Two factors still hamper efforts to constrain costs. First, hospitals have opposed policies designed to shift care when warranted to less expensive outpatient settings because the hospitals fear their incomes will fall. Second, the vast number of insur- ance providers in the German system has kept administrative costs high.
Health Outcomes Whether because of its health care system or because of its high standard of living and commitment to providing social services to its population, Germany enjoys a high standard of health. Although conditions in the former East Germany remain poorer than in West Germany, those differences are rap- idly disappearing. Life expectancy in Germany now averages 80, two years more than in the United States (and with far less variation among its citizenry). Infant mortality in Germany is among the lowest in the world: 3.3 per 1000 live births compared with 5.8 in the United States.