The German health care system has been recognized as one that provides good quality care with attentive service in which wait times are not considered to be a problem, as well as a system that rapidly adopts new medical innovations. A careful examination of the German health care system may provide insights and information to inform the Canadian debate over the future of Medicare.

Health care expenditures in Germany are considerably lower than in Canada. In 2009, Germany?s health expenditures, as an age-adjusted share of GDP, were 22% lower than Canada?s, and 1% lower than in the average nation with universal access to medical care. On health care inputs, the Canadian system has higher ratios of nurses to population, MRI machines to population, and CT scanners to population than the German health care system. On the other hand, Germany has higher ratios of physicians to population and hospital beds to population. Germans experience shorter wait times for emergency care, primary care, specialist care, and elect¬ive surgery than Canadians.

Looking at factors such as the health care systems? ability to success¬fully manage and treat chronic and critical illnesses, and provide protection from medically avoidable mortality, it seems that the German health care system broadly performs at a level similar to that in Canada, with a stronger performance in measures of patient safety.

The German health care system provides universal coverage through two insurance premium-funded systems: a Social Health Insurance sys¬tem for all Germans and a Private Health Insurance system that is an option for high-income and self-employed Germans. Though important in terms of funding, regulation, and oversight, governments play little role in the direct delivery of health care.