In view of reforms implemented in health care systems in many countries, both developed or developing, and especially in view of the implementation of the Sistema Único de Saúde - SUS (Single Health System) in Brazil, the author presents some aspects of the reform process in the German Health Care System. Special attention is given to the various mechanisms employed in Germany to keep health care costs stable in the system in relation to the Gross Domestic Product (GDP), mainly through the adoption of measures to rationalize use of medical technologies. Some aspects related to the broad bargaining process between the Medical Boards and the funds providing health care services are discussed, with a view towards elaboration of parameters for assessing medical performance, particularly in relation to utilization of medical technological resources. Finally, the author briefly discusses the impact of such measures in producing changes in medical performance standards.
Medical Technology; Health Care Systems; Medical Practice; Health Policy; Public Health
