Of all the former Soviet-bloc countries, only East Germany gave the appearance of avoiding the downturn in male life expectancy. Yet this was not actually the case, as reliable statistics show that the East German state did not entirely escape regional trends, and increases in longevity were significantly slowing over time. Furthermore, the population experienced declining male mortality after the collapse of the communist regime. Had the health and life expectancy of East Germans been better than that of West Germans, the superiority of Soviet-style health care delivery could have been demonstrated. The division of Germany into separate capitalist and socialist states offered the opportunity to evaluate “a natural experiment in history” (Light and Schuller 1986; Volpp 1991). However, by uni-fication, East Germany’s health care system was judged a major failure and none of its features were retained (Apelt 1991; Knox 1993; Niehoff, Schneider, and Wetzstein 1992; Volpp 1991). Like Soviet-style health care systems elsewhere in Eastern Europe, the East German approach was becoming increasingly ineffective in coping with heart disease (Knox 1993).
Germany lay in ruins after its defeat in 1945. Neither the victorious Soviet Union nor the Western allies were certain about the future of the country. Stalin expected a communist state to emerge and the Western