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Country Profile: Germany Country Profile: Germany COUNTRY PROFILE: GERMANY COUNTRY PROFILE: GERMANY The healthcare system in Germany is made up of both public and private insurances and dates back to the 1880s, making it the oldest in Europe. The country’s universal, multi-payer healthcare system includes both statutory health insurance for people who earn less than a certain salary, as well as private health insurance for those who earn more and choose to purchase their own. Health insurance is required for the whole population in Germany. Employees and salaried workers who earn less than €60,750 per year are automatically enrolled into one of the nearly 130 public, non-profi t insurance collectives. Healthcare is funded by mandated contributions from employers and their employees through premiums. All workers contribute about 7.5 percent of their salary into a public health insurance pool. Employers match that 7.5 percent contribution. These contributions also cover dependents such as nonearning spouses and children. In addition to the mandated health insurance, which covers the majority of residents, those with a yearly income exceeding €60,750—as well as students and civil servants—can opt for private health insurance to replace or complement the public option. Germany has long had the most restriction-free and consumer-oriented healthcare system in Europe. Patients can seek almost any type of care they wish whenever they want it. Co-payments, which exist for medicines and other items are relatively low compared to other countries. The total out-of-pocket costs for medications are capped at two percent of an individual's income, and one percent of income for people with chronic diseases. The Federal Ministry of Health is responsible for developing health policy in Germany as well as any reforms to the system. One of its central tasks is to maintain, secure, and develop the effi ciency of statutory health insurance and long-term care insurance. Another of the Ministry’s objectives is to further develop the quality of the health system, to strengthen the system in the interest of patients, to ensure profi tability, and to stabilize contribution rates. The Ministry of Health plays another important role in setting the framework for the manufacture, clinical testing, approval, distribution, and monitoring of pharmaceuticals and medical devices in order to meet the high quality and safety requirements. The Ministry directs the Federal Institute for Drugs and Medical Devices, which makes decisions concerning the approval of pharmaceuticals along with the Paul Ehrlich Institute, which is responsible for approving vaccines. When it comes to matters concerning health insurance, the Federal Joint Committee has wide- ranging regulatory power to determine the services to be covered by insurance and to set quality measures for providers. The Committee is made up of members representing doctors, dentists, psychotherapists, insurers, hospitals, and patients. The Committee carries out its work under the legal supervision of the Federal Ministry of Health. www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 2 Last updated on 22 November 2019 COUNTRY PROFILE: GERMANY National Language: German Capital: Berlin Currency: Euro Time Zone: Central European Time (CET) is used as standard time, while Central European Summer Time (CEST) is observed when Daylight Saving Time is in force. BASIC STATISTICS Population: 82,927,922 (as of 2018) Population aged under 15: 13.6% (as of 2018) Population aged over 65: 21.5% (as of 2018) Median age: 47.1 years Total fertility rate: 1.57% per woman (as of 2017) Number of live births: 551,579 Number of deaths: 714,936 Birth registration coverage: 100% (in 2014) Cause-of-death registration coverage: 100% (in 2011) Gross national income per capita (PPP international $): $47,180 (2018) Percentage of the total world population: 1.05% Ranks in the list of countries (and dependencies) by population: 19th Percentage of the population that is urban: 77.3% (64,113,235 people in 2018) Population density: 228.1 per square kilometer (590.8 people per square mile) Total land area: 357,021 square kilometers (137,847 square miles) Sources: https://data.worldbank.org/country/germany; https://www.worldometers.info/world-population/population-by-country/ www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 3 Last updated on 22 November 2019 LIFE EXPECTANCY AT BIRTH: 80.99 years AT BIRTH FEMALE: 83.5 years AT BIRTH MALE: 78.6 years At Birth At Birth Female At Birth Male 90 80 70 60 50 Age 40 30 20 10 0 Source: https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=DE&view=chart HEALTH EXPENDITURE PER CAPITA Health expenditure (US$) in Germany was reported at $5,182 per capita in 2014. Source: https://www.who.int/countries/deu/en/ www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 4 Last updated on 22 November 2019 www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 5 Last updated on 22 November 2019 ADULT RISK FACTORS DEATHS FROM NON- COMMUNICABLE DISEASES Source:https://www.who.int/nmh/countries/2018/deu_en.pdf?ua=1 www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 6 Last updated on 22 November 2019 IMMUNISATION PERCENTAGES (2018) % of children immunised Diphtheria, Tetanus, Pertussis Measles Hepatitis B 93% 97% 87% Source: https://data.worldbank.org/indicator/SH.IMM.HEPB?locations=DE INPATIENT CARE (2014) Inpatient care discharges (all hospitals) 21,059,705 Source: https://stats.oecd.org/ www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 7 Last updated on 22 November 2019 DID YOU KNOW? • In Germany, the average number of physician visits per capita is 10. • There are 4.2 physicians per 1,000 people in Germany. • Germany has 8.3 hospital beds per 1,000 people. • The average length of a hospital stay in Germany is nine days. • Germany is the third largest medical devices market in the world after the United States and Japan. • One out of six jobs in Germany is linked to the healthcare sector. Source: https://data.worldbank.org/country/germany PROVISION • About 11 percent of the German population have private health insurance. • In 2014, out-of-pocket spending accounted for 13.2 percent of total health spending, mostly on nursing homes, pharmaceuticals, and medical aids. • Public hospitals make up about half of all beds, while private not-for-profits account for about a third. • The number of inpatient facilities in hospice care has grown significantly over the past 15 years, to 235 hospices and 304 palliative care wards nationwide as of the spring of 2016. Source:https://international.commonwealthfund.org/countries/germany/ www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 8 Last updated on 22 November 2019 FINANCE Healthcare, in Germany, is financed mostly from the premiums paid by insured employees and their employers. Tax revenue surpluses also contribute. The premiums that employees pay are based on their income and calculated based on a percentage scale up to a certain income level. Germany is one of the biggest spenders on healthcare in Europe as well. It spends 11.1 percent of annual GDP on healthcare expenditure. Only Switzerland and France spend more in terms of GDP percentage. German healthcare spending works out at just over €4,000 per inhabitant each year. Source: https://www.ncbi.nlm.nih.gov/books/NBK298834/ TIPS FOR CONDUCTING MARKET RESEARCH IN GERMANY • Germans are usually direct and frank about what they want, and they expect you to do the same. • Germans shake hands in greeting. The handshake is firm and brief, conveying confidence and reliability. • When conducting face-to-face research, observe the personal space of others and avoid patting shoulders, arms or generally any physical contact beyond that all-important handshake. • When addressing a study participant, always use last names and appropriate titles of courtesy. Make sure you use the proper forms – Herr (Mr.), Frau (Mrs.) followed by the title, i.e. Herr Doktor Schmidt. • Be respectful of study participants’ time. Keep small talk to a minimum. Germans like to get down to business quickly. • Punctuality in German business culture is sacred; be sure to be on time for your research interviews. • Although Germans’ command of English is quite impressive, it is considered a show of respect to at least make an attempt to communicate in German. Source: https://www.todaytranslations.com/consultancy-services/business-culture-and-etiquette/doing-business-in-germany/; https://countrynavigator.com/blog/cultural-intelligence/germany/; https://itcraftapps.com/blog/15-tips-for-doing-business-in-germany-earning-trust/ www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 9 Last updated on 22 November 2019 USING M3’S PANEL FOR MARKET RESEARCH IN GERMANY In 2018, M3 Global Research completed 948 research projects in Germany comprised of 680 quantitative, 207 qualitative, and 61 hybrid projects. These studies delivered 46,281 survey completes that included 41,596 quantitative surveys, 1,656 qualitative surveys, and 3,029 hybrid surveys. The studies covered 44 specialties, 41 therapy areas, and serviced 248 clients. www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 10 Last updated on 22 November 2019 www.M3GlobalResearch.com www.M3GlobalResearch.com © 2019 M3 USA Corporation. All rights reserved. | 11 Last updated on 22 November 2019.
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