Resumo

OUVERNEY, Assis Mafort  e  FLEURY, Sonia. The process of statutory health insurance reforms in Germany during the '90s: impasses and breakthroughs. Salud Colectiva [online]. 2005, vol.1, n.2, pp. 173-194. ISSN 1851-8265.  http://dx.doi.org/10.1590/S1851-82652005000200004.

This article describes the process of health care reform in Germany during the '90s which was organized based on corporate interests. We also analyze the impact of the reform on system performance. The results are based on a review of the literature on health care systems. The analysis was based on the methodology proposed by Evans focusing on three dimensions: organization and management, financing, and health care delivery. The analysis suggests that, despite the rigidity of social protection systems based on corporatate interests, it is possible to make changes that result in positive outcomes in terms of efficacy and efficiency. The article also suggests that this process can produce negative effects on equity and population coverage.

Palavras-chave : Social Security Reform in Health Care; Conflict of Interest; Coverage Equity; Efficacy; Efficiency.