[Economic limits in rehabilitation]

At the end of the 90s, the German government imposed strict budget restrictions--to an extent previously unknown--on German rehabilitation medicine, arguing that this was necessary for economic reasons. In particular, these restrictions have led to considerable and permanent cuts in the area for which the pension insurance system is responsible. The consequence of this has been that in 1998--for the first time in the history of the rehabilitation system--expenditure on medical rehabilitation was distributed approximately equally between the pension and health insurance systems. A factor which contradicts the restrictions imposed by law is that an increase in the need for rehabilitation among those in gainful employment--due to demographic factors--can also be observed at the macro-economic level. This increase will peak in 2015 as will the increased demand for rehabilitation due to a change in the curative paradigm--for example due to sharp rates of growth in surgery which is performed. An internal contradiction to a restrictive health policy in rehabilitation medicine arises from the increasing number of evidence-based instances of proof of the effectiveness of rehabilitation, which also indicate economic benefits.