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Germany has a universal〔 〕 multi-payer health care system with two main types of health insurance: "Statutory Health Insurance" (''ドイツ語:Gesetzliche Krankenversicherung'') known as sickness funds (''Krankenkasse'') and "Private Health Insurance" (''ドイツ語:Private Krankenversicherung'').〔(【引用サイトリンク】title=The Case for Universal Health Care in the United States )〕〔(Health Insurance in Germany – Information in the English & German Language )〕 Health insurance is compulsory for the whole population in Germany. Salaried workers and employees below the relatively high income threshold of almost 50,000 Euros per year are automatically enrolled into one of currently around 130 public non-profit "sickness funds" at common rates for all members, and is paid for with joint employer-employee contributions. 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). The sickness funds are mandated to provide a unique and broad benefit package and cannot refuse membership or otherwise discriminate on an actuarial basis. Social welfare beneficiaries are also enrolled in statutory health insurance, and municipalities pay contributions on behalf of them. Besides the "Statutory Health Insurance" (''ドイツ語:Gesetzliche Krankenversicherung'') covering the vast majority of residents, the better off with a yearly income above almost €50,000 (), students and civil servants for complementary coverage can opt for private health 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. Recently, private insurers provide various types of supplementary coverage as an add upon of the SHI benefit package (e.g. for glasses, coverage abroad and additional dental care or more sophisticated dentures). The health economics of Germany sector was about US$368.78 billion (€287.3 billion) in 2010, equivalent to 11.6 percent of gross domestic product (GDP) this year and about US$4,505 (€3,510) per capita.〔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〕 According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004.〔(World Health Organization Statistical Information System: Core Health Indicators )〕 In 2004 Germany ranked thirtieth in the world in life expectancy (78 years for men). It had a very low infant mortality rate (4.7 per 1,000 live births), and it was tied for eighth place in the number of practicing physicians, at 3.3 per 1,000 persons. In 2001 total spending on health amounted to 10.8 percent of gross domestic product.〔(Germany country profile ). Library of Congress Federal Research Division (December 2005). ''This article incorporates text from this source, which is in the public domain.''〕 ==History== Germany has the world's oldest national social health insurance system,〔 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''. Bismarck stressed the importance of three key principles; solidarity, the government is responsible to ensure access by those who are in need, subsidiarity, policies are implemented with smallest no political and administrative influence, and corporatism, the government representative bodies in health care professions deems feasible procedures. Mandatory health insurance originally applied only to low-income workers and certain government employees, but has gradually expanded to cover the great majority of the population.〔(【引用サイトリンク】title=History of German Health Care System )〕 The system is decentralized with private practice physicians providing ambulatory care, and independent, mostly non-profit hospitals providing the majority of inpatient care. Approximately 92% of the population is covered by a 'Statutory Health Insurance' plan, which provides a standardized level of coverage through any one of approximately 1,100 public or private sickness funds. Standard insurance is funded by a combination of employee contributions, employer contributions and government subsidies on a scale determined by income level. 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.〔(Gesetzliche Krankenversicherungen im Vergleich ) ((English Translation) )〕 Historically, the level of provider reimbursement for specific services is determined through negotiations between regional physician's associations and sickness funds. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Healthcare in Germany」の詳細全文を読む スポンサード リンク
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