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Health economics (Germany)
Health economics in Germany can be considered as a collective term for all activities that have anything to do with health in this country.〔A. J. W. Goldschmidt: Leading the Global Game - M&A between Competitiveness and Conflicts. Speech as „guest speaker“ with round table-discussion „health economy and logistics“, 9th Symposium of Organisationsforum Wirtschaftskongress e.V. in the University of Applied Science Cologne on March, 8th 2002〕 This interpretation done by Andreas Goldschmidt in 2002 seems, however, very generous due to several overlaps with other economic sectors.〔A. J. W. Goldschmidt: Paragraph „Unternehmensbedeutung“ in: Krankenhausmanagement mit Zukunft?. In: A. J. W. Goldschmidt, J. Hilbert (Hrsg.): Krankenhausmanagement mit Zukunft - Orientierungswissen und Anregungen von Experten. kma Medien in Georg Thieme Verlag KG, Stuttgart, 2011, (ISBN 978-3-13- 161231-1): p. 4.〕 A simple outline of the health sector in three areas provides an "onion model of health care economics" by Elke Dahlbeck and Josef Hilbert〔(Josef Hilbert )〕 from "Institut Arbeit und Technik (IAT)" at the University of applied sciences Gelsenkirchen:〔E. Dahlbeck, J. Hilbert: Beschäftigungstrends in der Gesundheitswirtschaft im regionalen Vergleich. Internet-Dokument. Gelsenkirchen: Inst. Arbeit und Technik. Forschung Aktuell, Nr. 06/2008 → http://www.iat.eu/forschung-aktuell/2008/fa2008-06.pdf〕 Core area is the ambulatory and inpatient acute care and geriatric care, and health administration. Around it is located wholesale and supplier sector with pharmaceutical industry, medical technology, healthcare, and wholesale trade of medical products. Health-related margins are the fitness and spa facilities, assisted living, and health tourism.
According to this basic idea an almost totally regulated health care market like in the UK were not very productive, but also a largely deregulated market in the United States would not be optimally. Both systems would suffer concerning sustainable and comprehensive patient care. Only a hybrid of social well-balanced and competitive market conditions created a relevant optimum.〔A. J. W. Goldschmidt, J. Hilbert: Von der Last zur Chance – Der Paradigmenwechsel vom Gesundheitswesen zur Gesundheitswirtschaft. In: A. J. W. Goldschmidt, J. Hilbert (Hrsg.): Gesundheitswirtschaft in Deutschland. Die Zukunftsbranche. Band 1 der Schriftenreihe: Gesundheitswirtschaft und Management. kma-Reader - Die Bibliothek für Manager. Wikom-Verlag (Thieme), Wegscheid, 2009 (ISBN 978-3-9812646-0-9): p. 20-40〕 Nevertheless forces of the healthcare market in Germany are often regulated by a variety of amendments and health care reforms at the legislative level, especially by the "Social Security Code" (Sozialgesetzbuch- SGB) in the past 30 years.
== Importance in Germany ==
Health care in Germany including its industry and all services is one of the largest sectors of the German economy. Direct inpatient and outpatient care equivalent to just about a quarter of the entire 'market' - depending on the perspective.〔A. J. W. Goldschmidt: Der 'Markt' Gesundheitswesen. In: M. Beck, A. J. W. Goldschmidt, A. Greulich, M. Kalbitzer, R. Schmidt, G. Thiele (Hrsg.): Management Handbuch DRGs, Hüthig / Economica, Heidelberg, 1. Auflage 2003 (ISBN 3-87081-300-8): S. C3720/1-24, with 3 revisions / additional deliveries until 2012〕 A total of 4.4 million people working in this, that means about one in ten employees in 2007 and 2008.〔Statistisches Bundesamt: Beschäftigung in der Gesundheitswirtschaft steigt weiter an. Pressemitteilung Nr. 490, Berlin, 17.12.2008〕 The total expenditure in health economics was about 287.3 billion Euro in Germany in 2010, equivalent to 11.6 percent of gross domestic product (GDP) this year and about 3.510 Euro per capita.〔(Statistisches Bundesamt Deutschland, Wiesbaden, 2012 )〕
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