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Hospital Healthcare Europe

European hospital healthcare update: Member State profiles

George Baum
1 January, 2008  

George Baum
Chief Executive
German Hospital Federation

The HOPE Yearbook 2007 is a great opportunity to present some of the recent developments that have taken place in the German healthcare sector, along with our demands for a European healthcare policy.

With regard to German healthcare, the last period has been ruled by the overwhelming health insurance reform, which aimed to establish more competition in the healthcare system based on sustainable financing. For months the debate about the reform occupied the agenda of most media broadcasts and initiated a wide and sometimes even wild debate among politicians, the different political parties, stakeholders and the public.

The reform law came into force at the beginning of April 2007. The law brings a totally new system of financing to the statutory healthcare system, with unique rates to be contributed to all sickness funds.

From the point of view of German hospitals, there are some points worth mentioning.

One negative effect of the health insurance reform is that hospital funding is to be cut by 0.5%, the aim being that this money will contribute to the financial stabilisation of the German health insurance system. This contribution will cost German hospitals €500m. Additionally there are other financial cutbacks and higher costs through increased taxes (eg, the value-added taxes), and working costs are burdens that will have to be balanced by hospitals.

But there are also some benefits to the reform. In the past, hospital care and nonhospital care were strictly differentiated, as hospitals did not provide outpatient services. This is no longer the case, as hospitals can now – to a certain extent – provide outpatient services. Furthermore, doctors working in their own practice can now also be employed by a hospital, which was prohibited before. These changes all create new opportunities for cooperation

Another major issue in German healthcare over the last year was the discussion on the future development of the German DRG system beyond its initial period until the end of 2008. The German Hospital Federation is pushing for the patient’s freedom of choice of hospital. Additionally, German hospitals want to enforce competition in quality matters (eg, by generating further activity in outpatient services).

On a European level, there is another wind blowing in the healthcare sector. Following our recommendation, the European Commission is taking a new approach to the implementation of health-related issues, making them a basic pillar for the future development of the common market and the future of European society. The declaration of common values and principles in healthcare by the Council in June 2006, a new health strategy and its implementation, community action on health services, and the publication of Health in all Policies, are just a few examples within an impressive number of initiatives currently in development by the European Union.

The German Hospital Federation is aware of these developments and is prepared to be a partner in the developing debate for a healthier Europe. By opening a representative office in Brussels and by tightening the close cooperation with HOPE, we want to be proactive and constructive.