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Zum Einfluss von Demographie und medizinisch-technischem Fortschritt auf die Gesundheitsausgaben


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  • Henke, Klaus-Dirk
  • Reimers, Lutz
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    Die demographische Entwicklung und der medizinisch-technische Fortschritt gelten als die beiden wichtigsten Gründe für den Anstieg der Gesundheitsausgaben. Der vorliegende Übersichtsartikel betrachtet den Einfluss der Alterung auf die Gesundheitsausgaben anhand der so genannten Medikalisierungs- und Kompressionsthese und zieht zur Verdeutlichung der Argumentation die Krankheitskosten nach Alter sowie die Leistungsausgaben der Gesetzlichen Krankenversicherung hinzu. Aufgrund der aus der gesetzlichen und der privaten Krankenversicherung folgenden Innovationsanreize ist vom medizinisch-technischen Fortschritt im Vergleich zum allgemeinen technischen Fortschritt eine übermäßige Produktion kostenverursachender Innovationen zu erwarten. Die existierenden Untersuchungen zur Wirkung des medizinisch-technischen Fortschritts auf die Gesundheitsausgaben lassen sich differenzieren in Untersuchungen, die den medizinisch-technischen Fortschritt als Residuum bestimmen, in Untersuchungen, die sich ihm mittels eines Proxies (etwa der Forschungs- und Entwicklungsausgaben) annähern bzw. Untersuchungen, die ihn durch einzelne Beispiele konkretisieren. Der Beitrag endet mit einer kurzen Diskussion einiger gesundheitspolitischer Lösungsansätze zur Verringerung der zu erwartenden wachsenden Diskrepanz zwischen Ausgaben und Einnahmen im Gesundheitswesen. -- Demographic development and technical progress in the health care system are considered as the two major reasons for rising health care expenditures. This paper discusses the influence of aging on health expenditures by focusing on the respective two competing views (expenditures may rise due to increased morbidity and they may stay constant because of smaller costs of mortality at higher age). The argumentation is based on cost-of-illnesses-data and expenditure-data from the German Social Health Insurance. The existence of social and private health insurances causes an overproduction of cost-intensive technical progress in the health system as compared to technical progress in other fields of the economy. The existing studies of the impact of technical progress on health care expenditures can be differentiated in studies treating technical progress as residuum, studies approximating the progress via certain variables such as research and development expenses and studies which focus on specific examples of medical innovations. The paper closes with a discussion of possible regulatory measures to reduce the growing discrepancy between expenditures and revenues in the health care system.

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    Paper provided by Technische Universität Berlin, School of Economics and Management in its series Discussion Papers with number 2006/8.

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    Date of creation: 2006
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    Handle: RePEc:zbw:tubsem:20068

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