The division of Germany after the Second World War has often been recognized as providing a unique opportunity to evaluate a natural experiment in history, one in which a homogenous population had been artificially separated for 45 years. The possible consequences for the healthcare reforms of the two very different social models have, however, received relatively little attention in modern literature. In particular, the division of Germany into two states at the conclusion of World War II had dramatic effects on their respective healthcare systems. The Federal Republic of Germany reinstated the decentralized, largely private system of health insurance that had begun in 1883. Meanwhile, the German Democratic Republic adopted a strongly centralized,
…show more content…
One of the greatest challenges facing German leaders at that time was the consolidation of health insurance systems. While the East German system of national health service lay in a state of complete disarray, West Germany’s comprehensive and compulsory health insurance scheme ranked as one of the world’s best healthcare systems. Legislators planned to transform the East German system into a social-insurance plan modeled on that of West Germany, but many details remained uncertain as the 16 million citizens of the former East Germany entered the West German healthcare system on January 1, 1991. To fully comprehend the problems encountered in creating one health system for reunified Germany, the structures of the former East and West German healthcare systems must be considered more closely. The aim of this paper is to examine the healthcare systems of both Western and Eastern Germany before and after Reunification, focusing on the rapid convergence of healthcare conditions since 1990 following roughly two decades of continuous divergence. This paper will argue that the strong dynamics of the process of political unification of the two German states also largely determined the transformation of the East German healthcare system, ultimately resulting in the replacement of its Soviet style system by the pluralist insurance-based West German system of medical care. The results of this study plan to show how different healthcare standards and social insurance systems can influence the improvement of public health – closing of the health gap between Western and Eastern
One of the greatest challenges facing German leaders at that time was the consolidation of health insurance systems. While the East German system of national health service lay in a state of complete disarray, West Germany’s comprehensive and compulsory health insurance scheme ranked as one of the world’s best healthcare systems. Legislators planned to transform the East German system into a social-insurance plan modeled on that of West Germany, but many details remained uncertain as the 16 million citizens of the former East Germany entered the West German healthcare system on January 1, 1991. To fully comprehend the problems encountered in creating one health system for reunified Germany, the structures of the former East and West German healthcare systems must be considered more closely. The aim of this paper is to examine the healthcare systems of both Western and Eastern Germany before and after Reunification, focusing on the rapid convergence of healthcare conditions since 1990 following roughly two decades of continuous divergence. This paper will argue that the strong dynamics of the process of political unification of the two German states also largely determined the transformation of the East German healthcare system, ultimately resulting in the replacement of its Soviet style system by the pluralist insurance-based West German system of medical care. The results of this study plan to show how different healthcare standards and social insurance systems can influence the improvement of public health – closing of the health gap between Western and Eastern