Abstract: Under the pressure of aging and declining population, the current social health insurance financing system in German needs reform. Introducing a single social health insurance, calculating premiums by heads, paig insurance fee according to the degree of risk are three major reform paths for German. The core of the reform is whether children and spouse who does not work still do not pay premiums and enjoy the insurance under the framework of the co-insurance system.The purpose of the reform is to change the dual track system of statutory medical insurance and private medical insurance to the monorail system of insurance of social medical treatment,and in combination with other supporting measures to convert the traditional social welfare state to modern social insurance state.