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Health care systems in transition – Germany

Busse R. Written in collaboration with A. Riesberg and edited by A. Dixon; also in German and Russian

Copenhagen: European Observatory on Health Care Systems





The Federal Republic of Germany covers an area of about 356 978 km2. The longest distance from north to south is 876 km, from west to east 640 km. The total population is 82 million (40 million males and 42 million females). The density of the population is 230 inhabitants per km2 (1998 figures). This includes over 7 million foreigners, of whom just over 2 million are Turkish. The population is unevenly distributed with far more people living in the western part of Germany. Of the 19 cities with more than 300 000 inhabitants only three (including Berlin) are in the eastern part of Germany. The largest city is Berlin with 3.5 million inhabitants. Other densely populated areas are the Rhine-Ruhr region with about 11 million people and the Rhine-Main area surrounding Frankfurt.

Germany is a federal republic consisting of 16 states (known in Germany as Länder). Each of the states has a constitution which must be consistent with the republican, democratic and social principles embodied in the constitution (known as the Basic Law or Grundgesetz). The constitutionally defined bodieswhich have primarily legislative functions are the lower and upper chambers of parliament, namely the Federal Assembly (Bundestag) and the Federal Council (Bundesrat).

The Federal Assembly is made up of 672 members who are elected every four years. Since 1998, the Social Democrats (SPD) and the Greens have held the parliamentary majority and have formed the government. The main functions of the Federal Assembly are to pass laws, to elect the Chancellor and to control the government.

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