Timeline of healthcare in Germany

This is a timeline of healthcare in Germany, focusing on modern healthcare system first adopted in this country. Major events such as policies and organizations are included.

Big picture

Year/period	Key developments
<1883	Modern science-based medicine is shaped through endless scientific discoveries by German scientists. Some major events from early times concerning healthcare include the foundation of University Hospital Heidelberg (1388).
1883–1911	Development of the first healthcare system of modern history, starting with policies of the introduced Otto von Bismarck's social legislation.[1]
1911–1933	After the Reich Insurance Code (RVO for Reichsversicherungsordnung) is introduced, health, pension and accident insurance are integrated under one set of laws. The RVO becomes the decisive legal basis for health insurance law. Compulsory insurance is extended to messengers, migrant workers, and those working in farming and forestry.[2]
1933–1945	Under the rule of National Socialism, the organization, financing and supervision of the health insurance funds are altered dramatically. Self-administration is abolished and state-approved directors are assigned to each fund. Among important reforms is the introduction of health insurance for pensioners in 1941.[2]
1945–1990	Two states period: The German Democratic Republic (GDR/East Germany) and the Federal Republic of Germany (FRG/West Germany). A socialist model healthcare system is adopted in East Germany, while self-administration is reinstated in West Germany in 1952.[2][3]
1990–present	After German reunification, former East Germany assimilates to the FRG healthcare system. The unification treaty rules that federal German health insurance law is to apply to the new east German Länder.[2][3]

Full timeline

Evolution of life expectancy in Germany for the period 1875-2011.^[4]

Year/period	Type of event	Event	Location
1388	Organization	University Hospital Heidelberg is founded. It is the first one within the actual Federal Republic of Germany.[5]	Heidelberg
1456	Organization	Greifswald University Hospital is founded.[6]	Greifswald
1457	Organization	University Medical Center Freiburg, a hospital and research unit, is founded.[7]	Freiburg im Breisgau
1710	Organization	The Charité – Universitätsmedizin Berlin founded.[8]	Berlin
1783	Organization	University Hospital Bonn founded.[9]	Bonn
1834	Organization	Rechts der Isar Hospital founded.[10]	Munich
1854	Policy	First components of social security created for miners.[11]
1865	Organization	Martin Gropius Krankenhaus, a neuro-psychiatric hospital, is founded.[12]	Eberswalde
1867	Organization	Bethel Institution founded.[13]	Bielefeld
1871	Development	German national unity is established. Workers begin to organize labor unions, fighting both industrial employers and the Prussian State. Under pressure, business leaders begin to conceive the idea of developing “sickness funds” to respond workers.[3]
1883	Policy/development	Under the rule of Otto Von Bismarck, Health Insurance Act is adopted.[14] Beginning of the national social health insurance, which is considered to be the first in history.[3] An estimated 5% to 10% of the total population is initially covered.[15] Coverage for blue-collar workers (in saltworks, processing plants, factories, metallurgical plants, railway companies, shipping companies, shipyards, building companies, trade companies, power plants), craftsmen, persons employed by lawyers, notaries, bailiffs, industrial cooperatives and insurance funds.[11]
1884	Policy	Statutory Accident Insurance is established.[11]
1885	Policy	Social health insurance in extended to transport workers.[11]
1888	Organization	Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil,a teaching hospital, is founded.[16]	Bochum
1889	Policy	Statutory pension insurance is established.[11]
1889	Organization	University Medical Center Hamburg-Eppendorf founded.[17]	Hamburg
1892	Policy	Social health insurance in extended to commercial office workers.[11]
1894	Organization	Berufsgenossenschaftliche Kliniken Bergmannstrost Halle, a teaching hospital, is founded.[18]	Halle
1900	Organization	The Bernhard Nocht Institute for Tropical Medicine, a research institute, is founded.[19]	Hamburg
1910	Report	37% of the population is covered by social health insurance.[15]
1911	Policy	The Reich Insurance Code is launched, systematizing health, pension and accident insurance, integrating them under one set of laws.[2] Social health insurance in extended to and forestry workers, Domestic servants and itinerant workers.[11]
1914	Policy	The health insurance law set down in the Reich Insurance Code goes into effect.[2] Health insurance in extended to civil servants.[11]
1917	Organization	Max Planck Institute of Psychiatry, a research institute, is founded.[20]	Munich
1917–1918	Policy	Social health insurance is extended to the unemployed.[11][14]
1919	Policy	Social health insurance is extended to persons employed in public and private cooperatives, persons who are only partially capable of gainful employment and wives and daughters without own income.[11]
1927	Policy	Seamen start to be covered by public health insurance.[14]
1930	Policy	All dependents start to be covered by public health insurance.[14] The national total covered population reaches 50%.[15]
1933	Policy	Under Nazi regime, health insurance becomes subject to total control by Berlin. Self-administration is abolished and state-approved directors are assigned to each fund.[2][3]
1938	Organization	Bayreuth Medical Center, a teaching hospital, is founded.[21]	Bayreuth
1938	Policy	Social health insurance is extended to midwives and self-employed workers in nursing and child-care.[11]
1939	Crisis	World War II starts with the German invasion of Poland.
1941	Policy	Legislation is passed allowing workers whose incomes have risen above the income ceiling for compulsory membership to continue their insurance on a voluntary basis. The same year, coverage is extended to all retired Germans.[14]
1945		German surrender. End of World War II in Europe.[22]
1947	Organization	The Kaiser Wilhelm Institute for Medical Research is founded (later renamed Max Planck Institute for Experimental Medicine).[23]	Göttingen
1949	Political change	Creation of the German Democratic Republic (GDR/East Germany) and the Federal Republic of Germany (FRG/West Germany). Control over sickness funds in West Germany reverts to business and labor, while East Germany keeps a state-run delivery system.[3]
1950	Report	70% of the population is covered by social health insurance.[15]
1952	Policy	FRG: self-administration is reinstated.[2]
1953	Policy	Social health insurance is extended to refugees, expellees and the seriously disabled.[11]
1957	Policy	Social health insurance is extended to all the physically disabled.[11]
1964	Organization	FRG: German Cancer Research Center is founded.[24]	Heidelberg
1964	Organization	FRG: Heidelberg University Faculty of Medicine in Mannheim is founded.[25]	Mannheim
1965	Organization	FRG: The Hannover Medical School is founded.[26]	Hannover
1966	Organization	FRG: Uniklinikum Aachen, a university hospital, is founded.[27]	Aachen
1966	Policy	FRG: Health insurance coverage is extended to salespeople.[14]
1969	Policy	FRG: The Act on Continued Payment of Wages establishes that blue-collar and white-collar (salaried) workers are to be treated equally in terms of continued remuneration in case of illness.[2]
1972	Policy	FRG: Health insurance coverage is extended to self-employed agricultural workers.[11][14]
1973	Organization	FRG: The German National Library of Medicine is founded.[28]	Cologne
1974	Policy	The Improved Benefits Act and the Rehabilitation Act are incorporated.[2]
1975	Policy	FRG: Social health insurance is extended to students and all disabled.[11]
1977	Policy	FRG: Health Care Cost Containment Act is introduced in an effort to keep spiraling costs under control.[2][29]
1980	Organization	FRG: Heart and Diabetes Center North Rhine-Westphalia founded.[30]	Bad Oeynhausen
1975	Policy	Social health insurance is extended to artists and publicists.[11]
1982	Policy	Reform in the FRG. Hospital Cost Containment Act: Hospital expenditure, which was largely excluded from the 1977 Act, begins to be remedied in this reform. The common goal is to bring the growth of healthcare expenditures in line with growth of wages and salaries of sickness fund members.[29][31]
1982	Organization	FRG: Augsburg Hospital is founded.[32]	Augsburg
1983	Policy	FRG: Cost containment law is reintroduced in order to control healthcare costs.[2]
1989	Policy	FRG: Health Care Reform Act. Described as the most important statute on the statutory health insurance system since the Law of 1911. Aimed both at cost containment and at financing some selected improvements to benefits.[29]
1990	Political change	German reunification. East Germany assimilates to the FRG healthcare system.[3]
1992	Organization	Max Delbrück Center for Molecular Medicine in the Helmholtz Association is founded.[33]	Berlin
1993	Policy	Health Care Structure Act comes into effect. Coping with a US$5.7 billion deficit among third-party payers, the German parliament imposes mandatory global budgets to physician, hospital, dental and pharmaceutical services.[34]
1993	Organization	Max Planck Institute for Infection Biology, a research institute, is founded.[2][35]	Berlin
1995	Policy	Statutory long-term care insurance is established. Germany introduces mandatory long-term care insurance to provide care for the elderly.[2][36]
1996	Policy	Germany begins to allow citizens to choose from among sickness funds.[36]
2000	Report	88% of the population is covered by social health insurance.[15]
2000	Organization	The German Institute for Health Technology Assessment (DAHTA) is established. DAHTA produces reports on medical, economic, social, ethical and legal issues related to the German health system. DAHTA is also involved in developing standards.[37]
2001	Organization	Max Planck Institute for Molecular Biomedicine, research institute, is founded.[38]	Münster
2004	Organization	The Institute for Quality and Efficiency in Healthcare (IQWiG) is established as an independent federal organization for the evaluation of medical efficiency, quality and effectiveness of drugs.[37]
2004	Policy	Germany adapts the Australian diagnosis-related group (DRG) system as the sole system of paying for recurrent hospital expenditures, except for psychiatric care where per diem charges still apply.[37]
2006	Organization	The Translational Centre for Regenerative Medicine is founded as a research institute.[39]	Leipzig
2009	Policy	A new health care reform act is established in order to redefine the hospital financial system.[37]
2010	Policy	The CDU-FPD coalition passes the GKV-Finanzierungsgesetz for insurance reform and the Arzneimittelmarktneuordnungsgesetz (AMNOG) for pharmaceutical reform in order to contain rising costs resulting from a demographic transition toward an older population.[40]
2016	Report	Life expectancy in Germany is estimated at 80.68 years, being ranked 28th out of 228 political subdivisions.[41]

See also

• Healthcare in Germany
• Timeline of global health

References

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7. "Information on the University Medical Center Freiburg". University Medical Center Freiburg. Retrieved 18 July 2016.
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11. Till Baarnighausen, Rainer Sauerborn. "One hundred and eighteen years of the German health insurance system: are there any lessons for middle- and low-income countries?" (PDF). Retrieved 19 July 2016.
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13. Enno Obendiek, „Die Theologische Erklärung von Barmen 1934: Hinführung“, in: „… den großen Zwecken des Christenthums gemäß“: Die Evangelische Kirche der Union 1817 bis 1992; Eine Handreichung für die Gemeinden, Wilhelm Hüffmeier (compilator) for the Kirchenkanzlei der Evangelischen Kirche der Union (ed.) on behalf of the Synod, Bielefeld: Luther-Verlag, 1992, pp. 52–58, here p. 57. ISBN 3-7858-0346-X
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20. "Max Planck Institute of Psychiatry". Retrieved 18 July 2016.
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41. "The World: Life Expectancy (2016)". Retrieved 20 July 2016.