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Eine ökonomische Analyse unterschiedlicher Finanzierungsmodelle der Krankenversorgung in Deutschland

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  • Henke, Klaus-Dirk
  • Borchardt, Katja
  • Schreyögg, Jonas
  • Farhauer, Oliver

Abstract

Die Debatte über eine Finanzierungsreform des deutschen Krankenversicherungssystems hat in der letzten Zeit viele Konzepte hervorgebracht. Die Vorschläge reichen von der Stabilisierung des Status quo in Form von Kopfpauschalen über die Einführung verschiedener Formen eines Teilkapitaldeckungsverfahrens bis hin zu einer kompletten Systemumstellung auf eine voll kapitalgedeckte Finanzierung. Zusätzlich wurde das Modell der Medical Savings Accounts in Singapur und Südafrika als internationales Konzept thematisiert. Der vorliegende Beitrag soll einerseits einen Überblick über die derzeit diskutierten Modelle geben. Andererseits wird der Versuch unternommen, die Konzepte anhand der Kategorien Beitragsbemessungsprinzip und Finanzierungsverfahren zu systematisieren und einer kurzen Beurteilung zu unterziehen. Dabei lag der Fokus der Arbeit auf den Vorschlägen zur Reform der Finanzierungsseite. Inwiefern sich eines der Modelle durchsetzen kann, wird nicht zuletzt von den politischen Konstellationen der nächsten Jahre abhängen. In dem korporatistischen deutschen Gesundheitswesen dürfte die Durchsetzung revolutionärer Ideen relativ unwahrscheinlich sein. Nach Einschätzung der Autoren ist eher eine evolutorische Weiterentwicklung des bestehenden Systems zu erwarten. -- The debate about reforming the German health Insurance offers a wide range of proposals reaching from the stabilisation of the existing system by introducing capitation to more extreme options pleading for a partial or complete funded system. Moreover, one international option as the model of Medical Saving Accounts was discussed. This paper aims to give an overview and tries to categorise and judge the proposed models. The focus of this contribution was laid on the financing part of the health insurance system. It is rather unlikely, that revolutionary approaches of reforming health insurance are supported by the corporatist German system of health care. Therefore from the authors’ point of view a more evolutionary advancement of the existing system seems most likely.

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Bibliographic Info

Paper provided by Technische Universität Berlin, School of Economics and Management in its series Discussion Papers with number 2003/4.

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Date of creation: 2003
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Handle: RePEc:zbw:tubsem:20034

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Web page: http://www.wm.tu-berlin.de/menue/fakultaet_vii/
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  1. Homburg, Stefan, 1988. "Theorie der Alterssicherung," EconStor Books, ZBW - German National Library of Economics, number 92902, February.
  2. 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.
  3. Friedrich Breyer, 2003. "Einkommensbezogene versus pauschale GKV-Beiträge: eine Begriffsklärung," Discussion Papers of DIW Berlin 330, DIW Berlin, German Institute for Economic Research.
  4. Martin Feldstein & Andrew Samwick, 1998. "The Transition Path in Privatizing Social Security," NBER Chapters, in: Privatizing Social Security, pages 215-264 National Bureau of Economic Research, Inc.
  5. Friedrich Breyer, 2000. "Kapitaldeckungs- versus Umlageverfahren," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, Verein für Socialpolitik, vol. 1(4), pages 383-405, November.
  6. Manning, Willard G. & Marquis, M. Susan, 1996. "Health insurance: The tradeoff between risk pooling and moral hazard," Journal of Health Economics, Elsevier, Elsevier, vol. 15(5), pages 609-639, October.
  7. Manning, Willard G. & Marquis, M. Susan, 2001. "Health insurance: tradeoffs revisited," Journal of Health Economics, Elsevier, Elsevier, vol. 20(2), pages 289-293, March.
  8. Feldman, Roger & Dowd, Bryan, 1991. "A New Estimate of the Welfare Loss of Excess Health Insurance," American Economic Review, American Economic Association, American Economic Association, vol. 81(1), pages 297-301, March.
  9. Markus M. Grabka & Hanfried H. Andersen & Klaus-Dirk Henke & Katja Borchardt, 2002. "Kapitaldeckung in der Gesetzlichen Krankenversicherung: zur Berechnung der finanziellen Auswirkungen eines Umstiegs vom Umlage auf das Kapitaldeckungssystem," Discussion Papers of DIW Berlin 275, DIW Berlin, German Institute for Economic Research.
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Cited by:
  1. Henke, Klaus-Dirk & Rich, Robert F. & Steinbach, Axel & Borchardt, Katja, 2004. "Auf dem Wege zu einer integrierten Versorgung: Neue sozialrechtliche Rahmenbedingungen unter Berücksichtigung der Erfahrungen aus den USA und am Beispiel Berlins," Discussion Papers 2004/12, Technische Universität Berlin, School of Economics and Management.

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