Volume 390, Issue 10097, Pages (August 2017)

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Volume 390, Issue 10097, Pages 882-897 (August 2017) Statutory health insurance in Germany: a health system shaped by 135 years of solidarity, self-governance, and competition Prof Reinhard Busse, MD, Miriam Blümel, Franz Knieps, Prof Till Bärnighausen, MD The Lancet Volume 390, Issue 10097, Pages 882-897 (August 2017) DOI: 10.1016/S0140-6736(17)31280-1 Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 1 Central actors in Germany's statutory health insurance system The Lancet 2017 390, 882-897DOI: (10.1016/S0140-6736(17)31280-1) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 2 Main health reforms and acts since 1993 A narrative of these developments is provided in the appendix (p 3). CDU=Christian Democratic Union. CSU=Christian Social Union. FDP=Free Democratic Party. SPD=Social Democratic Party. The Lancet 2017 390, 882-897DOI: (10.1016/S0140-6736(17)31280-1) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 3 Expenditures, human resources, and use of hospital care, 2003–1443–45 GDP=gross domestic product. The Lancet 2017 390, 882-897DOI: (10.1016/S0140-6736(17)31280-1) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 4 Daily activities within the German health system, estimated for 201543,54,67 The values have been rounded for ease of presentation. The Lancet 2017 390, 882-897DOI: (10.1016/S0140-6736(17)31280-1) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 5 Quality of care for patients with chronic and acute illness by country in 2013 (or most recent data)45,61 The data show measures of selected quality indicators defined by the Organisation for Economic Co-operation and Development. The deviation for asthma hospital admission rate in the USA is 356·2%; this outlier is not shown on the graph. COPD=chronic obstructive pulmonary disease. The Lancet 2017 390, 882-897DOI: (10.1016/S0140-6736(17)31280-1) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 6 Amenable mortality per 100 000 people and changes in total health expenditure in Germany and selected countries, 2000–1470 The graphs show age-standardised changes in amenable mortality and include all persons aged 0–74 years of age. The Lancet 2017 390, 882-897DOI: (10.1016/S0140-6736(17)31280-1) Copyright © 2017 Elsevier Ltd Terms and Conditions