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October 1998

Ophthalmology in Germany

Arch Ophthalmol. 1998;116(10):1366-1368. doi:10.1001/archopht.116.10.1366

THE GERMAN health care budget for a stable but aging population of 81 million (with an average life expectancy of 76 years) amounts to 9% to 10% of the gross national product. Ninety percent of the population pays for mandatory insurance covering health, unemployment, a retirement pension, and—since 1995—nursing care. Half of the insurance fees are paid by the employee and half are paid by the employer. Private insurance is chosen by 10% of the population.

Of the 320000 physicians in Germany, 6000 are unemployed and 260000 are working, which translates into 1 working physician for every 311 people. Forty percent of the physicians are women and 4% are foreign-born. Physicians are responsible for providing health service and quality control, and for negotiating fees in a self-governance arrangement. The advertising of medical services is illegal, and the federal government sets limits on what can be charged for all medical services.