The Federal Republic of Germany is composed of sixteen states, the so-called Bundesländer or Länder. Germany has one of the highest population densities within the European Union. The proportion of physicians in the population is around 4.6 per 1,000 inhabitants.
The number of physicians in Germany rose again in 2018. Of a total of 515,640 physicians living in the Federal Republic at the end of 2018, 392,402 were professionally active. Of these, 201,811 were working in hospitals and 157,288 in a practice.
Healthcare in Germany is funded by a statutory contribution system that ensures free healthcare for all via health insurance funds. Insurance payments are based on a percentage of income, shared between employee and employer. Health insurance in Germany is divided between statutory and private schemes. The statutory health insurance, the so-called Gesetzliche Krankenversicherung(GKV), occupies a central position in the healthcare system in the Federal Republic of Germany. About 88% of the population are covered by statutory health insurance, which is compulsory for all with a gross income of less than 5,062 EUR per month. Private healthcare schemes can either provide a complete health service for those who opt out of the GKV, or top-up cover for those who remain within it.
In Germany, the provision of healthcare can be broadly separated into outpatient and inpatient sectors. Outpatient services are largely the responsibility of independent physicians practising on a freelance basis under contract to the statutory health insurer. Physicians treating patients who are members of the statutory health insurance funds must by law be registered with the regional Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung).
Hospitals in Germany are grouped into three main types:
- Public hospitals (Öffentliche Krankenhäuser) run by local authorities, towns and the Länder
- Voluntary, non-profit making hospitals (Frei gemeinnützige Krankenhäuser) run by churches or non-profit organisations, such as the German Red Cross
- Private hospitals (Privatkrankenhäuser) run as free commercial enterprises