IDEAS home Printed from https://ideas.repec.org/a/diw/diwvjh/71-40-11.html
   My bibliography  Save this article

Freie Kassenwahl und Preiswettbewerb in der GKV: Effekte und Perspektiven

Author

Listed:
  • Stefan Greß

Abstract

Mitte der 90er Jahre wurde in der GKV die freie Kassenwahl für alle Versicherten - flankiert durch den Risikostrukturausgleich (RSA) - eingeführt. Der Preiswettbewerb zwischen den Kassen soll die Anreize für die Krankenkassen verstärken, eine möglichst wirtschaftliche und qualitativ hochwertige Versorgung für ihre Versicherten zuerreichen. Die Versicherten nehmen ihre Wechseloption in zunehmendem Maße wahr. Das Wechselverhalten ist abhängig vom Beitragssatz der Krankenkassen. Allerdings wechseln schlechte Risiken weniger häufig als gute Risiken. Dadurch wird der Trend zur Risikoentmischung in der Gesetzlichen Krankenversicherung (GKV) verstärkt, der durch den RSA nur unvollständig kompensiert wird. Darüber hinaus haben Krankenkassen nur wenig Möglichkeiten, aufdie Qualität der Gesundheitsversorgung Einfluss zu nehmen. Um die Anreize für einen regulierten Wettbewerb in der GKV weiterzuentwickeln, müssen der RSA um eine Morbiditätskomponente erweitert und die Möglichkeit zur selektiven Kontrahierung mit Leistungsanbietern vergrößert werden. Erst dann kann der Preiswettbewerb zwischen Krankenkassen eine wirkungsvolle Funktion wahrnehmen.

Suggested Citation

  • Stefan Greß, 2002. "Freie Kassenwahl und Preiswettbewerb in der GKV: Effekte und Perspektiven," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 490-497.
    • Handle: RePEc:diw:diwvjh:71-40-11
    DOI: 10.3790/vjh.71.4.490
    as

    Download full text from publisher

    File URL: https://doi.org/10.3790/vjh.71.4.490
    Download Restriction: no
    File URL: https://libkey.io/10.3790/vjh.71.4.490?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Johannes Schwarze & Hanfried H. Andersen, 2001. "Kassenwechsel in der gesetzlichen Krankenversicherung: welche Rolle spielt der Beitragssatz?," Discussion Papers of DIW Berlin 267, DIW Berlin, German Institute for Economic Research.
    2. Gerlinger, Thomas, 2002. "Zwischen Korporatismus und Wettbewerb: Gesundheitspolitische Steuerung im Wandel," Discussion Papers, Research Group Public Health P 02-204, WZB Berlin Social Science Center.
    3. Francesca Colombo, 2001. "Towards More Choice in Social Protection?: Individual Choice of Insurer in Basic Mandatory Health Insurance in Switzerland," OECD Labour Market and Social Policy Occasional Papers 53, OECD Publishing.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bettina Becker & Silke Uebelmesser, 2010. "Health Insurance Competition in Germany - the Role of Advertising," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 130(2), pages 169-194.
    2. Robert Nuscheler, 2004. "Krankenkassenwettbewerb in der GKV: Evidenz für Risikoselektion?," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 73(4), pages 528-538.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brigitte Dormont & Pierre-Yves Geoffard & Karine Lamiraud, 2007. "The influence of supplementary health insurance on switching behaviour: evidence on Swiss data," PSE Working Papers halshs-00587785, HAL.
    2. Marcus Tamm & Harald Tauchmann & Stefan Greß & Jürgen Wasem, 2005. "Price Elasticities and Social Health Insurance Choice in Germany: A Dynamic Panel Data Approach," RWI Discussion Papers 0028, Rheinisch-Westfälisches Institut für Wirtschaftsforschung.
    3. Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany," Journal of Health Economics, Elsevier, vol. 56(C), pages 330-351.
    4. Andersen Hanfried H. & Grabka Markus M. & Schwarze Johannes, 2007. "Beitragssatz, Kassenwettbewerb und Gesundheitsreform / Premium Rates, Competition Among Health Insurance Funds and the Health Care Reform 2007: Eine empirische Analyse / An Empirical Analysis," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 429-450, October.
    5. Robert Nuscheler, 2004. "Krankenkassenwettbewerb in der GKV: Evidenz für Risikoselektion?," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 73(4), pages 528-538.
    6. Mark Stabile & Sarah Thomson, 2014. "The Changing Role of Government in Financing Health Care: An International Perspective," Journal of Economic Literature, American Economic Association, vol. 52(2), pages 480-518, June.
    7. Daniel Osberghaus & Astrid Dannenberg & Tim Mennel & Bodo Sturm, 2010. "The Role of the Government in Adaptation to Climate Change," Environment and Planning C, , vol. 28(5), pages 834-850, October.
    8. Göpffarth, Dirk, 2004. "Die Reform des Risikostrukturausgleichs: Eine Zwischenbilanz," Discussion Papers 2004/18, Technische Universität Berlin, School of Economics and Management.
    9. repec:hal:spmain:info:hdl:2441/3ihldo33ik9ee94procjtfki5f is not listed on IDEAS
    10. Okma, Kieke G.H. & Crivelli, Luca, 2013. "Swiss and Dutch “consumer-driven health care”: Ideal model or reality?," Health Policy, Elsevier, vol. 109(2), pages 105-112.
    11. Dalit Daily-Amir & Hansjörg Albrecher & Martin Bladt & Joël Wagner, 2019. "On Market Share Drivers in the Swiss Mandatory Health Insurance Sector," Risks, MDPI, vol. 7(4), pages 1-25, November.
    12. Schmitz, Hendrik & Ziebarth, Nicolas R., 2011. "In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice," Ruhr Economic Papers 304, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    13. repec:dau:papers:123456789/1623 is not listed on IDEAS
    14. Dieterich, Felix, 2005. "Risikoselektion und Risikoausgleich am Beispiel der gesetzlichen Krankenkassen in Deutschland," Discussion Papers in Economics 718, University of Munich, Department of Economics.
    15. Bettina Becker & Silke Uebelmesser, 2010. "Health Insurance Competition in Germany - the Role of Advertising," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 130(2), pages 169-194.
    16. Mathias Kifmann, 2006. "Risk selection and complementary health insurance: The Swiss approach," International Journal of Health Economics and Management, Springer, vol. 6(2), pages 151-170, June.
    17. Omar Paccagnella & Vincenzo Rebba & Guglielmo Weber, 2013. "VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 289-315, March.
    18. Karolin Becker & Peter Zweifel, 2005. "Cost Sharing in Health Insurance: An Instrument for Risk Selection?," SOI - Working Papers 0513, Socioeconomic Institute - University of Zurich.
    19. Pendzialek, Jonas B. & Danner, Marion & Simic, Dusan & Stock, Stephanie, 2015. "Price elasticities in the German Statutory Health Insurance market before and after the health care reform of 2009," Health Policy, Elsevier, vol. 119(5), pages 654-663.
    20. Andersen, Hanfried H. & Grabka, Markus M. & Schwarze, Johannes, 2007. "Beitragssatz, Kassenwettbewerb und Gesundheitsreform: Eine empirische Analyse," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 227(5/6), pages 429-450.
    21. Brigitte Dormont & Pierre‐Yves Geoffard & Karine Lamiraud, 2009. "The influence of supplementary health insurance on switching behaviour: evidence from Swiss data," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1339-1356, November.
    22. Knaus, Thomas & Nuscheler, Robert, 2002. "Incomplete risk adjustment and adverse selection in the German public health insurance system [Unvollständiger Risikostrukturausgleich und Adverse Selektion in der Gesetzlichen Krankenversicherung ," Discussion Papers, Research Unit: Market Processes and Governance FS IV 02-27, WZB Berlin Social Science Center.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:diw:diwvjh:71-40-11. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Bibliothek (email available below). General contact details of provider: https://edirc.repec.org/data/diwbede.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.