Migration of Greek Physicians to Germany
This organization of the German health system described here guaranteed increasing health expenditures in Germany over the last several years , as the following Figure 1 demonstrates ( OECD Health Statistics 2016 ). The majority of expenditures originate from public sources , although private expenditures are also on the rise , as the following table demonstrates .
Key Actors of the Health System in Germany . One very characteristic element of the German health system is the framing of the state actors , despite their central role in the health policy , by corporate elements and self-ruling organizations , as already explained . The most representative element is the dominant role of physician associations in Germany . First of all , the regional associations of SHI physicians distribute the remuneration from health insurance companies to their members . Apart from that , like the GKV organizations , the physician associations are able to influence legislation about health politics in preliminary stages ( Wendt 2003 , 110 ).
Furthermore , these groups of physicians have a privileged double function as recognized public bodies , especially as long as they participate in the federal joint committee ( Gemeinsamer Bundesausschuss ) through the association of SHI physicians , as well as through their federal associations into the federal association of insurance funds ( GKV- Spitzenverband ), but also as independent organizations , a practice which has secured strong influence in the formulation of health policies ( Bandelow 2004 , 52 ). This occurs due to their double representation and organization into self-ruling and corporatism — every licensed doctor is automatically a member of a chamber . At the same time , every SHI physician is also a member of his regional association of SHI physicians ( KV ). This fact endows these bodies with power , due not only to the numerous memberships of the physicians , but also financial security through the compulsory membership fees . ( Hoesch 2012 , 12 ).
The multidimensional and dominant role of physician associations can also be detected in the manpower configuration of the German health sector , especially regarding the current number of practicing physicians . In 1992 , a reform concerning the introduction of a capped budget and a maximum number of doctors in the ambulant sector caused a strong reaction from physicians , who via lobbying had achieved a reduction in training capacities and access to medical schools in that same year by 22 % ( ibid ., 13 – 14 ). According to Hoesch ’ s research , this development and the reaction of the organized interest of physicians can be considered a very crucial moment for the current “ looming shortages ” because its effects on the number of practicing physicians in Germany were still felt 10-12 years later ( ibid ., 18 ).
One field where the role of an actor is also highly relevant to the case of medical graduates ’ migration is the issuing of professional licenses and the recognition of qualifications . Regarding the latter issue , Greek physicians in Germany have the privilege of facing fewer problems compared to their colleagues from non- EU countries , having the right to receive a full license while also having their qualifications automatically recognized . Seventeen medical chambers in Germany are responsible for recognition of specialist training , showing the connection of the physician associations in this field . Moreover , every federal state sets different norms and
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