The Effects of Federalism, Corporatism and Legislative Power on Health System Transformation in Germany

ABSTRACT International comparisons show that although health services are becoming increasingly digital, interconnected, and person-centred in industrialised countries, Germany lags behind in utilising and linking health data to provide better healthcare. A detailed analysis focusing on structural factors is crucial for policy studies involving international comparisons and country rankings. In Germany, factors such as the constraints of federalism, a well-established bureaucracy and a fragmented political decision-making system contribute to a deeply rooted resistance to change across various public service sectors. In the same vein, this article outlines the current landscape of data-driven innovations in the German health system. It identifies federalism, corporatism, and legislative power as three structural reasons why the country has been lagging behind in this field, while also discussing potential future developments.