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The self-regulatory German health care system between growing competition and state hierarchy

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  • Wendt, Claus
  • Rothgang, Heinz
  • Helmert, Uwe

Abstract

This article focuses on the changing role of the state in financing, providing and regulating health care services under the German health care system from 1970-2000. While a reduced role of the state can be observed in terms of financing, our analysis of service provision indicates inconsistent developments. Monetary resource flow analyses indicate a decrease in private service provision as a percentage of total health expenditure, but when analysing the development of health employment we see a growth in "private" health care personnel. The most important changes, however, have taken place in terms of regulation. Since the early 1990s, the traditionally self-regulatory German health care system has simultaneously faced growing competition and state hierarchy.

Suggested Citation

  • Wendt, Claus & Rothgang, Heinz & Helmert, Uwe, 2005. "The self-regulatory German health care system between growing competition and state hierarchy," TranState Working Papers 32, University of Bremen, Collaborative Research Center 597: Transformations of the State.
    • Handle: RePEc:zbw:sfb597:32
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    References listed on IDEAS

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    1. Castles, Francis G., 2004. "The Future of the Welfare State: Crisis Myths and Crisis Realities," OUP Catalogue, Oxford University Press, number 9780199273928.
    2. Rosewitz, Bernd & Webber, Douglas, 1990. "Reformversuche und Reformblockaden im deutschen Gesundheitswesen," Schriften aus dem Max-Planck-Institut für Gesellschaftsforschung Köln, Max Planck Institute for the Study of Societies, volume 5, number 5.
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