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Health premiums or health contributions? An evaluation of health care reform options in Germany

Author

Listed:
  • Hans Fehr
  • Heinrich Jess

Abstract

The present study quantifies the revenue, distributional and efficiency effects of various reform options for the German health care system. Starting from a baseline path of the economy which represents the existing public and private mixture of health care providers in the German health care system, we introduce various reform packages which change the financing, the contribution base and the membership in the public system. Our simulations indicate that a premium system is superior to the citizen insurance model, since the former allows the redistribution to be financed through consumption taxes instead of wage taxes. Efficiency gains are maximized with the health premium model because this reform allows an immediate transition (compared to a privatization strategy) and minimizes the required compensation payments (compared to the citizen premium model) which distort labor supply. Winners of such a reform are mainly younger workers, while older workers, civil servants and self-employed will lose.

Suggested Citation

  • Hans Fehr & Heinrich Jess, 2006. "Health premiums or health contributions? An evaluation of health care reform options in Germany," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 126(1), pages 20-57.
    • Handle: RePEc:aeq:aeqsjb:v126_y2006_i1_q1_p20-57
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    Citations

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    Cited by:

    1. Kemnitz Alexander, 2013. "A Simple Model of Health Insurance Competition," German Economic Review, De Gruyter, vol. 14(4), pages 432-448, December.
    2. Christian Bünnings & Harald Tauchmann, 2015. "Who Opts out of the Statutory Health Insurance? A Discrete Time Hazard Model for Germany," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1331-1347, October.
    3. Jess Heinrich, 2006. "Steuerfinanzierung von Sozialleistungen? / Tax Funding of Social Security Benefits?: Verteilungs- und Effizienzeffekte einer Umfinanzierung von Sozialleistungen in der gesetzlichen Renten- und Kranken," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 226(4), pages 436-462, August.
    4. Kallweit Manuel & Kohlmeier Anabell, 2014. "Zusatzbeiträge in der Gesetzlichen Krankenversicherung / Income-independent Surcharges in German Statutory Health Insurance: Weiterentwicklungsoptionen und ihre finanziellen sowie allokativen Effekte ," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 234(4), pages 490-517, August.
    5. Göpffarth Dirk & Henke Klaus-Dirk, 2007. "Finanzierungsreform und Risikostrukturausgleich – Was bleibt vom Ausgleichsverfahren? / Health Care Finance Reform in Germany – Effects on the Risk Adjustment Scheme," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(1), pages 27-48, February.
    6. repec:jns:jbstat:v:227:y:2007:i:1:p:27-48 is not listed on IDEAS
    7. Feil, Michael & Klinger, Sabine & Zika, Gerd, 2006. "Sozialabgaben und Beschäftigung : Simulationen mit drei makroökonomischen Modellen," IAB-Discussion Paper 200622, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    8. Schubert, Stefanie & Schnabel, Reinhold, 2009. "Curing Germany's health care system by mandatory health premia?," Journal of Health Economics, Elsevier, vol. 28(5), pages 911-923, September.

    More about this item

    JEL classification:

    • D58 - Microeconomics - - General Equilibrium and Disequilibrium - - - Computable and Other Applied General Equilibrium Models
    • H22 - Public Economics - - Taxation, Subsidies, and Revenue - - - Incidence
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts

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