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The history of institutions is often a history of deception and illusions; for their virtue depends on the ideas that produce and on the spirit that preserves them, and the form may remain unaltered when the substance has passed away.

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Karl Lauterbach

The German health care system is unique in its attempt to combine competition among sickness funds on the one hand and a universal coverage plan on the other hand. Most health care systems are either one or the other, so you either have private insurance and competition but not everyone is covered for everything, or you have a single-payer system. So the ideal types are like the American system on the one hand or the Scandinavian or U. K. systems on the other end. Germany tries to combine the advantages.

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