The health care system of Germany is often advocated as an alternative model to the Canadian system for lessons for health reform in the United States. As described in an earlier article in The Journal,1 the German system is pluralistic and relies on a regulated system of private financing and delivery to provide virtually universal coverage. The system in Germany has received less attention than the Canadian system over the past decades for several reasons, one of the most important having been lack of accessible information. Less than a handful of American health policy researchers read German, and few German health policy researchers have published in English.
This lack of easy access to information on health care in this complex system has been eliminated by the publication of Richard Knox's exhaustive examination. For a book of such scope, it is also very readable. Knox avoids jargon and clearly presents