Wettbewerb ohne Risikoselektion auf dem deutschen Krankenversicherungsmarkt
In: List Forum Band 30
Risk Selection is an issue in social health insurance in Germany as well as in private health insurance markets with long-term contracts. The inducement to primariliy select healthier insurants (cream skimming) is high. For community-rated systems there are attempts to install a morbidity-oriented risk-adjustment scheme. In private insurance markets risk-adjusted transferable ageing provisions should avoid risk selection. We claim that it is not possible to completely specify a morbidity-related risk adjustment scheme. Risk Selection cannot be prevented entirely. Furthermore, there are no inducements for insurance to strenghen prevention because expenses can be collectivized by way of the of risk-adjustment scheme. It is possible to solve both issues by combining equivalent premiums with transferable risk-adjusted ageing provisions, without jeopardizing affordable insurance premiums for insurants with higer risks. (Original text only available in german language)
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