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Zur zukünftigen Finanzierung der Gesundheitsausgaben in Deutschland


  • Wolfram F. Richter


One institutional peculiarity of the German health care system is the division of health insurance into public and private spheres. Another one is the financing of public insurance. Contribution payments are wage-related and shared between employers and employees. The article presents a blueprint for overcoming these peculiarities. The proposal is to substitute employers' contributions by increased rates of the value-added tax. The employees' contributions should be substituted by some combination of a flat premium and an adjustment of marginal income tax rates. Private health insurance should be constrained to supplemental coverage and it should phase out as far as basic coverage is concerned. Implications for equity and efficiency are discussed. Copyright 2009 die Autoren Journal compilation 2009, Verein für Socialpolitik und Blackwell Publishing Ltd.

Suggested Citation

  • Wolfram F. Richter, 2009. "Zur zukünftigen Finanzierung der Gesundheitsausgaben in Deutschland," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 10(4), pages 469-479, November.
  • Handle: RePEc:bla:perwir:v:10:y:2009:i:4:p:469-479

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    References listed on IDEAS

    1. Friedrich Breyer & Andreas Haufler, 2000. "Health Care Reform: Separating Insurance from Income Redistribution," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 7(4), pages 445-461, August.
    2. Haufler, Andreas, 2004. "Welche Vorteile bringt eine Pauschalprämie für die Finanzierung des Gesundheitswesens? Einige einfache Äquivalenzresultate," Discussion Papers in Economics 440, University of Munich, Department of Economics.
    3. Stiglitz, Joseph E., 1987. "Pareto efficient and optimal taxation and the new new welfare economics," Handbook of Public Economics,in: A. J. Auerbach & M. Feldstein (ed.), Handbook of Public Economics, edition 1, volume 2, chapter 15, pages 991-1042 Elsevier.
    4. Homburg, Stefan, 2010. "Allgemeine Steuerlehre," EconStor Books, ZBW - German National Library of Economics, number 92547.
    5. Wolfgang Buchholz, 2005. "A Note on Financing Health-Care Reform: Some Simple Arguments Concerning Marginal Tax Burden," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 61(3), pages 438-438, November.
    6. Richter, Wolfram F., 2005. "Gesundheitsprämie oder Bürgerversicherung? Ein Kompromissvorschlag," Wirtschaftsdienst – Zeitschrift für Wirtschaftspolitik (1949 - 2007), ZBW – German National Library of Economics / Leibniz Information Centre for Economics, vol. 85(11), pages 693-697.
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    Cited by:

    1. Friedrich Breyer, 2010. "Gesundheitspolitik," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 79(1), pages 44-55.

    More about this item

    JEL classification:

    • H24 - Public Economics - - Taxation, Subsidies, and Revenue - - - Personal Income and Other Nonbusiness Taxes and Subsidies
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health


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