Throughout Europe, a complex political structure of government has emerged from the once simple Monarchial rule. These new systems of Government, with respect to specific nation-states, have developed domestic policies that people depend on for daily life. Of these many dependencies is the health care system. The nation-states of Europe are entitled to bring forth and confront these issues, in order to ensure a sense of safety and well being into the lives of everyday citizens. The significance of the health care system is that it is an issue people are always trying to reform and build upon. Working alongside this idea, is the notion that other countries will develop intellectual health care systems from understanding those system
These basic principles have created a very important difference between the two types of health insurance. The PHI system has diversified payment rates, while in the SHI system, benefits are financed by an income-related payroll tax. In 1995, the average SHI contribution rate was 13.2 percent of labor income, half paid by the employer and the other half by the employee. Individuals who voluntarily join a private insurance plan are normally not allowed to re-enter the SHI system if the cross-subsidization effects of SHI change to their advantage. Germany draws a sharp difference between hospital-based and office-based physicians. Office-based practitioners provide the population with ambulatory care, prescribe drugs and medical aids, and serve as gatekeepers for specialist referrals and hospitalization. "In 1993, more than 266,000 physicians were working in various positions in the German health care sector. The number of office-based physicians was 89,000, which indicates a physician/population ratio of 1.18 per thousand inhabitants in the western part of Germany. Approximately 90,000 doctors were employed by hospitals". (Knox 49)
As compared with other SHI treatment spending, hospital expenditures have grown disproportionately over the last three decades. This growth is explainable by several factors: medical, technological, and economic. For example, more diseases can