With a system that has evolved in a stepwise manner over the last 120 years, Germany presents an interesting case for studying today's challenges. In chapter 10, contributor Reinhard Busse discusses the struggle to overcome some of Germany's main system weaknessese.g., the strict separation between ambulatory and inpatient sectors. Busse lays out the basic framework of the system, explores health care financing and delivery, and gives an account of major reforms and their objectives in the last decade.