Table 1.Hospital ownership in East Germany: 1960-1989
Year |
Total
|
Public hospitals
|
Free charitable hospitals
|
Private hospitals
|
n |
Beds |
n |
Beds |
n |
Beds |
n |
Beds |
1960 |
822 |
204 767 |
679 |
189 260 (92.4%) |
88 |
13 523 (6.6%) |
55 |
1984 (1%) |
1970 |
626 |
190 025 |
523 |
176 536 |
82 |
12 540 |
21 |
949 |
1980 |
549 |
171 895 |
464 |
159 828 |
80 |
11 711 |
5 |
356 |
1989 |
539 |
163 305 |
462 |
151 969 (93.1%) |
75 |
11 076 (6.8%) |
2 |
260 (0.2%) |
Table 2.Ambulatory active doctors in East Germany: 1965-1989
Year |
Ambulatory active doctors |
Population per doctor |
Doctors in private practice |
Percentage of doctors in private practice |
1965 |
7270 |
1740 |
2524 |
35 |
1979 |
10 690 |
1375 |
1888 |
18 |
1980 |
16 730 |
950 |
863 |
5 |
1989 |
20 840 |
808 |
340 |
2 |
Table 3.Timeline of German unification and health care integration
Year |
Events in general and in the health care system |
1972. 12 |
Basic Treaty (Grundlagenvertrag) |
Reconciliation and rapprochement of East and West Germany |
1974. 4 |
Health Agreement (Gesundheitsabkommen) |
1989. 11 |
Fall of the Berlin Wall |
1990. 3 |
First free election in East Germany and new government |
1990. 5 |
State Treaty for Monetary, Economic, and Social Union (Staats- vertrag zur Waehrungs-, Wirtschafts- und Sozialunion) |
Article 22 on health care system |
1990. 7 |
Law for Restructuring of the State Ambulatory Health Care, Veterinary System, and Pharmacy System (Gesetz zur Umstruk- turierung des staatlichen ambulanten Gesundheitswesens, Veterinaerwesens und Apothekenwesens) |
Important prerequisites for privatization |
1990. 8 |
Unification Treaty (Einigungsvertrag) |
45 Articles, including articles on health care system |
1990. 8 |
Hospital Financing Act (Krankenhausfinanzierungsgesetz) |
1990. 9 |
Health Insurance Establishment Act (Krankenkassenerrich- tungsgesetz) |
1990. 9 |
Health Insurance Contract Act (Krankenkassen-Vertragsgesetz) |
2000. 1 |
Law on Legal Harmonization of Statutory Health Insurance (Gesetz zur Rechtsangleichung in der gesetzlichen Krankenver- sicherung) |
Table 4.Overview of the negotiations on health care integration
When |
Who |
What |
1990. 1 |
Representatives of the Federal Insurance Office of West Germany and the social security of workers and employees of East Germany |
Neither the creation of the social union nor the German unification was on the agenda |
1990. 1-3 |
East and West German government and health policy experts |
Initial position of both countries assumed a mid- and long-term process of unification |
Many health policy experts from both sides developed proposals, which provided for the reform of the East German health care system but were not an unmodified transfer of West German structures |
1990. 3-5 |
East and West German government |
New East German government decided on the fastest way toward unifica- tion according to Article 23 of the German Basic Law because of the rapid fall of the East German economy and continually growing emigra- tion of East German residents |
The idea, to mix two systems and to take over some positively viewed elements of East German social system in a new common welfare state, was rejected by West Germany |
1990. 5-9 |
East and West German government |
A series of laws were enacted, which brought about a departure from the previous East German state health care system and acceptance of es- sential elements of the West German health care system |