(Mess; 01-06; p.2)
The structure of the health system so far
Most Germans are insured by public, self-organised
and non-profit health insurances. This system, shortly known in
German as "GKV", consists of more than 200 different
insurers, most of them open to all employees. An employee has
to be insured within the GKV up to a gross income of about 3,500
Euro per month, half of the premium is paid by the employee, the
other by the employer.
If someone is an entrepreneur or self-employed,
he may choose to insure himself in a private, profit-orientated
insurance company, abbreviated in German as "PKV". The
same goes for employees who earn more than the mentioned 3,500
Euro per month. Opting for PKV automatically means that there
is no way back to GKV – a regulation that currently leaves self-employed
people who cannot pay there premiums any more without insurance.
Since Germany is a social state by constitution, health costs
for this group, as well as for long-time unemployed and people
unable to work, have eventually to be paid by the tax payer.
While premiums for the GKV are stipulated by
the insurers as percentage of the employees gross income, insurers
in the PKV-system conclude individual contracts, based on age,
health risks, etc. Currently, a change between GKV insurers is
possible without problems, this way opening the market for competition;
as a side-effect, some insurers indebted themselves to offer low
A change within the PKV-system is more complicated: a contract
has to be terminated, another to be concluded – practically, no
change is possible at the moment.
Children are cost-free insured within the GKV;
within the PKV, parents have to conclude individual contracts
for them, too. (read on here)