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.