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Demographic development and moral hazard: Health insurance with medical savings accounts

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  • Schreyögg, Jonas

Abstract

In times of ever-rising health expenditures it is becoming more and more obvious that conventional models for funding health care are increasingly experiencing difficulties in meeting up this challenge. The concept of Medical Savings Accounts (MSAs) represents an innovative and so far rarely analysed alternative for the funding of health care systems. In this concept an anticipated amount of money needed is saved up ex ante by each individual in a special account set aside to cover health care expenses. Since, however, health care expenses for certain kinds of treatment frequently exceed the financial capacity of the individual, Medical Savings Accounts are normally introduced in combination with health insurance covering defined services with higher financial risk. From a theoretical point of view the MSA concept helps counteracting the phenomenon of moral hazard in health insurance systems and at the same time coping with the future challenges posed by demographic development. This paper also examines first experiences gained so far with the implementation and use of Medical Savings Accounts in different countries. It draws a mixed but rather positive picture of the results. Therefore it could be feasible to integrate certain elements of this concept into health care systems of European countries. -- Das Konzept der Medical Savings Accounts als Instrument zur Finanzierung von Gesundheitssystemen hat in den letzten Jahren international Aufmerksamkeit erregt. Länder wie Singapur, Südafrika, China und die USA haben diese neue Form der Finanzierung bereits eingeführt oder in Pilotprojekten erprobt. Dieser Beitrag gibt zunächst einen Überblick über Erfahrungen, die einzelne Länder bisher mit der Konzeption der Medical Savings Accounts gemacht haben. Er geht auf aktuelle Entwicklungen in diesen Ländern ein. Außerdem wird anhand erster Ergebnisse aufgezeigt, dass sich das Modell der Gesundheitssparkonten sowohl als Tarifmodell für private Krankenversicherung sowie als konstitutiver Bestandteil eines gesetzlichen Krankenversicherungssystems bewährt hat. Abschließend wird vorgeschlagen, bestimmte Elemente dieses Systems in die Krankenversicherungssysteme Europas zu integrieren.

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Bibliographic Info

Paper provided by Technische Universität Berlin, School of Economics and Management in its series Discussion Papers with number 2004/16.

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Date of creation: 2004
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Handle: RePEc:zbw:tubsem:200416

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Web page: http://www.wm.tu-berlin.de/menue/fakultaet_vii/
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Cited by:
  1. Michel Grignon, 2005. "Aging, Health and Aggregate Medical Care Spending in France," Department of Economics Working Papers 2005-06, McMaster University.
  2. Pablo Gottret & George Schieber, 2006. "Health Financing Revisited : A Practitioner's Guide," World Bank Publications, The World Bank, number 7094, August.
  3. Jonas Schreyögg & Lim Meng Kin, 2004. "Health-Care Reforms in Singapore - Twenty Years of Medical Savings Accounts," CESifo DICE Report, Ifo Institute for Economic Research at the University of Munich, vol. 2(3), pages 55-60, October.

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