2021: Health Expenditures of 465.9 Billion Euros (First Health Market)

The healthcare sector (first health market) in Germany is becoming increasingly expensive, and government transfer payments are rising: 81. 4 billion euros of the ongoing health expenditures in Germany in 2021 were financed solely through government transfers and subsidies. According to the Federal Statistical Office (Destatis), this was 18.

8% or 12. 9 billion euros more than in 2020. The share of government subsidies and transfers increased by 1.

6 percentage points compared to the previous year to 17. 5% of the ongoing health expenditures of 465. 9 billion euros.

The rise in government transfers and subsidies, which include the annual federal contribution to the health fund as well as subsidies from public employers, was also due to direct federal subsidies in the second year of the pandemic to combat the crisis. As a direct federal subsidy, the federal government financed through the health fund in 2021, among other things, 17. 2 billion euros for compensation payments to hospitals, protective masks under the Coronavirus Protection Mask Regulation, tests under the Coronavirus Testing Regulation, and expenditures at vaccination centers.

In addition to the direct federal subsidy, the federal government paid an additional federal subsidy of 5. 0 billion euros for further pandemic measures. The central procurement of vaccines was subsidized by the federal government with around 3.

5 billion euros. Furthermore, the federal government reimbursed 1. 0 billion euros of the coronavirus-related expenses of social long-term care insurance.

A total of 286. 8 billion euros in ongoing health expenditures in Germany in 2021 were financed through social insurance contributions. They accounted for 61.

6% of the ongoing health expenditures of 465. 9 billion euros, continuing to be the most important source of financing. However, compared to 2020, this share fell by 1.

1 percentage points. Of this, employers financed the largest share of ongoing health expenditures in 2021, with 113. 7 billion euros (24.

4%), followed by employee contributions with 111. 7 billion euros (24. 0%).

Other social insurance contributions (e. g. , health insurance contributions paid by pension insurance providers for retirees) covered 61.

4 billion euros, or 13. 2%. Another pillar of financing ongoing health expenditures came from other domestic revenues (e.

g. , payments by private households for outpatient and inpatient care), amounting to 61. 9 billion euros (13.

3%). Mandatory premiums, such as those for private health insurance, financed 29. 8 billion euros (6.

4%) of ongoing health expenditures, while voluntary premiums, such as for supplementary health insurance, financed 5. 9 billion euros (1. 3%).

Methodological Notes The results presented in the financing calculation complement the health expenditure calculation. The financing calculation shows how the individual bearers of health expenditures are financed. Both calculations follow the international concept of the “System of Health Accounts.

” For the financing calculation, the individual revenues are directly or indirectly assigned to the expenditure bearers and financing types via keys. In this way, the revenues are considered in relation to the expenditures and equated with them. Therefore, the financing calculation does not capture deficits or surpluses.

The ongoing health expenditures presented here include total health expenditures excluding investments. For total health expenditures in Germany in 2021, including an estimate for 2022, please refer to the Destatis press release No. 136 from April 5, 2023.