Health policy

from Wikipedia, the free encyclopedia

On the one hand, health policy is understood to mean the policy area that deals with the planning, organization, control and financing of the health system and is responsible for its functionality. This includes, among many other things, negotiations with the associations of the health insurance companies , hospital operators, doctors and pharmacists and the pharmaceutical industry and regulation in corresponding laws and regulations.

On the other hand, health policy (introduced to the public as a term from 1913 by the Karlsruhe internist and social hygienist Alfons Fischer ) also includes influencing other health-related political and life areas such as education, work, living, nutrition, transport, the environment, family, leisure. This “indirect health policy” ( Health in All Policies ) can have a greater impact on the health of the population than the health system itself .


The goals of health policy should be

  • that diseases and accidents through prevention ( prevention be avoided) as possible,
  • that every citizen receives the necessary care in the event of illness, regardless of his income and assets,
  • that this care is provided in the best possible quality while respecting human dignity and the patient's right to self-determination,
  • that the health system works as efficiently and cheaply as possible,
  • that the population is satisfied with the health care and
  • that the staff in the health sector have good working conditions.

These goals do not only concern the state. A large part of it does not fall into his competencies, but into those of private-sector structures (e.g. private hospitals, resident doctors, dentists, pharmacies, health insurers, etc.).


The health system, especially its largest component, the health care system, is a highly complex structure of hundreds of institutional organizations and thousands of individual participants. These actors partly represent their own economic interests, partly also professional professional interests or also general social order interests.

As in every other political field, actors who are affected by political decisions try to influence them through lobbying . Mainly through contact with and exchange of information with political decision-makers, members of parliament, but also with civil society and through public relations work. Lobbying largely determines which issues are discussed in detail in public and which are not. Through lobbying, politicians find out what resistance and what difficulties their legislative initiatives will encounter. If necessary, they can adapt their initiatives before the vote in Parliament. Since lobbyists represent the interests of their clients, the information provided is presumably distorted in favor of their concerns.


At the federal level, the Federal Ministry of Health is mainly responsible for administrative purposes. It also has the legal supervision of the organs of the joint self-government and can intervene if the decisions made by the self-government are outside the framework established by the state, or if no agreement can be reached between the parties within the self-government. The most important body of self-government is the Federal Joint Committee .

The federal states have their own responsibilities, e.g. B. the organization of the public health service. The guarantee of sufficient hospital capacities is basically the duty of the districts and independent cities, but the hospitals do not have to provide them on their own. In addition, districts and urban districts also have health offices that are part of the public health service. The tasks of the health authorities include the performance of official medical activities, such as carrying out school examinations or the municipal planning of protective measures against pandemics.

Since the costs of the health system should be limited as far as possible despite the demographic change , there have been numerous reforms and reform attempts in this area ( see: Health reform in Germany ). The trend is towards no longer distributing the costs jointly among everyone (e.g. the legally insured and the employers on an equal footing), but imposing different costs on the individual according to individual risks (so-called "personal responsibility"). By relieving, in particular, the employer's share of the statutory health insurance, the non-wage costs are to be reduced.

Since 1976 there have been indirect transfer payments from statutory health insurance to other social security systems (pension and unemployment insurance ) in Germany. The resulting increases in contributions were used under the term of cost explosion as a political means to reduce benefits and, under the catchphrase of "reform", led to numerous changes in the structure of this social system. The complexity of these structural changes resulted in an increasing influence of the administrations and thus an increasing formalization of the work processes.

Since 2002, models have been under discussion in Germany that define the previous duality of statutory health insurance with mandatory contraction and family co- insurance as well as private health insurance , which defines risks per person from a certain income level (income threshold ) according to an individual assessment (age, previous illnesses, gender, etc.) , replace. Mainly in the debate is a model of the health premium and a citizen insurance in different forms.

See also


on the history of health policy:

  • Wolfgang Woelk et al. (Ed.): History of health policy in Germany. From the Weimar Republic to the early history of the 'double state foundation' . Duncker & Humblot, Berlin 2002, ISBN 3-428-10610-5

Web links

Wiktionary: Health policy  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. Wilfried Witte: Fischer, Alfons. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 401 f.