IDEAS home Printed from
   My bibliography  Save this paper

Herausforderungen für die nationale Gesundheitspolitik im Europäischen Integrationsprozess


  • Susanna Kochskämper


The European national health systems - Bismarckian pay-as-you-go systems as well as Beveridge systems financed by taxes - are characterized by redistribution within and between generations. Both types are more or less similar in their mode of functioning and both bear inefficiencies in many fields. The lack of resistance towards demographical changes is a threat for the stability of these systems, even without migration. Yet in a world with migration, the problem of instability has to be considered also from a different angle. Competition of health systems could induce financial difficulties or even the collapse of redistribution within these systems. This problem is even more relevant if the Enlargement of the Union continues and heterogeneity of the social and medical services granted by the states grows. Which measures have therefore to be taken to stabilize the national health systems within the European Union, where the right of freedom of movement is granted to every citizen? Is harmonization or even centralization an efficient solution to choose? In this article it is argued that reforms of the national health systems are necessary to overcome the problems induced by migration. The main step to be taken is the separation of both the intragenerational and the intergenerational distribution from the insurance system. This is inevitable to provide an efficient health care system at the national level and to insure the freedom of movement in the European Union without undermining the solidarity of the insurance pool.

Suggested Citation

  • Susanna Kochskämper, 2009. "Herausforderungen für die nationale Gesundheitspolitik im Europäischen Integrationsprozess," Otto-Wolff-Institut Discussion Paper Series 01/2009, Otto-Wolff-Institut für Wirtschaftsordnung, Köln, Deutschland.
  • Handle: RePEc:kln:owiwdp:dp_01_2009

    Download full text from publisher

    File URL:
    Download Restriction: no

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    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:kln:owiwdp:dp_01_2009. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: .

    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.

    We have no bibliographic references for this item. You can help adding them by using 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: Christian Müller (email available below). General contact details of provider: .

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.