For many observers, our healthcare system is characterized by standstill. Good ideas would not be implemented, citizens and patients would be denied progress, and two-tier medicine would possibly be promoted. This is often attributed to over-regulation, bureaucratic obstacles and mutual blockade by interest groups. On the other hand, there are also those who point out that the range of services on offer is constantly growing, that this growth is not adequately controlled, and that this is essentially a result of uptake induced by the providers. Representatives of this position therefore prefer to discuss the aspect of limiting growth instead of the question of a backlog of innovation according to the motto: “How much more growth should we afford?” These “minus” and “plus” perspectives on the development of the Health care systems usually come face to face suddenly. However, it is noticeable that the position taken is often influenced by the role of the viewer in this system. Representatives of the minus or standstill thesis are primarily assigned to service providers or the healthcare industry, while representatives of the plus or growth thesis are usually assigned to payers and public health-oriented science. What is interesting is that both camps agree that the healthcare system functions irrationally and inefficiently, that it is risky and even sometimes hostile to patients.

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