Long-term care (Pflegeversicherung) is covered half and half by employer and employee and covers cases in which a person is not able to manage his or her daily routine (provision of food, cleaning of apartment, personal hygiene, etc.).
In 2001 total spending on health amounted to 10.8 percent of gross domestic product.
According to the Euro health consumer index, which placed it in 7th position in its 2015 survey, Germany has long had the most restriction-free and consumer-oriented healthcare system in Europe.
Although reimbursement of providers is on a fee-for-service basis the amount to be reimbursed for each service is determined retrospectively to ensure that spending targets are not exceeded. Copayments were introduced in the 1980s in an attempt to prevent overutilization and control costs. The difference is partly driven by the fact that hospital reimbursement is chiefly a function of the number of hospital days as opposed to procedures or the patient's diagnosis.
The average length of hospital stay in Germany has decreased in recent years from 14 days to 9 days, still considerably longer than average stays in the U. Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. The healthcare system is regulated by the Federal Joint Committee (Gemeinsamer Bundesausschuss), a public health organization authorized to make binding regulations growing out of health reform bills passed by lawmakers, along with routine decisions regarding healthcare in Germany.
The remaining 11% opt for private health insurance, including government employees.
All wage workers pay a health-insurance contribution based on their salary if they are enrolled in the public subsystem whereas private insurers charge risk-related contributions.Higher income workers sometimes choose to pay a tax and opt out of the standard plan, in favor of 'private' insurance.The latter's premiums are not linked to income level but instead to health status.Provider payment is negotiated in complex corporatist social bargaining among specified self-governed bodies (e.g.physicians' associations) at the level of federal states (Länder).Patients are allowed to seek almost any type of care they wish whenever they want it.with origins dating back to Otto von Bismarck's social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889.Besides the "Statutory Health Insurance" () covering the vast majority of residents, the better off with a yearly income above 59,400 Euros (2018) (US,967), students and civil servants for complementary coverage can opt for private healt/h insurance (about 11% of the population).Most civil servants benefit from a tax-funded government employee benefit scheme covering a percentage of the costs, and cover the rest of the costs with a private insurance contract.Health insurance in Germany is split in several parts.The largest part of 89% of the population is covered by a comprehensive health insurance plan provided by statutory public health insurance funds regulated under specific the legislation set with the Sozialgesetzbuch V (SGB V), which defines the general criteria of coverage, which are translated into benefit packages by the Federal Joint Committee.