A tale of two countries: how decentralized organization and long-term investment build resilient healthcare systems

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Healthcare systems are faced with unique challenges during the ongoing Covid-19 pandemic. This viewpoint compares the response to the Covid-19 pandemic in the UK and in Germany. Despite being two large European countries of comparable size with good healthcare systems and similar patterns of exposure to Covid-19, Covid-19 related deaths in the UK currently far outnumber those in Germany. This has several reasons, but two explanations stick out: 1. lower long-term investment into healthcare in the UK rendered the NHS more vulnerable to Covid-19; 2. the existence of a well-governed decentralised and partially redundant organisation of healthcare increased resilience in Germany’ s healthcare systems, enhancing the ability to adapt in response to unexpected challenges to healthcare. The response to the current pandemic also illustrates the power and the necessity to learn from each other through transparent communication of successes and mistakes.

Bibliographic note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.


Original languageEnglish
Pages (from-to)201-203
Number of pages3
JournalEuropean Heart Journal
Issue number3
Early online date6 May 2020
Publication statusPublished - Jul 2020


  • Germany, investments, organizations, pandemics, health care systems, stick dosage form, adaptability, national health service (UK), covid-19, coronovirus pandemic, Covid-19, Mortality, Healthcare delivery, Health economics, Cardiovascular medicine