The opportunity to do better: lessons old and new from Germany's health system

As the U.S. undertakes national health reform, it would do well to consider both the old and new lessons offered by Germany's century-old universal health system. "Old" principles include an explicit national policy, shared financial responsibility, universality of coverage, and structured financing. New lessons, which are more concerned with operational strategies, include societal affordability, budgets, supply side restrictions, and volume controls.