"How many hospitals does Germany need?" was the title of the VDEK Forum at this year's 17th European Health Congress on 25.10.2018 at the Hilton in Munich. Approximately 325 acute hospitals for Germany instead of the current 1400 are according to Prof. Dr. med. Reinhard Busse only necessary. Technically better equipped will they supply better. Due to the fact, that small hospitals with lower annual case numbers have a higher mortality rate than institutions with high case numbers. In addition, 50% of the hospitals are in deficit. With a a total volume of SHI shares account for 75 billion EUR. Heavy arguments, which were controversially discussed in the panel discussion. Participants agreed, that the overall situation can not go on like this, however, historically grown structures, patient expectations (partly very emotional), jobs and economic effects on the region and the classification as a required hospital by law have been listed as counterarguments by regional leaders and hospital organizations. At this point, it is necessary to have clear supply concepts and intelligent successor uses of the existing infrastructure so that the necessary structural change takes place. MArS Health Policy supports you with analysis and developing of transforming plan.