Editing Health care reform (section)

===Germany===
{{Further|Health care in Germany}}

Numerous healthcare reforms in Germany were legislative interventions to stabilise the public health insurance since 1983. 9 out of 10 citizens are publicly insured, only 8% privately. [[Health care in Germany]], including its industry and all services, is one of the largest sectors of the [[German economy]]. The total expenditure in [[Health economics (Germany)|health economics of Germany]] was about 287.3 billion euro in 2010, equivalent to 11.6 percent of the gross domestic product (GDP) this year and about 3,510 euro per capita. Direct inpatient and outpatient care equal just about a quarter of the entire expenditure - depending on the perspective.<ref>[[:de:Andreas Goldschmidt|Andreas 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</ref> Expenditure on [[pharmaceutical drug]]s is almost twice the amount of those for the entire hospital sector. Pharmaceutical drug expenditure grew by an annual average of 4.1% between 2004 and 2010.{{citation needed|date=August 2014}}

These developments have caused numerous healthcare reforms since the 1980s. An actual example of 2010 and 2011: First time since 2004 the drug expenditure fell from 30.2 billion euro in 2010, to 29.1 billion Euro in 2011, i. e. minus 1.1 billion Euro or minus 3.6%. That was caused by restructuring the Social Security Code: manufacturer discount 16% instead of 6%, price moratorium, increasing discount contracts, increasing discount by wholesale trade and pharmacies.<ref>[http://www.iges.de/presse07/pressemeldungen_2012/arzneimittel_atlas_2012/index_ger.html B. Häusler, A. Höer, E. Hempel: Arzneimittel-Atlas] {{webarchive|url=https://web.archive.org/web/20130101163421/http://www.iges.de/presse07/pressemeldungen_2012/arzneimittel_atlas_2012/index_ger.html |date=2013-01-01 }} 2012. Springer, Berlin u. a. 2012 ({{ISBN|978-3-642-32586-1}})</ref>