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Kapitaldeckung in der Gesetzlichen Krankenversicherung: Wer bezahlt den Uebergang?

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  • Stefan Felder

    ()
    (Inst. f. Sozialmedizin u. Gesundheitsoekonomie, Magdeburg)

  • Stefan Fetzer

    ()
    (Wiss. Beirat der Betrieblichen Krankenversicherung, Essen)

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    Abstract

    The double ageing of the population leads to income redistribution from future to present generations as net payments to social health insurance are negative at young age and positive at old age. Economists arguing in favour of flat health insurance premiums combined with ageing provisions often neglect the transition from the pay-as-you-go to funded system. Using a generational accounting approach we analyze a reform to funded premiums, taking into account the transition. Furthermore, we implement a tax-transfer scheme designed to protect low income persons facing higher payments in the premium scheme. Our calculations reveal that under the current pay-as-you-go system German social health insurance burdens future generations by almost 30 percent of GDP. Funding could reduce this burden to 5 percent of GDP but would involve higher payments up to 700 Euro p.a. for the present generations. A delay of the reform would increase the burden for future generations again and benefit baby boomers born before 1970. We conclude from a public-choice perspective that it will be difficult to implement even a delayed reform to a more funded health insurance system.

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    Bibliographic Info

    Article provided by Justus-Liebig University Giessen, Department of Statistics and Economics in its journal Journal of Economics and Statistics.

    Volume (Year): 227 (2007)
    Issue (Month): 5+6 (December)
    Pages: 603-620

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    Handle: RePEc:jns:jbstat:v:227:y:2007:i:5-6:p:603-620

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    Related research

    Keywords: Funding social health insurance; intergenerational distribution; generational accounting;

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    References

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    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
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    1. Friedrich Breyer & Volker Ulrich, 2000. "Gesundheitsausgaben, Alter und medizinischer Fortschritt: Eine Regressionsanalyse," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), Justus-Liebig University Giessen, Department of Statistics and Economics, vol. 220(1), pages 1-17.
    2. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1994. "Generational Accounting: A Meaningful Way to Evaluate Fiscal Policy," Journal of Economic Perspectives, American Economic Association, vol. 8(1), pages 73-94, Winter.
    3. Cassel, Dieter & Oberdieck, Veit, 2002. "Kapitaldeckung in der gesetzlichen Krankenversicherung," Wirtschaftsdienst – Zeitschrift für Wirtschaftspolitik (1998 - 2007), ZBW – German National Library of Economics / Leibniz Information Centre for Economics, vol. 82(1), pages 15-22.
    4. Friedrich Breyer & Stefan Felder, 2004. "Life Expectancy and Health Care Expenditures: A New Calculation for Germany Using the Costs of Dying," Discussion Papers of DIW Berlin 452, DIW Berlin, German Institute for Economic Research.
    5. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1991. "Generational Accounts: A Meaningful Alternative to Deficit Accounting," NBER Chapters, in: Tax Policy and the Economy, Volume 5, pages 55-110 National Bureau of Economic Research, Inc.
    6. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
    7. Friedrich Breyer, 2000. "Kapitaldeckungs- versus Umlageverfahren," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 1(4), pages 383-405, November.
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    Cited by:
    1. Klaus Dirk Henke, 2007. "Zur Dualitaet von GKV und PKV, The Future of Private and Public Health Insurance in Germany," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), Justus-Liebig University Giessen, Department of Statistics and Economics, vol. 227(5+6), pages 502-528, December.

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