Anreizkompatibilität als zentrales Element eines neu gestalteten Gesundheitsmarktes

Market failures in the "Physician-Patient-Market", caused by asymmetric information between patients and physicians, is a standard problem of any health system. Frequently, administrative rules defined by the government or private health (doctor) associations dominate the allocation mechanisms of the health system. These administrative rules along with asymmetric information often cause moral hazard problems leading to vast inefficiencies in the "Physician-Patient-Market". Therefore, the discussion of efficient health systems should focus on the problem of compatible incentives within the allocation system of the health sector. Even more, without incentive consistency instruments recently suggested to cure the inefficiency of the German system like "Managed Care", "Disease Management" or "Diagnosis Related Groups" will not be able to improve the efficiency of the health system. Introducing these instruments without a full incentive - compatible allocation system covering all segments of the health system will just shift the problem of asymmetric information and moral hazard to another sub-market of the system, the "Health Insurance-Patient-Market". Therefore, the intention of the paper is to identify the major elements of a suitable incentive - compatible allocation scheme for the health market. Further, we propose an independent evaluation and information institution as a major tool to cure the problem of asymmetric information in the health market. Copyright Verein für Socialpolitik und Blackwell Publishers Ltd, 2004