Pre-print, Working paper: The paper reports on the evolution of the hospital industry in Germany according to three targets of analysis: first, I examine the reasons of the reforms; for that, I position the hospital in the offer of care and in the structuring the regional industrial spaces of Germany, called "professional" or "based on the knowledge" economy. Then I find out the applicability of the health economy improvements into the medical policy: I evoke the succession of the reforms in Germany and in particular on the territory of ex-GDR i.e. the reforms of convergence, those which remedy current demographic deteriorations, and those which are impelled by the evolution of economic situation.