Abstract
Germany was the first country to institute nationwide insurance-based social and health programs. Three powerful ideas or principles underlie the development of German health insurance and medical care policy, Solidarity, Subsidiarity, and Corporatist organization. The main roles of government (State and Federal governments) are providing legal framework and regulation while providing of services and insurance are delegated to self-governance agencies, sickness funds, various associations (Association of Sickness Funds, Association of Panel doctor, etc), and health care carriers.The German reform aimed to achieve overall social benefits. Enactment of laws achieved universal access to health care and delegation of public roles to various self-governance bodies enable accountability and transparency of the system. The later reforms intended to control increase of medical care cost to be not exceeding level of income growth and more emphasized on controlling provider and hospital behavior. By conclusion, success of the German health system reform is according to values and principles of the society while economic, political context and increase of health care expenditure determine the need for reform.