Germany introduced the world’s first national sickness-insurance law in 1883.
The law was enacted under Chancellor Otto von Bismarck, whose government created compulsory health insurance for many industrial workers. It was part of a broader programme of social insurance that also included accident insurance in 1884 and old-age and disability insurance in 1889.
The 1883 scheme was funded through contributions from workers and employers, with administration handled through sickness funds. Coverage was not universal at first: it primarily applied to specified categories of wage earners and certain lower-paid workers.
Bismarck’s system became a major model for later social insurance programmes. It is often called the Bismarckian model, distinguishing it from tax-funded systems such as the later British National Health Service. The law was designed partly to improve workers’ security and partly to reduce support for socialist movements.