"The quality of health care in Germany is not as good as people sometimes believe it to be. We have problems with chronic diseases. The German system allows too many hospitals and specialists to treat chronic diseases. We do not have enough volume in many institutions to deliver good quality, and we do have fairly strict separations ... between primary physicians, office specialists and hospital specialists. But I think the quality problems can be solved in the next couple of years, and we have made major progress in diabetes, coronary artery disease and pulmonary disease care."