Pflege und Gesundheit – zwei ungleiche Schwestern?: Marktversagenstatbestände und institutionelle Konsequenzen

The Social Long-term Care Insurance (Gesetzliche Pflegeversicherung, GPV) is in a crisis which will clearly intensify without reforms. An important solution strategy is the introduction of competition elements. This concerns the competition between the Long-term Care Insurance as well as the competition between the service providers. In comparison to the Social Health Insurance (Gesetzliche Krankenvereicherung, GKV) this coordination procedure can be found up to now very rarely. It is examined with the help of the market failure theory which market problems can be found in the area of long-term care. Here, nursing goods as well as the market for nursing insurances are examined. In comparison to the GKV, the lacking consumer’s sovereignty and problems with principal-agent-relations aggravate the situation in the GPV. However, other market failures are rather less important. An enlarged discussion of differences between GPV and GKV leads to the question of the institutional arrangement. This concerns on the one hand the possible amount of market and competition in the GPV as well as, on the other hand, the relation between GKV and GPV. In particular the interface problems between both social insurance systems are discussed.