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Finanzierungsreform und Risikostrukturausgleich – Was bleibt vom Ausgleichsverfahren? / Health Care Finance Reform in Germany – Effects on the Risk Adjustment Scheme

Author

Listed:
  • Göpffarth Dirk

    () (Bundesversicherungsamt, Friedrich-Ebert-Allee 38, D-53113 Bonn, Germany)

  • Henke Klaus-Dirk

    () (Technische Universität Berlin, Sekr. H51, Straße des 17. Juni 135, D-10623 Berlin, Germany)

Abstract

In Germany, there is an ongoing debate on how to finance the statutory health insurance (SHI). Proposals include a “civic insurance” with a contribution rate drawn on a broader base and capitated payments. This debate will not subside with the recently issued white paper on health care reform, since fundamental issues were left open. This article does not develop a further variant of the discussed models. Instead, the components of which the future finance reform will have to consist are isolated and discussed with regard to their influence on the risk adjustment (RSA) scheme. The discussed topics are the differences between contribution rates and capitated payments, funded vs. pay-as-you-go systems, the question of whom to include in the statutory health insurance and central vs. decentralised collection of payments. This new perspective does not only allow conclusion on how the RSA scheme ought to be constructed in the future, it can also be shown which role the scheme has as framework for competition and for a possibly partially funded health insurance system.

Suggested Citation

  • 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.
  • Handle: RePEc:jns:jbstat:v:227:y:2007:i:1:p:27-48:n:3
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    References listed on IDEAS

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    1. 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.
    2. Grabka, Markus M. & Andersen, Hanfried H. & Henke, Klaus-Dirk & Borchardt, Katja, 2003. "Kapitaldeckung für die GKV? Zur Berechnung der finanziellen Auswirkungen eines Umstiegs vom Umlage- auf das Kapitaldeckungssystem," EconStor Open Access Articles, ZBW - German National Library of Economics, pages 265-283.
    3. Friedrich Breyer & Mathias Kifmann, 2001. "Optionen der Weiterentwicklung des Risikostrukturausgleichs in der GKV," Discussion Papers of DIW Berlin 236, DIW Berlin, German Institute for Economic Research.
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    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.
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    7. Hagist, Christian & Fetzer, Stefan, 2004. "GMG, Kopfpauschalen und Bürgerversicherungen: Der aktuelle Reformstand und seine intergenerativen Verteilungswirkungen," Discussion Papers 114, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    8. Stefan Fetzer & Christian Hagist, 2004. "GMG, Kopfpauschalen und Bürgerversicherungen: Der aktuelle Reformstand und seine intergenerativen Verteilungswirkungen," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 124(3), pages 387-420.
    9. Andreas Haufler, 2004. "Welche Vorteile bringt eine Pauschalprämie für die Finanzierung des Gesundheitswesens?," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 124(4), pages 539-556.
    10. 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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