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Unified Germany has a population of 81 million people living in 16 states. Based on epidemiologic studies, it has been estimated that 810,000 people have some form of epilepsy and as many as 130,000 to 170,000 people suffer from a severe or disabling epilepsy.1 Current therapies provide only partial control for many of the latter group of individuals.1 The following report briefly describes the principle features of epilepsy care in Germany (table).
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Table Principle features of epilepsy care in Germany
The German health care system offers almost complete health care coverage to the German population (prevention, treatment, and rehabilitation). The system is supported by a multi-structured network of public and private health care insurers. Costs of this insurance are paid for equally by employers and employees. Approximately one-third of the national health care spending involves hospital expenditures with the remaining funds covering physician fees, clinic visits, and medications.2 Currently, 8.6% of the gross national product is spent on health care. In 1995, the public health insurance system ended with a deficit, prompting politicians to call for a greater contribution by the public unless strong measures could be enacted to reduce costs. Recently, there has been an effort to reduce health care spending by capping both outpatient expenditures for medications and across the board fees for inpatient and outpatient care. At the same time, patients have been asked to pay more toward services and the pharmaceutical industry has been required to reduce prices. The Federal Minister for Health is faced with the challenge of maintaining quality services in an era when progress in, and costs of, medicine and medical technology are accelerating simultaneously with a population that is aging and a worker pool that is declining. This is a daunting task-one that is not unique to Germany. …
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