Germany has one of the most comprehensive healthcare systems in the world. Nevertheless, there are growing signs of quality impairment due to the relative scarcity of resources in some medical specialties, as well as in both outpatient and inpatient care. It is therefore imperative to discuss prospectively the limits that will inevitably be placed on solidarity-based (collective) funding of healthcare treatments. If it will eventually no longer be possible to finance a comprehensive system of medical care in which every citizen is entitled to every medically relevant benefit, it is essential to discuss the questions of legitimate entitlements and fair distribution – that is to say, ultimately, issues of social justice in healthcare. The debate must concern the extent of the morally required and legally (pertaining to fundamental rights) guaranteed entitlements.
On 27 January 2011, the German Ethics Council published the Opinion Medical Benefits and Costs in Healthcare: The Normative Role of their Evaluation.