Health care costs in Germany have surged dramatically in recent years, reaching a staggering €491.6 billion in 2023. This represents a significant increase compared to €430.1 billion in 2020 and €337.1 billion in 2015. According to the Federal Statistical Office (Destatis), the average per capita health expenditure rose to €5,900 in 2023, marking a 42.4% increase from eight years earlier and a 12.7% rise since 2020. This upward trend highlights growing financial pressures on the German health care system amid an aging population and rising incidence of chronic illnesses.
Diseases of the cardiovascular system remain the most expensive health issue, accounting for €64.6 billion or 13.1% of total costs. Mental and behavioral disorders closely follow, responsible for €63.3 billion or 12.9%. These two categories combined represent over a quarter of all health care expenditures in 2023. Other costly conditions include digestive system diseases (€50.6 billion), musculoskeletal disorders (€49.9 billion), and neoplasms including cancer (€47.6 billion). These five major disease groups consistently account for about half of Germany’s overall health expenses, reflecting a stable cost distribution pattern over recent years.
Age plays a critical role in health care costs, with older adults incurring substantially higher expenses. More than half of the total health costs, €261.8 billion, were attributed to people aged 65 and over. The per capita costs for this age group reached €14,070, compared to just €2,270 for individuals aged 15 to 29. The highest per capita costs were observed among the very elderly (85+), with expenses soaring to €28,860 per person. This stark age-related disparity underscores the growing burden on Germany’s health care resources as the population continues to age.
Women’s health care costs were 22.5% higher than men’s, with average per capita spending of €6,490 versus €5,300. While men had higher per capita costs related to cardiovascular diseases (€800 compared to €750 for women), women incurred significantly higher costs from mental and behavioral health conditions, around 1.5 times more than men (€920 versus €600). The overall higher expenses for women are partly due to gender-specific health issues, including pregnancy and childbirth, but primarily result from women’s longer life expectancy and larger share of older age groups. Of the nearly 2.8 million people aged 85 or older in 2023, nearly two-thirds were female.
The sharp increase in health care spending, particularly driven by chronic diseases and an aging population, poses significant challenges for Germany’s health care system and public finances. Policymakers must address these rising costs while ensuring quality care and sustainability. Efforts to prevent chronic diseases, improve mental health services, and support healthy aging could be key to managing future expenditures.
As Germany’s population continues to grow older and the prevalence of costly illnesses rises, understanding these trends is essential for shaping effective health policy and resource allocation.
The health cost accounting records direct health costs by age, gender, and healthcare facility. These costs include expenses directly related to medical treatment, preventive care, rehabilitation, and nursing care measures.
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