As a result of rationalization of labour, innovations in economy and the state administration, within the framework of scientific and technical development the FRG has greatly increased its investments and great social changes were implemented. The system of health services in the FRG is considered very efficient. The services are built on the principle on the patient's completely free selection of doctors. Specialists, research and technical facilities have a high standard. In 1988 a fundamental structural reform of the health services was implemented, due to the fact that the cost of health insurance has increased since 1960 three times faster than wages, whereby 13% of the insurance money has to be met by various additional payments. A further increase is not possible and therefore the entire reform of the structure of the health services was conditioned and governed by economic reasons.