European Policy Analysis
authorized to inform health policy , regulate quality standards for patients in the German health sector , and additionally to allocate funding into health services of the statutory health insurance ( GKV ).
Although the federal government of Germany appears theoretically to be the main policymaker and therefore the main actor of the German health sector , the fact that the health services in Germany are basically financed by social security contributions , bypasses the possibility of direct state interference in financial terms ( Hoesch 2012 , 9 ). However , the statutory health insurance ( GKV ) receives extra financing sources besides social security contributions , such as grants through taxation from the federal states and federal government .
Today , the basis of the German health sector — the statutory health
( GKV-Spitzenverband ). In comparison to years prior , the number of health insurance companies in Germany has been reduced , mainly due to the implementation of an act to strengthen competition in SHI ( GKV- Wettbewerbstärkungsgestz ), which basically standardized a universal contribution rate , introduced the central reallocation pool ( the so-called health fund ), and allows each health insurance company to “ match allocations and expenditures by either charging a supplementary communityrated premium from their insured or paying them back a certain amount ” ( Busse and Blümel 2014 , 39 ). As a consequence of this implementation , many health insurance companies with additional contributions suffered heavy losses in membership ( Schölkopf and Pressel 2014 , 56 ). In Germany , insured persons have been able to choose their health insurance company freely and without limitation since 2009 , insurance ( GKV ) on which 90 % of the German population is insured — is organized into 118 health insurance companies and has been represented within the system of joint self-ruling since 2009 by the federal association of insurance funds but every employee with a monthly salary not exceeding the upper wage threshold ( Versicherungspflichtgrenze ) is obliged to be insured in the GKV .
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