Germany’s state financing of healthcare expenditures decreased significantly in 2023, reflecting a return to pre-pandemic funding levels. According to data released by the Federal Statistical Office (Destatis), state contributions totaled approximately €75.7 billion, representing 15.4% of Germany’s total healthcare spending of €491.6 billion. This figure is a substantial decrease of €34.1 billion, or 31.1%, compared to 2022, primarily attributable to the expiration of pandemic-related measures.
The 15.4% state contribution aligns with levels observed prior to the pandemic in 2019 (14.4%) and is a marked difference from the 22.3% seen in 2022. Healthcare funding in Germany is shared amongst various actors, including the state, companies, private households and non-profit organizations.
Conversely, contributions from private households and companies rose considerably. Private households increased their financing contribution by €19.4 billion – an 8% increase – reaching €262.5 billion. Companies’ contributions rose by €13.9 billion, up 10.2%, to €150.2 billion. These increases stem from a general increase in healthcare expenditures across all funding sources, with the exception of public finances.
The share of financing provided by private households increased from 49.4% to 53.4%, while the share from companies rose from 27.7% to 30.6%. Non-profit organizations also saw a slight increase, from 0.6% to 0.7%. Consequently, private households now fund over half of Germany’s healthcare spending.
Of the €262.5 billion financed by private households, nearly half (€124.9 billion) was allocated to employee social security contributions. A further €55.1 billion covered miscellaneous domestic income, including expenses for outpatient and inpatient care and the purchase of over-the-counter medications. This reflects a year-on-year increase in employee social security contributions (€10.4 billion, +9.1%) and miscellaneous income (€3.0 billion, +5.8%).
For companies, 85.1% of the €150.2 billion financing contribution is attributed to employer social security contributions, which rose by €11.3 billion to reach €127.8 billion (+9.7%) compared to the previous year.
The state channeled approximately €69 billion – some 91% of its total contribution – towards transfers and subsidies.
Finally, health-related services funded by non-profit organizations increased by €171 million (+5.6%) to a total of €3.2 billion.
