The German health care system is on a collision course with budget realities. Costs are high and rising, and quality problems are becoming increasingly apparent. Decades of reforms have produced little change to these troubling trends. Why has Germany failed to solve these cost and quality problems? The reason is that Germany has not set value for patients as the overarching goal, defined as the patient health outcomes achieved per euro expended. This book lays out an action agenda to move Germany to a high-value system: care must be reorganized around patients and their medical conditions, providers must compete around the outcomes they achieve, health plans must take an active role in improving subscriber health, and payment must shift to models that reward excellent providers. Additionally, private insurance must be integrated into the risk-pooling system. These steps are practical and achievable.