmacy, they can freely choose a medical practitioner and a specialist, and they can choose hospitalization within a certain range under the guidance of a medical practitioner. Hospital. No matter what the economic situation at the time, you can get timely treatment, no need to pay cash when you visit.
Germany implements strict medical separation to prevent doctors from abusing prescription rights and colluding with drug dealers. At the same time, the outpatient and inpatient hospitals are strictly separated, ensuring the smooth flow of referrals and eliminating the situation of patients staying in hospitals.
Invest in more than one, mutual aid
German law stipulates that all persons participating in statutory or private health insurance have the right to refuse any form of risk assessment by the insurance institution, and no health care institution can impose limits on the age, sex and number of family members of the insured. For all those who participate in statutory health insurance, their families and minor children can automatically become the insured, and they can enjoy the same medical benefits as the actual insured without additional insurance premiums.
Prior to 2005, the payment of health insurance costs was paid 50% by employees and employers. After that, the form of the cost burden was slightly adjusted, with the employer burdening 46% and the employee burden 54%, which is more conducive to employers. At the same time, the payment base has a capping line and a bottom line. If the salary exceeds the top line, the premium will not be collected. If the salary income is below the guarantee line, the payment obligation will be waived. At the same time, the government will cover the top line according to the actual situation. The standard of the bottom line is adjusted appropriately. This has formed a more reasonable redistribution mechanism of wealth. If the income is overpaid, the less is paid less, and the non-income is not paid, but the medical services enjoyed by the statutory medical insurance policy holders are exactly the same.
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