IDEAS home Printed from https://ideas.repec.org/a/lus/zwipol/v67y2018i1p30-41n5.html
   My bibliography  Save this article

Was spricht gegen Zwei-Klassen-Medizin?

Author

Listed:
  • Breyer Friedrich

    (Universität Konstanz, FB Wirtschaftswissenschaften, Postfach 135, 78457 KonstanzGermany, Tel.: (07531) 88–2568)

Abstract

In Germany, there is a lively debate on a so-called „two-class-medicine“, meaning that privately insured persons get better medical treatment than sickness fund members. As an economist, the author is not in a position to judge whether this is true. However, the co-existence of social and private health insurance (GKV and PKV) constitutes a „two-class-health insurance“, which leads to severe inequities in the distribution of the financial burden of illness. In this article it is shown that there are legal ways to address and eliminate these inequities without abolishing the private health insurance system altogether. The instruments are the inclusion of private health insurance in the risk adjustment scheme of the sickness funds and the transformation of the GKV contributions into flat per-person amounts, independent of earnings, accompanied by a tax-financed compensation for families with below-average income, as in Switzerland and the Netherlands. Interestingly, this second reform proposal has been vigorously opposed by all leftist parties ever since, who fight for the chimaera of a „people's insurance“, which sounds good but cannot be implemented in a legal way and, moreover, would not even eliminate „two-class-medicine“.

Suggested Citation

  • Breyer Friedrich, 2018. "Was spricht gegen Zwei-Klassen-Medizin?," Zeitschrift für Wirtschaftspolitik, De Gruyter, vol. 67(1), pages 30-41, May.
  • Handle: RePEc:lus:zwipol:v:67:y:2018:i:1:p:30-41:n:5
    DOI: 10.1515/zfwp-2018-0005
    as

    Download full text from publisher

    File URL: https://doi.org/10.1515/zfwp-2018-0005
    Download Restriction: For access to full text, subscription to the journal or payment for the individual article is required.

    File URL: https://libkey.io/10.1515/zfwp-2018-0005?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Hendrik Schmitz & Nicolas R. Ziebarth, 2017. "Does Price Framing Affect the Consumer Price Sensitivity of Health Plan Choice?," Journal of Human Resources, University of Wisconsin Press, vol. 52(1), pages 88-127.
    2. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536, Elsevier.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bofinger, Peter & Feld, Lars P. & Schmidt, Christoph M. & Schnabel, Isabel & Wieland, Volker, 2018. "Vor wichtigen wirtschaftspolitischen Weichenstellungen. Jahresgutachten 2018/19 [Setting the Right Course for Economic Policy. Annual Report 2018/19]," Annual Economic Reports / Jahresgutachten, German Council of Economic Experts / Sachverständigenrat zur Begutachtung der gesamtwirtschaftlichen Entwicklung, volume 127, number 201819.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Werbeck, Anna & Wübker, Ansgar & Ziebarth, Nicolas R., 2021. "Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 1325-1350.
    2. Pierre-Thomas Léger & Erin C. Strumpf, 2010. "Système de paiement des médecins : bref de politique," CIRANO Project Reports 2010rp-12, CIRANO.
    3. Currie, Janet & Lin, Wanchuan & Zhang, Wei, 2011. "Patient knowledge and antibiotic abuse: Evidence from an audit study in China," Journal of Health Economics, Elsevier, vol. 30(5), pages 933-949.
    4. van de Vijsel, Aart R. & Engelfriet, Peter M. & Westert, Gert P., 2011. "Rendering hospital budgets volume based and open ended to reduce waiting lists: Does it work?," Health Policy, Elsevier, vol. 100(1), pages 60-70, April.
    5. Jeanne Lievaut & Philippe Batifoulier, 2011. "La transformation des actes gratuits en actes payants en médecine libérale. Une étude micro-économétrique longitudinale," EconomiX Working Papers 2011-12, University of Paris Nanterre, EconomiX.
    6. repec:dau:papers:123456789/1637 is not listed on IDEAS
    7. James M. Malcomson, 2005. "Supplier Discretion Over Provision: Theory and an Application to Medical Care," RAND Journal of Economics, The RAND Corporation, vol. 36(2), pages 412-429, Summer.
    8. Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 245-265, December.
    9. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2008. "Policy Analysis in Health-Services Market: Accounting for Quality and Quantity," Annals of Economics and Statistics, GENES, issue 91-92, pages 293-319.
    10. Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2014. "Payment mechanism and GP self-selection: capitation versus fee for service," International Journal of Health Economics and Management, Springer, vol. 14(2), pages 143-160, June.
    11. Bührer, Christian & Fetzer, Stefan & Hagist, Christian, 2020. "Adverse selection in the German Health Insurance System – the case of civil servants," Health Policy, Elsevier, vol. 124(8), pages 888-894.
    12. Iversen, Tor, 2004. "The effects of a patient shortage on general practitioners' future income and list of patients," Journal of Health Economics, Elsevier, vol. 23(4), pages 673-694, July.
    13. Karen Eggleston & Winnie Yip, 2004. "Hospital Competition under Regulated Prices: Application to Urban Health Sector Reforms in China," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 343-368, December.
    14. Kifmann, Mathias, 2017. "Competition policy for health care provision in Germany," Health Policy, Elsevier, vol. 121(2), pages 119-125.
    15. Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2010. "Physicians self selection of a payment mechanism: Capitation versus fee-for-service," Post-Print halshs-00523370, HAL.
    16. Nolan Miller & Karen Eggleston & Richard Zeckhauser, 2006. "Provider choice of quality and surplus," International Journal of Health Economics and Management, Springer, vol. 6(2), pages 103-117, June.
    17. Lu, Fangwen, 2014. "Insurance coverage and agency problems in doctor prescriptions: Evidence from a field experiment in China," Journal of Development Economics, Elsevier, vol. 106(C), pages 156-167.
    18. Rudy Douven & Ron van der Heijden & Thomas McGuire & Erik Schut, 2017. "Premium levels and demand response in health insurance: relative thinking and zero-price effects," CPB Discussion Paper 366, CPB Netherlands Bureau for Economic Policy Analysis.
    19. Douven, Rudy & van der Heijden, Ron & McGuire, Thomas & Schut, Frederik, 2020. "Premium levels and demand response in health insurance: relative thinking and zero-price effects," Journal of Economic Behavior & Organization, Elsevier, vol. 180(C), pages 903-923.
    20. Francisco J. Gomes & Laurence J. Kotlikoff & Luis M. Viceira, 2012. "The Excess Burden of Government Indecision," NBER Chapters, in: Tax Policy and the Economy, Volume 26, pages 125-163, National Bureau of Economic Research, Inc.
    21. Gabrielle Demange & Pierre-Yves Geoffard, 2006. "Reforming incentive schemes under political constraints: the physician agency," Annals of Economics and Statistics, GENES, issue 83-84, pages 221-250.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:lus:zwipol:v:67:y:2018:i:1:p:30-41:n:5. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Peter Golla (email available below). General contact details of provider: https://www.degruyter.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.