[Determining priorities in German public health--triad between rationing, rationalization and rational allocation]

Is there a crisis of the German health system? Will necessary medical services be rationed? These or similar questions have been intensely discussed in the public ever since the realization of reforming the health system by the Red-Green coalition. Opposers of the health structure reform 2000 have especially regarded the global budget, which was meanwhile stopped by the Federal Council, as an enormous threat for a functionable health system. Many actors of the health system have uttered deep apprehensions regarding a reform of the health system. As various attempts of legal controlling have proved during the last ten years, it will be necessary in our society to negotiate the health services which we will be able to afford in future at which price, and which we want to realize. Even presently it is not possible to guarantee maximum medical care according to the latest technology. The future question in the german health care system will no more be whether it will be necessary to set priorities, but only how they will have to be established.