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In Switzerland different gatekeeper-systems to improve the capacity and economic efficiency were successfully tried and tested. The systems show clear advantages of the gatekeeper-system concerning the costs and quality of health care over the customary Swiss health insurances. The German as well as the Swiss health care system are facing similar problems. The introduction of the Swiss gatekeeper-system in Germany would offer a promising opportunity to achieve economic efficiency and quality in German Statutory Health Insurance. Thus, greater flexibility is imperative in the subjects of legal conditions, especially the contract, incentive and information systems.

The German as well as the Swiss health care system are facing similar problems. However, in Switzerland different gatekeeper systems to improve the capacity and economic efficiency were successfully tried and tested. The main structures of gatekeeping are the HMO health centres and different GP systems. Central to this idea is the primary care physician functioning as a gatekeeper. He has to control the demands of medical services according to the patient's needs to fulfil integral, comprehensive and economic criteria. Although data processing has not yet been completed yet, first results show clear advantages of the gatekeeper system in respect of the costs and quality of health care compared with the customary Swiss health insurance. Although in Switzerland there are still relatively few persons insured according to the gatekeeper system, it is expected that particularly the family physician systems will expand considerably in the future. Reorganisation and rearrangements of the medical care providers are likely.