[Financial development of the Munich General Hospital 1830-1894]

The Munich General Hospital is typical for the modern hospital developing in the late 18th century. Before the introduction of the compulsory Imperial Health Insurance in 1884 in many southern states of Germany municipals installed some kind of insurance system to take care for their poor. These insurance systems were intended to provide hospital care for the lower classes and give the hospital a new source of income. The Munich General Hospital has been founded in 1813 and a voluntary insurance scheme was installed. This paper examines the financial development of the Munich General Hospital in the long run through studying its expenditures and sources of income from 1830/31 until 1894. Especially the effects of the various kinds of insurance schemes from the first voluntary insurance system (1813) until the compulsory Imperial Health Insurance (1884) on the hospital's financial capacity have been analysed. Until the 1830s the hospital struggled with serious financial problems because the founding fund was too small for the high number of non-paying patients. This situation was aggravated through the failure of the first insurance system which was subsequently reformed in 1832. With the new mandatory insurance scheme and the revenues of the founding fund the hospital reached in the following decades a high level of independence from traditional financing sources such as donations and public subsidies. The compulsory Imperial Health Insurance reinforced this trend. In consequence the hospital did not need any municipal subsidies to finance its regular expenditures.