There is an informative book to download or free about Social Security in Germany. Edited by Federal Ministry of Labour and Social Affairs.
There is a system of double specialists in Germany. This means that there are outpatient specialities provided by independent doctors in their offices, and in-house specialities provided by doctors in hospitals. The medical care centres (MVZ in German) play here a hybrid role. Many independent doctors can have become part of a facility which is similar to an outpatient centre. It is therefore possible that the administrators of medical insurance companies buy up quotas from insurance companies in order to place their hired doctors in these MVZ and, therefore, be part in the outpatient care. In more than 95% of the cases, the speciality training takes place at the hospitals. A doctor must apply for a training authorisation in order to be allowed to train younger doctors. This authorisation is dependant on the quality and the scope of the medical work in his or her unit. All doctors who have received a training authorisation can be found in data bases of the respective medical colleges web pages.
After completing his or her speciality training, the specialist can treat patients independently. This is a prerequisite to work as a senior physician, senior doctor, head physician, or independent specialist. According to EU provisions, this further training normally takes 5 years, and it is recognised in all Europe. In each German state, there are specific rules regarding this further training, which vary slightly from state to state. During the time in which the assistant doctors do their speciality training, they do a presence service, which is complemented by a senior doctor or head physician on call. This safeguard guarantees that the standard of the speciality is met.
The German health system has existed in different versions since December 1st, 1884.
It basically rests upon three types of stakeholders: the receivers, the providers, and those who give the funding for it. As patients, the receivers have compulsory insurance and, in case they develop a disease, they get their care free of charge. This includes outpatient medical care, lab work, hospital treatment, medication and rehabilitation therapy. The services are provided by a wide variety of professionals, a well as doctors, nurses, pharmacists, physiotherapists, and psychotherapists. Most of the 2,100 hospitals are part of the public health system. A little more than 1 million professionals work at hospitals. Altogether, around 10% of the employees in Germany work in the health system.
To pay for the treatments, there are a number of health insurance companies from which to choose. On principle, people can have private or public health insurance in Germany. This depends on the type of job you have. People who earn more or people or who are self-employed can leave the compulsory public insurance and hire a private medical insurance. Around 10% of the population have private medical insurance. Treatments that are not medically necessary, such as plastic surgery, are not covered by the health system. For the care of patients at home, the long-term care insurance is used, which is linked to the medical insurance.
The German State helps to fund the health system through special expenditure.