West European Studies

Germany is credited with having one of the most innovative and advanced health care systems in the world. Germany healthcare system is characterized by a powerful and efficient network connecting medical specialists, health insurance funds, universities, hospitals, and research institutions. Research shows that Germany health care system is under diversified ownership that has encouraged competition which means continuous efforts are put in place to raise the health standards. Literature shows that in 2002, 54 percent of health care system was owned by public sector while 38 percent was run by private sector making it a mixed health care system. It is therefore important to note that the health care system is greatly socialized because it is indicated that Germany view health care as a unifying factor for all groups of individual sharing similar geography into a real state. The implication is that all social groups in Germany share the identical health care system. Literature shows that legislative health insurance that was enacted in 1883 through the Health Insurance Act has offered an organizational framework that guides delivery of public health care and it has also helped in shaping the roles of insurance, payers, physicians, providers, as well as hospitals. Since 1885, efforts were made by the government to start offering medical cover for almost 26  of the low income earners, which was approximately 10  of the countries population.  Later on, medical protection was extended to cover more occupational grouping and by 1930 it covered all dependants. The health care system has therefore achieved higher level of justice and equity because there is no given group that can dictate the terms of service delivery (Carrera 2007, 47).

Germany health care system has witnessed a number of changes since 1883 as an effect of latest federal regulations. One of the changes that took place in Germany health care system was the introduction of health insurance which made it mandatory for health care services to be financed by health insurance. Currently, Germany law requires that all legally insured individuals making up more than 90 percent of the entire population must be issued with insurance cards that provide information of medical insurance cover.

Similarly, there has been implementation of information and communication technology in secondary and primary ambulatory care. This has enabled general practitioners, as well as office experts to use computers for reimbursement functions while carrying out their duties. This has also enabled people to access health information on internet which implies that use of computers in health care system has changed the lives of many people (Marscholleck, et al 2007, 255).  Likewise, German health care system use computerized systems in cardiology, radiotherapy as well as radiology. Hospitals also use computer systems in connection with important signs monitors in operating theatre and intensive care section. All these strategies aim at promoting efficiency within health care system. Germany government has also put into place plans to contain the ever rising expenses of health care services as well as enlarging the outpatient departments so as to meet the health care needs of its citizens (Marscholleck, et al 2007, 258).

Health care challenges in Germany
Germany health care system is facing a number of challenges which have hindered its effectiveness in delivering health care services to its citizens. One of the challenges is high medical costs and health care service costs. Literature shows that Germany is one of the countries in the world with very expensive costs of medication and there are no cases of free medication because all care services comprising of emergencies are either paid by an individual or health insurance. Research points out that illness fund membership is obligatory for employees with a gross income that does not go beyond euro 40, 000 annually. Today, over 88 percent of Germany population is covered by statutory health insurance but still many Germany feel that health care services are expensive because most of the people who pay national insurance funds also pay for the deprived population which means most of their pay is diverted to meeting health care expenses (E.O.H.C.S 2000, 39).

There is also reported shortfall of physicians in Germany. Although the number of physicians has increased, literature shows that out of the 357 700 physicians who worked in Germany by 1998, only 287, 000 are active. It is also indicated that some of the medical specialists are not in rural areas thus making it difficult for the residents in rural areas to access some services that requires health specialists. Research carried out in 1996 to establish Germany satisfaction rates shows that 11 percent of the population was not satisfied with the health care services offered. This may be attributed to hang-ups in the health care management where retention of experienced health care staff is quite difficult and recruitments are geared towards specialists from overseas. Such occurrences, in conjunction with other factors have greatly lowered the morale of health officers   (E.O.H.C.S 2000, 72-74).

Epidemiological evidence shows that health status of large population, especially the immigrants, is very poor because of high rates of poverty and social discrimination. This has made many people not to get appropriate care which meets their needs. It is also indicated that most of the population occupying Roma are faced with serious health challenges due to poor living conditions since most of the people are unable to acquire basic utilities and they live in poor sanitary and environmental conditions making them prone to higher incidence of infant mortality, communicable diseases such as measles, tuberculosis, sexually transmitted diseases as well as malnutrition. Literature also shows that there is prevalence of heart diseases, obesity and hypertension. Some of the challenges the population face in their efforts to deal with such diseases and poor living conditions involve problems of mobilizing resources to enable the victims access health services, problem of accessing information pertaining what is accessible as well as difficulties in organizing practical and social support essential to impede attending medication services at distant places (Stock et al, 2007, 90).