The Health and Social System in Germany – An Overview for Study and Practice
2. Module 1 · Welfare state and the solidarity principle – basic concepts of social protection
- You can name the welfare state principle (Sozialstaatsprinzip) set out in Art. 20(1) of the Basic Law (Grundgesetz, GG) and explain its significance for social protection.
- You can explain the solidarity principle (Solidarprinzip) using the example of statutory health insurance (gesetzliche Krankenversicherung, GKV) (‘contributions according to income, benefits according to need’).
- You can distinguish between the insurance, social assistance and provision principles (Versicherungs-, Fürsorge- und Versorgungsprinzip) on the basis of financing, legal basis of entitlement and clarification of need.
- You can use guiding questions to assign benefits and enquiries from your field of work to a structural principle and justify that assignment to others (application).
- You can place Germany within the typology of welfare states and evaluate the strengths and limits of the German model.
This module lays the foundation for the entire course: it explains why Germany is a welfare state (Sozialstaat), according to which basic logics social protection is organised and how you can recognise these logics in everyday practice. The concepts you work on here will come up again in every subsequent module.Opening question: Think of the last situation in which you had to explain to someone why they were receiving a benefit – or why they were not. What logic did you base your reasoning on at the time?
What you will be able to do afterwardsYou will be able to use a few guiding questions to assign benefits and enquiries in your practice to one of the three structural principles and to explain this assignment clearly in conversations and within your team.
PART 1 – Why a welfare state? Life risks, basic concepts and overview
Cushioning life risks collectively
Illness, need for long-term care, accidents, unemployment, old age: these are life risks that can overwhelm individuals and their families both financially and organisationally – even if they have made honest efforts to provide for themselves. A welfare state responds by not leaving such risks to individuals alone but cushioning them collectively: through insurance schemes, through help in situations of need and through special benefits for particular groups.
For you as a professional in social work, nursing and care, or counselling – and all the more so as a manager or future leader – this system is not background noise but the framework for action in your work. Whether a measure is funded, which body is responsible, which documents an application requires and how you explain this clearly to people seeking advice: all of this follows rules that can be traced back to a few basic logics. If you know these logics, you do not need to have every individual provision in your head to find your way. If you do not know them, you quickly get lost in a thicket of legal sections – and so do the people who rely on your guidance. This knowledge is also indispensable for decisions at management level: anyone who plans services, clarifies funding questions or leads teams is constantly operating within this framework.
Important basic concepts
You should keep four concepts clearly apart from the outset.Social protection (soziale Sicherung) refers in this course to the totality of legally regulated benefits and institutions intended to protect people against life risks and in situations of need and to enable them to participate in society (working definition of this course). The Social Code (Sozialgesetzbuch, SGB) already formulates the corresponding entitlement in its General Part, Social Code Book I (SGB I): within the framework of the Social Code, everyone has a right of access to social insurance (section 4(1) SGB I), and anyone who cannot help themselves and does not receive sufficient help from other sources has a right to personal and financial assistance (section 9 SGB I).
Thewelfare state (Sozialstaat) is the state that has committed itself under constitutional law to social responsibility; its foundation is the welfare state principle in Art. 20(1) GG, which Part 2 deals with. Thesolidarity principle describes the basic idea that many people bear risks together and that benefits are geared to the needs of those affected rather than to their own contributions; Part 3 illustrates it using the example of statutory health insurance (GKV). Finally, thestructural principles of insurance, social assistance and provision form a classification grid with which the wide variety of social benefits can be sorted – a teaching classification that you will need again and again in practice.
The overview as a mind map
Figure 1 shows as a mind map how the building blocks of this module fit together: the welfare state principle forms the constitutional basis, the solidarity principle the basic logic of contribution-based financing, the three structural principles classify the benefits, the subsidiarity of social assistance (Nachrang der Sozialhilfe) governs the relationship between self-help and state assistance, and the typology of welfare states places Germany in international comparison. Feel free to return to this figure if you lose track during the course.
PART 2 – Legal framework: the welfare state principle and its statutory anchors
Art. 20(1) GG – the welfare state principle
Article 20(1) of the Basic Law states: ‘The Federal Republic of Germany is a democratic and social federal state.’ The welfare state principle is derived from the word ‘social’ (Art. 20(1) GG). It is remarkable how brief this text is: it names neither benefits nor amounts nor responsibilities. It stipulates that the order of the state is to be social and leaves it to the legislature to translate this mandate into specific rules – for example, into the books of the Social Code.
This leads to an important distinction for practice: the welfare state principle is the constitutional guideline; the individual entitlements that your clients, patients or residents assert arise from the social legislation. So when you explain why someone does or does not receive a benefit, you refer to the relevant statutory provision – the welfare state principle stands behind it like a foundation, without itself determining the level of any benefit.
Art. 20(1) GG: welfare state principle (‘democratic and social federal state’).Section 4 SGB I: right of access to social insurance and to the necessary measures to protect health, as well as to financial security.Section 9 SGB I: right to social assistance where there is no possibility of self-help.Section 2(1) of Social Code Book XII (SGB XII): subsidiarity of social assistance. Legal position: October 2026. This module provides orientation knowledge. Professionals do not provide legal advice in individual cases; for legal questions, refer people to the responsible benefit providers, counselling services or legal services, and act as a team in line with the procedures of your organisation.
Outlook: the minimum subsistence level as a fundamental right
A landmark decision shows how seriously the welfare state principle is taken in law: in 2010 the Federal Constitutional Court (Bundesverfassungsgericht, BVerfG) derived from Art. 1(1) GG in conjunction with the welfare state principle of Art. 20(1) GG a fundamental right to the guarantee of a minimum subsistence level consistent with human dignity, which secures not only physical existence but also a minimum level of participation in social life (BVerfG, 2010).
You do not need to go into this in more depth at this point. The topic is deliberately framed as an outlook: Module 7 returns to the decision when it deals with Grundsicherungsgeld (basic income support benefit) and social assistance. For this module it is enough to recognise that, at the lower end of protection, the welfare state principle is linked to a fundamental right. Help in extreme need is therefore not charity but a legally anchored task of the state.
Sections 4 and 9 SGB I – two statutory anchors
The Social Code anchors the two most important logics of social protection in its General Part. Under section 4(1) SGB I, everyone has a right of access to social insurance within the framework of the Social Code. Under section 4(2) SGB I, insured persons in health, long-term care, accident and pension insurance have a right to the necessary measures to protect, maintain, improve and restore their health and capacity to work, and to financial security in the event of illness, maternity, reduced earning capacity and old age; surviving dependants also have a right to financial security. Here you can recognise theinsurance principle: anyone who is insured is entitled to protection when the insured risk occurs.
Section 9 SGB I, by contrast, describes welfare in the form of social assistance (Sozialhilfe). Anyone who cannot meet their living costs from their own resources or cannot help themselves in particular circumstances, and does not receive sufficient help from other sources, has a right to personal and financial assistance. This assistance is to meet the particular need, enable self-help, make participation in community life possible and secure a life consistent with human dignity; those entitled to benefits must cooperate to the best of their ability (section 9 SGB I). Note the two building blocks ‘no sufficient help from other sources’ and ‘cooperation to the best of one’s ability’: they lead on to subsidiarity, the next topic.
The subsidiarity of social assistance (section 2 SGB XII)
Under section 2(1) SGB XII, social assistance is subsidiary: it is not granted to anyone who can help themselves, above all by using their capacity to work, their income and their assets, or who receives the necessary support from others – for example from relatives or from providers of other social benefits. Subsidiarity explains why counselling sessions so often begin by asking which priority benefits exist: before welfare steps in, insurance benefits, a person’s own means and other forms of help have to be clarified. Subsidiarity does not imply that the help is of lesser value; it describes an order of precedence.
For managers this has a practical consequence: counselling and social services should design their processes so that priority entitlements are systematically clarified before welfare benefits are applied for – and so that people are not lost between the different bodies in the process. Module 3 and Module 8 deal with how this can be achieved.
PART 3 – The solidarity principle and the three structural principles
The solidarity principle: contributions according to income, benefits according to need
At the heart of social insurance is the solidarity principle: many people pay in, and anyone affected by a risk receives benefits – regardless of how much they themselves have contributed. You can see this most clearly in the GKV. Contributions depend on income: according to the Federal Ministry of Health (Bundesministerium für Gesundheit, BMG, 2026a), the general contribution rate in 2026 is 14.6 per cent; in addition there is a supplementary contribution (Zusatzbeitrag), which averages 2.9 per cent and may vary from one health insurance fund to another. For employees, employers and employees each pay half of the contribution.
Benefits, on the other hand, are based on need. Insured persons receive them as benefits in kind and services (benefits-in-kind principle, Sachleistungsprinzip, section 2(2) sentence 1 of Social Code Book V, SGB V), and the health insurance funds (Krankenkassen) provide them in accordance with the principle of economic efficiency (Wirtschaftlichkeitsgebot), insofar as they are not attributed to personal responsibility (section 2(1) sentence 1 SGB V). Whether someone sitting in the emergency department pays a higher or lower contribution therefore makes no difference to the fact that the necessary care is based on need – not on the level of contributions. Solidarity is particularly visible in family insurance (Familienversicherung): co-insured family members – children as well as spouses and registered civil partners – do not pay their own contributions (BMG, 2026a).
Figure 2 shows this balancing effect in figures: in March 2026, 74,495,244 people were insured in the GKV, of whom 58,714,600 were members and 15,780,644 were co-insured family members (BMG, 2026b). This is a finding about the structure of the insured population. The interpretation that it reflects a balancing of solidarity follows from the rules on family insurance, not from the statistics themselves; moreover, the figures say nothing about how the burden of contributions is distributed in detail.
Solidarity principle: contributions according to income, benefits according to need. The stronger contribute to protecting the weaker; anyone who falls ill receives the necessary care regardless of the level of their own contribution.
Quick thought: in social insurance, what are contributions based on – and what are benefits based on?
Three structural principles: insurance, social assistance, provision
To classify the large number of social benefits, a threefold division has proved useful in teaching. Theinsurance principle (Versicherungsprinzip) refers to contribution-financed social insurance; its statutory anchor is section 4 SGB I. Thesocial assistance principle (Fürsorgeprinzip) refers to means-tested, subsidiary, tax-financed assistance; its statutory anchors are section 9 SGB I and section 2 SGB XII. Theprovision or compensation principle (Versorgungs- oder Entschädigungsprinzip) stands for benefits for particular groups, for example after an event causing harm; this course deals with it only in general terms. Module 2 systematically classifies the five branches of social insurance – health, long-term care, pension, accident and unemployment insurance.
The threefold division is ateaching classification, not a legal term. The law contains no ‘social assistance principle’ provision, but individual benefit laws with their own requirements. The grid serves understanding and initial orientation; it does not replace looking at the specific legal basis and is not a binding classification. Mixed forms and transitions occur.
Figure 3 arranges the three principles in a four-field table according to two guiding questions: who finances the benefit – the community of insured persons through contributions or the general public through public funds? And is need clarified? Insurance is at the top left, social assistance at the bottom right, provision at the top right; the fourth field – contribution-financed and at the same time dependent on need – is not a typical case in this classification scheme.
Table 1 adds further features to the four-field table that are important for your counselling and management practice: the legal basis of entitlement, the example and the statutory anchor.
‘If you pay higher contributions, you also get better benefits in statutory health insurance.’
Correct: No. The solidarity principle applies in the GKV: the contribution is based on income, the benefit on need. Anyone who pays in little does not receive poorer care – and anyone who pays in a lot does not acquire an entitlement to additional benefits. Explaining this noticeably eases conversations with patients and their relatives.
Assigning with three guiding questions
In practice, three guiding questions are enough to provisionally classify a benefit or an enquiry; Figure 4 summarises them as a decision tree. The first question is whether the benefit is financed from contributions by insured persons. If not, ask secondly whether need is clarified, i.e. whether income and assets play a role. If that does not apply either, ask thirdly whether the benefit is linked to a special reason, such as harm suffered. If the assignment remains open, this is not a mistake but an indication that the legal basis and the responsible body need to be clarified more precisely. The tree deliberately simplifies and is not a legally binding classification.
PART 4 – Application: assigning, explaining, classifying
Worked example: one family, three principles
Before you practise on your own, here is a fully worked example. The Arnold family is fictitious; the sole purpose is to demonstrate the logic of assignment, not to evaluate or calculate individual entitlements. Figure 5 shows the five steps that we will now go through one after the other.
Initial situation. Moritz Arnold has been ill for several weeks and is receiving medical treatment. His partner Ella Arnold loses her job and registers as unemployed. Their daughter Mila is co-insured in the GKV through her parents. Ella’s mother Nele Voigt, Mila’s grandmother, receives an old-age pension that is barely enough to live on. One of Moritz’s brothers, Henry Arnold, receives benefits under social compensation (Soziale Entschädigung) because of the consequences of an event that caused him harm.
- Moritz Arnold’s illness. Who pays? The community of insured persons, through income-related contributions (BMG, 2026a). Is need clarified? No; treatment is provided as a benefit in kind and service according to need (section 2(2) sentence 1 SGB V). →Insurance principle.
- Ella Arnold’s unemployment. Unemployment insurance is regulated as employment promotion (Arbeitsförderung) in Social Code Book III (SGB III) and is financed from contributions. Need is not the starting point. →Insurance principle. Should the family nevertheless later be in need of assistance, Grundsicherungsgeld (basic income support benefit) under SGB II would come into play – that would then be social assistance and the topic of Module 7.
- Mila’s co-insurance. Co-insured children do not pay their own contributions (BMG, 2026a). The financing is borne by the community of insured persons; this is the solidarity principle in its purest form (see Figure 2). →Insurance principle.
- Nele Voigt’s old-age pension. Financial security in old age is one of the tasks of pension insurance (section 4(2) SGB I). →Insurance principle. If the pension is not sufficient, basic income support in old age (Grundsicherung im Alter) under section 41 SGB XII may be considered as a supplement if the necessary living costs cannot be adequately covered from income and assets. In that case need is clarified and subsidiarity is observed (section 2(1) SGB XII). →Social assistance principle. In Ms Voigt’s case, therefore, two principles apply one after the other.
- Henry Arnold’s compensation. The benefit is linked to an event causing harm, not to contributions or need. →Provision/compensation principle (only in general terms).
Result: One family, three principles – and in Nele Voigt’s case even two at once, in this order: insurance first, social assistance as a supplement. This is exactly the order that subsidiarity refers to. Also note what the example doesnot do: it does not answer whether the family is entitled to a specific benefit in an individual case. That is clarified by the benefit providers.
Two case examples from the field
Practical semester in hospital social services. Oskar Yılmaz, a social work student, is spending his practical semester accompanying the social counselling service of a hospital. Ms Sauer, who has been unable to work for months because of a serious illness, asks him anxiously: ‘I’ve only paid in a little – will I now get worse treatment than others?’ Oskar Yılmaz uses the logic of the GKV to explain that the contribution is based on income, whereas treatment is based on medical need. He adds that the health insurance fund provides benefits as benefits in kind and services and that, to provide security during longer periods of incapacity for work, there is also sickness benefit (Krankengeld), the amount of which is covered in Module 4. For open questions about the individual calculation of benefits, he refers her to the health insurance fund and then discusses the situation with his practice supervisor (Praxisanleitung).
In context: The student uses the solidarity principle (contributions according to income, benefits according to need; section 2(2) SGB V) to relieve the patient’s shame and worry. He does not give legal advice in an individual case but classifies, explains clearly and refers on. For managers, the case shows how valuable a shared explanatory model is within the team – especially for students on placement and new staff.
Sorting enquiries at the counselling centre. Ms Wolff leads the team at a counselling centre. On Monday there are three enquiries on the table: a mother asks whether her child can remain co-insured with her. An older man describes how his pension is not enough despite his thriftiness. A third person wants to know whether special benefits exist for the consequences of an event causing harm. She asks her team to sort the enquiries using the three guiding questions: the first follows the insurance logic, the second the social assistance logic with the question of priority benefits, the third the provision or compensation logic. Mr Pfeiffer from the team suggests documenting each enquiry with a short note on the presumed logic and the open question of responsibility.
In context: The assignment serves to pre-sort enquiries and pass them on to the right body, not to make a legal decision. It gives the team leader a shared language for handovers and case discussions and allows uncertainties to be named openly. Where the assignment remains open, responsibility is clarified (Module 3).
Exercise: assigning five situations
Assign each situation to the insurance, social assistance or provision principle and note in one sentence how you can tell. You check the solution yourself; there is nothing to submit and no grading.
- An employee has become unemployed and receives benefits from unemployment insurance.
- A pensioner cannot adequately cover his necessary living costs from income and assets and receives basic income support in old age.
- A child is co-insured with their father in the GKV and receives treatment.
- A resident in need of care receives long-term care assistance (Hilfe zur Pflege) because she cannot raise the necessary funds from her income and assets.
- A person receives benefits under social compensation after an event causing harm.
Tip 1: Who pays?
Tip 2: Is financial need checked?
Show suggested solutions
- Insurance – contribution-financed unemployment insurance (SGB III).
- Social assistance – basic income support in old age under section 41 SGB XII; need and subsidiarity play a role.
- Insurance – family insurance; the child does not pay their own contribution, the financing is borne by the community of insured persons (solidarity principle).
- Social assistance – long-term care assistance under section 61 SGB XII; income and assets are taken into account. Long-term care insurance takes precedence (insurance), social assistance supplements it.
- Provision/compensation – the benefit is linked to the event causing harm (only in general terms).
If your assignment differs: check which of the guiding questions you answered differently – that is usually the core of the misunderstanding.
PART 5 – Critical evaluation: Germany in comparison, limits and open questions
Types of welfare state: Germany in international comparison
A look beyond national borders helps you to understand the German solution as one of several possible ones. The typology put forward by Esping-Andersen in 1990 distinguishes three ‘worlds of welfare capitalism’, as Schmid (2020) sets out in his encyclopaedia article on the welfare state in Europe. Figure 6 summarises the three types with their example countries and characteristics.
- Examples: Sweden, Norway, Denmark
- universal provision based on social citizenship rights
- active labour market policy
- Examples: USA, Canada, Australia
- primacy of the market
- low, means-tested and stigmatising benefits
- Examples: Austria, France, Italy, Germany
- status-bound social rights geared to social insurance and wage labour
- relatively high inequality
Germany is assigned to the conservative continental European type and is regarded as an example of a social policy oriented towards classic social insurance schemes (Schmid, 2020). The typology is a classification grid: it helps with comparison but does not capture every particular feature of a country, and real systems contain elements of several types. Please also note that only the three types presented by Schmid (2020) are used here; other classifications are not the subject of this module.
Criticism, limits and open questions
The characteristics that Schmid (2020) names for the conservative continental European type are at the same time the starting points for criticism. This is an interpretation, and you should label it as such when you use it in your studies or in practice:
- Status-related rights: If social rights are linked to status and to an insurance relationship, protection depends on whether and how someone is positioned within the system. Anyone who is not, or only patchily, integrated into insured employment is more dependent on subsidiary social assistance.
- Focus on wage labour: A system that is strongly geared to social insurance and wage labour reflects life courses outside the classic employment biography less well – care work, for example.
- Inequality: The typology attributes relatively high inequality to this type (Schmid, 2020). Whether and to what extent it occurs in a specific field is an empirical question that this module does not answer.
The solidarity principle itself also has limits. The GKV levies contributions only up to the contribution ceiling (Beitragsbemessungsgrenze), which in 2026 is 5,812.50 euros per month, and the compulsory insurance threshold (Versicherungspflichtgrenze) of 77,400 euros per year limits the group of compulsorily insured persons (BMG, 2026a). What this means for the distribution of the burden is judged differently in political terms: one position emphasises that solidarity-based protection should rest on the broadest possible contribution base. Another position highlights personal responsibility, which the law also mentions when benefits are only provided insofar as they are not attributed to personal responsibility (section 2(1) sentence 1 SGB V). Both views can be justified; as a professional you need to know them and be able to present them objectively without taking sides yourself.
Finally, there remains a question of access: rights are only of use if people know about them and can enforce them. A structured system with many responsibilities can itself become a barrier. Module 3 and Module 8 take this up and ask what professionals and managers can do about it.
If you use the typology in a term paper, pay attention to three points: (1) name criteria and types exactly as the source presents them instead of adding your own attributions. (2) Separate findings (characteristics of the type) from interpretation (criticism). (3) Point out the limits of a classification grid. In this way you show that you use models as thinking tools and not as a complete description of reality.
Several reforms affect the areas covered by this course; Module 8 brings them together in a timeline. Here is a brief preview: since 1 July 2026 the New Basic Income Support (Neue Grundsicherung) has been taking effect in stages (BGBl. 2026 I Nr. 107); the former citizen’s income (Bürgergeld) is now called Grundsicherungsgeld (basic income support benefit) (Bundesregierung, 2026a). The standard needs rates (Regelbedarfe) for 2026 are unchanged (Bundesregierung, 2026c). Since 1 January 2026 the Act to Extend Powers and Reduce Bureaucracy in Nursing Care (Gesetz zur Befugniserweiterung und Entbürokratisierung in der Pflege) has applied (Bundesregierung, 2026b). The 2024 hospital reform has been amended by the Hospital Reform Adjustment Act (Krankenhausreformanpassungsgesetz, BGBl. 2026 I Nr. 98) (BMG, 2026d).Draft: the Long-Term Care Reorganisation Act (Pflegeneuordnungsgesetz) is so far only a cabinet draft of 30 September 2026 and not law in force (BMG, 2026c). The principles of this module remain unaffected: the new rules, too, can be classified using the guiding questions from Figure 4.
Implications for management and practice
What does all this mean for your day-to-day work? First: a shared language within the team saves time and avoids misunderstandings. If everyone knows what is meant by insurance or social assistance logic, handovers and case discussions become more precise. Second: attitude matters. Social benefits are rights granted by the welfare state on the basis of laws, not acts of grace; this applies also, and especially, in the area of social assistance. Respectful language towards benefit recipients is therefore a professional requirement, not merely a matter of courtesy. Third: be honest about the limits of your role. You classify and refer on, but you do not decide on entitlements. And fourth: keep in mind the order that subsidiarity prescribes – priority entitlements first, social assistance as a supplement.
In the next modules you will build on this foundation: Module 2 covers the five branches of social insurance with their risks and contributions, Module 3 the responsibilities within the structured system. The guiding questions from this module will continue to accompany you.
What does Art. 20(1) GG say about the welfare state?
What does the solidarity principle mean in the GKV?
What does the subsidiarity of social assistance mean?
Which three structural principles classify the benefits?
How does Esping-Andersen classify Germany?
True or false: higher contributions mean better benefits?
- The welfare state principle (Art. 20(1) GG) is the constitutional basis; specific entitlements arise from the social legislation.
- In the GKV, the solidarity principle means: contributions according to income, benefits according to need – higher contributions do not mean better benefits.
- Insurance, social assistance and provision form a teaching classification with statutory anchors (section 4 SGB I, section 9 SGB I, section 2 SGB XII), not a legal term.
- The subsidiarity of social assistance establishes an order: self-help and priority benefits first, social assistance as a supplement.
- Germany is regarded as a conservative continental European welfare state; its characteristics show strengths and at the same time starting points for criticism.
Practice checklist for your own self-check – no legal advice in individual cases:
- I can use the three guiding questions to assign a provisional structural principle to an enquiry within a few minutes.
- I can explain to people seeking advice why the level of contributions in the GKV says nothing about their care.
- For social assistance benefits, I first ask about priority entitlements (subsidiarity) and record this in the documentation.
- I name open questions of assignment and responsibility within the team instead of passing over them.
- For questions about individual cases, I refer people to the responsible benefit providers or counselling services and act in line with the procedures of my organisation.
Voluntary self-reflection – not graded, just for your own understanding:
- Which benefits in your field of work tend to follow the insurance logic, and which the social assistance logic – and where are you unsure?
- How have you explained so far why someone does or does not receive a benefit? What would you put differently after this module?
- Where do you see status-related rights making it harder for people to access protection, and what role does your organisation play in this?
Bundesministerium für Gesundheit. (2026a, 3 September).Beiträge der gesetzlichen Krankenversicherung (GKV) [Contributions to statutory health insurance (GKV)]. https://www.bundesgesundheitsministerium.de/beitraege
Bundesministerium für Gesundheit. (2026b).Gesetzliche Krankenversicherung – Mitglieder, mitversicherte Angehörige und Krankenstand. Monatswerte Januar–Juni 2026 [Statutory health insurance – members, co-insured dependants and sickness rate. Monthly figures January–June 2026] (Results of the GKV statistics KM1, as of 2 July 2026).https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/Statistiken/GKV/Mitglieder_Versicherte/KM1_Januar_bis_Juni_2026.pdf
Bundesministerium für Gesundheit. (2026c, 30 September).Kabinett beschließt Pflegeneuordnungsgesetz [Cabinet adopts Long-Term Care Reorganisation Act] [Press release].https://www.bundesgesundheitsministerium.de/presse/pressemitteilungen/kabinett-beschliesst-pflegeneuordnungsgesetz
Bundesministerium für Gesundheit. (2026d, 22 April).Krankenhausreform [Hospital reform]. https://www.bundesgesundheitsministerium.de/themen/krankenhaus/krankenhausreform
Bundesregierung. (2026a, 1 July).Neue Grundsicherung löst Bürgergeld ab [New basic income support replaces citizen’s income]. https://www.bundesregierung.de/breg-de/aktuelles/neue-grundsicherung-2399562
Bundesregierung. (2026b, 1 January).Qualifikationen von Pflegekräften besser nutzen [Making better use of nursing staff’s skills] [on the Gesetz zur Befugniserweiterung und Entbürokratisierung in der Pflege (Act to Extend Powers and Reduce Bureaucracy in Nursing Care) of 22 December 2025, BGBl. 2025 I Nr. 371].https://www.bundesregierung.de/breg-de/aktuelles/befugnisse-pflegekraefte-2376966
Bundesregierung. (2026c, 1 January).Regelsätze der Sozialleistungen bleiben unverändert [Standard rates of social benefits remain unchanged]. https://www.bundesregierung.de/breg-de/aktuelles/nullrunde-buergergeld-2383676
Bundesverfassungsgericht. (2010, 9 February).Urteil des Ersten Senats vom 9. Februar 2010 – 1 BvL 1/09, 1 BvL 3/09, 1 BvL 4/09 [Judgment of the First Senate of 9 February 2010] [Headnotes].https://www.bundesverfassungsgericht.de/SharedDocs/Entscheidungen/DE/2010/02/ls20100209_1bvl000109.html
Grundgesetz für die Bundesrepublik Deutschland (GG) [Basic Law for the Federal Republic of Germany] of 23 May 1949 (BGBl. S. 1), in the version in force on 8 October 2026, Art. 1(1) and Art. 20(1). Available athttps://www.gesetze-im-internet.de/gg/art_20.html
Schmid, J. (2020). Wohlfahrtsstaat in Europa [The welfare state in Europe]. In Große Hüttmann & Wehling (Eds.),Das Europalexikon [The Europe encyclopaedia] (3rd ed.). Verlag J. H. W. Dietz Nachf.; Bundeszentrale für politische Bildung.https://www.bpb.de/kurz-knapp/lexika/das-europalexikon/177357/wohlfahrtsstaat-in-europa/
Sozialgesetzbuch (SGB) Drittes Buch (III) – Arbeitsförderung – [Social Code Book III – Employment Promotion], § 341; Viertes Buch (IV) – Gemeinsame Vorschriften für die Sozialversicherung – [Book IV – Common Provisions for Social Insurance], § 1; Siebtes Buch (VII) – Gesetzliche Unfallversicherung – [Book VII – Statutory Accident Insurance], §§ 1 and 150; each in the version in force on 8 October 2026. Available athttps://www.gesetze-im-internet.de/sgb_4/__1.html
Sozialgesetzbuch (SGB) Erstes Buch (I) – Allgemeiner Teil – [Social Code Book I – General Part] of 11 December 1975 (BGBl. I S. 3015), in the version in force on 8 October 2026, §§ 4, 9, 12, 13, 14, 15 and 16. Available athttps://www.gesetze-im-internet.de/sgb_1/__14.html
Sozialgesetzbuch (SGB) Fünftes Buch (V) – Gesetzliche Krankenversicherung – [Social Code Book V – Statutory Health Insurance] of 20 December 1988 (BGBl. I S. 2477), in the version in force on 8 October 2026, §§ 2 and 47. Available athttps://www.gesetze-im-internet.de/sgb_5/__2.html
Sozialgesetzbuch (SGB) Zweites Buch (II) – Grundsicherung für Arbeitsuchende – [Social Code Book II – Basic Income Support for Jobseekers] in the version promulgated on 13 May 2011 (BGBl. I S. 850, 2094), amended by the Dreizehntes Gesetz zur Änderung des Zweiten Buches Sozialgesetzbuch und anderer Gesetze [Thirteenth Act amending Book II of the Social Code and other Acts] of 16 April 2026 (BGBl. 2026 I Nr. 107), in the version in force on 8 October 2026, §§ 7 and 19. Available athttps://www.gesetze-im-internet.de/sgb_2/__19.html
Sozialgesetzbuch (SGB) Zwölftes Buch (XII) – Sozialhilfe – [Social Code Book XII – Social Assistance] of 27 December 2003 (BGBl. I S. 3022), in the version in force on 8 October 2026, §§ 2, 41 and 61. Available athttps://www.gesetze-im-internet.de/sgb_12/__41.html
Figures and tables: own illustration. Citation style: APA 7 (German-language adaptation).
Self-reflection – 5 questions
Voluntary · not graded – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.
Question 1.What does Art. 20(1) GG lay down about the welfare state?
Question 2.What does the solidarity principle mean in statutory health insurance?
Question 3.What does the subsidiarity of social assistance under section 2(1) SGB XII mean?
Question 4.How is Germany classified in Esping-Andersen’s typology of welfare states, as presented by Schmid (2020)?
Question 5.Which statement about contribution-free family insurance in the GKV is correct?