Reinhardt U E
Health Care Financ Rev. 1981 Dec;3(2):1-14.
This paper presents a structured survey of the West German health care and health insurance system. The West German health insurance system is very comprehensive and generous. The scheme provides full coverage for all medically necessary services, including ambulatory and inpatient care, prescription drugs, dental care, medical appliances and even prolonged rehabilitation in the so called Kurorten (localities with health spas). Typically, patients do not bear any copayment at the point of service, or only very modest ones. Physicians are paid on a fee-for-service basis (according to negotiated fee schedules), hospitals are reimbursed on the basis of prospectively negotiated per diems, and the suppliers of drugs and appliances are reimbursed at what is referred to as "market prices" (that is, at prices set by suppliers with only mild indirect control from the public sector or third-party payors). This extraordinarily liberal insurance system causes West Germany to devote no greater a proportion of their Gross National Product (GNP) to health care than does the United States. Using the American definition of "national health care expenditures," both nations currently devote about 9.4 percent of their GNP to health care.
本文对西德的医疗保健和医疗保险系统进行了结构化调查。西德的医疗保险系统非常全面且慷慨。该计划为所有医疗必需服务提供全额覆盖，包括门诊和住院护理、处方药、牙科护理、医疗设备，甚至在所谓的疗养地（设有温泉浴场的地区）提供长期康复服务。通常情况下，患者在接受服务时无需支付任何自付费用，或者只需支付很少的费用。医生按服务收费（根据协商的收费标准），医院按事先协商的每日费用报销，药品和设备供应商则按所谓的“市场价格”（即由供应商定价，公共部门或第三方付款人仅有轻微间接控制）报销。这种极为宽松的保险系统使得西德在医疗保健方面投入的国民生产总值（GNP）比例并不高于美国。按照美国对“国家医疗保健支出”的定义，两国目前都将约9.4%的GNP用于医疗保健。
