OBJECTIVES: The focus of present health political discussion in Germany is concentrated on financing as an instrument to meet the future needs of German population. Government wants to cut back benefits by offering alternative funding mechanism, which is tax financing and additional patient payments. The recent and significant changes to Health care funding in Germany is reviewed. METHODS: A literature review was conducted to analyze a number of strengths to the financing and funding arrangements in the German Health care system. The potential advantages for priorities, efficiency, and equity from this structure of financing are considered. The results will be compared to the design of the currently started plans for a further Health care reform in Germany with focus on financing. RESULTS: The current most important scheme of social health insurance (SHI) finance intended to mobilize resources for Health care, to insure against risk, and to provide stable finance seems for the government not to be any longer the funding mechanism that helps to control costs and to secure access to broad priority services. Government intends to use finance mechanism to shift low priority services into SHI and put high priority services into finance mechanism of user charges. The level of priority services is - so far - not a result of discussions in the community. Financial fairness is best served by the cornerstone of more progressive prepayments as it is the case for SHI premiums instead of patient payments. Co-payments have the effect of rationing use Health care services but does not effect in rationalizing its demand by insured. CONCLUSIONS: Currently risks are distributed according to ability to pay rather than to risk of disease. Financing fairness is best served by the cornerstone of progressive prepayments as it is the case for SHI premiums instead of patient payments.