The German health care system
The Gesundheitsstrukturgesetz (GSG) which was introduced in January 1993 has changed the German Health Market dramatically. Prior to the introduction, the health market was structured by more or less equal influential participants. The pharmaceutical industry even could be regarded as primus inter pares. After the introduction the Ministry of Health became the most powerful force in the health care system. From then on, the ministry dominated all developments and decisions. Each of the other participants found themselves in the situation of reacting instead of acting. Therefore, the Ministry reached absolutely its aim. The costs of health care system could be reduced by 10 billions DM. The doctors in private practice were worried of loosing money. Their obliging adaptation to the governmental aims made the huge cost reduction possible. The main loosers of the GSG were the pharmaceutical industry, the pharmacists and the population. The pharmaceutical industry had to figure de- creasing profits and turnovers. They had to reduce their staff and their in- vestments. The Positiv-Liste which will show up at the end of 1995 will cause again trouble for the financial situation of the pharmaceutical industry. It is very doubtful that the OTC-market will substitute the losses of the prescription- market. The chance of the future is the evolution of holistic therapy concepts instead of the simple sale of drugs.
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