How well does the German health system perform amid current reforms?
As part of LSE Health's 30th anniversary celebrations, we were delighted to welcome Reinhard Busse for a lecture on the German health system.
Germany's health system is often cited as a model for universal coverage and healthcare quality, yet it faces mounting pressures from high overprovision (due to overcapacities), leading to high costs, and a moderate quality-for-money. Recent years have witnessed significant reform proposals aimed at addressing these challenges, from restructuring hospital planning and payment to expanding digital health infrastructure. In this lecture, Professor Busse examined how the German health system measures up across key dimensions of performance, i.e. access, quality, responsiveness, and efficiency, particularly in light of these ongoing and recent reforms. Drawing on comparative evidence from across Europe, he assessed whether Germany's traditional strengths in access and comprehensiveness are being maintained, where critical gaps remain, and what lessons can be drawn for other health systems grappling with similar pressures. This lecture offers an evidence-based assessment of one of Europe's most prominent health systems at a critical juncture of transformation.
Meet the speaker and chair
Reinhard Busse is department head for health care management in the Faculty of Economics and Management at Technische Universität Berlin, Germany. He is also Co-Director and Head of the Berlin hub of the European Observatory on Health Systems and Policies, a partnership to bridge the gap between research and evidence-informed policy-making. His research focuses on methods and contents of comparative health system analysis and performance assessment (in Germany and Europe, but also low- and middle-income countries), health services research (with emphasis on hospitals, human resources, financing and payment mechanisms, quality as well as disease management), health economics and health technology assessment (HTA).
From 2011 to 2022, he was editor-in-chief of the international peer reviewed journal Health Policy. Since 2012, he has been director of the Berlin Centre of Health Economics Research, one of four centres in Germany funded by the Federal Ministry of Research. He has been speaker of the board of the inter-university Berlin School of Public Health since its beginning in 2015. In 2016/17, he was President of the German Health Economics Association. Since 2017, he has supported the School of Public Health at Kwame Nkrumah's University of Science and Technology (KNUST) in Kumasi, Ghana, in setting up a new master's program in Health Systems' Research and Management – and since 2021 in running the German-West African Centre for Global Health and Pandemic Prevention. In 2022, he chaired the European Public Health Conference. He was and is a member of several expert committees, e.g. for the German Federal Ministry of Health on Modern and Needs-based Hospital Care (2022-2025) and for the German Chancellor’s Office on Health and Resilience (2024-2025).
Elias Mossialos is Cheng Yu Tung Chair in Global Health and Director of LSE Health. He was the founding Head of the Department of Health Policy. His primary research focus revolves around health systems and policy, with a particular emphasis on issues related to healthcare financing, accessibility, quality, regulation, pharmaceutical policies, AMR, and cancer care and policy. He has developed the Options Market for Antibiotics, an incentive scheme to stimulate research and development (R&D).
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