An assessment of the existing elements of a health monitoring system in Germany is given. Based on the analysis of deficits, the necessity for a comprehensive health monitoring system is recognised. The authors suggest starting points for the development of such a system in Germany by integrating different actors and taking into account different interests. The proposed system is based on a modular principle and allows for continuity as well as flexibility. As one key element in this monitoring system, a longitudinal health study is suggested, which allows the observation of developments in health matters as well as the evaluation of health policy actions. A plan for the step-wise development and testing of the health monitoring system is presented. Cooperation and data networking are essential elements. Whereas the flexible parts of the monitoring system should be financed by interested partners and customers, a basic sustainable financial support is a prerequisite. This paper provides arguments for the implementation of a health monitoring system and the need for long-term funding.