IDEAS home Printed from https://ideas.repec.org/p/oec/ecoaaa/612-en.html
   My bibliography  Save this paper

Moving Towards more Sustainable Healthcare Financing in Germany

Author

Listed:
  • Nicola Brandt

    (OECD)

Abstract

The aim of the recent healthcare reform was to increase the sustainability of healthcare finances, by reducing its negative impact on employment and increasing cost-effectiveness via enhanced competition. Higher budget contributions will help decouple healthcare finances from labour income a bit, if and once they materialise. An improved risk adjustment between insurers could reduce incentives for risk selection, raising chances for competition to lead to more cost-effectiveness instead. However, the segmentation of the healthcare system in a private and a social insurance market will continue to pose equity and efficiency problems. Owing to its design, the price signal in the new financing system for social health insurance will be both weak and distorted and this will need to be corrected for competition to produce desired results. More freedom for contractual relations between insurers, healthcare providers and pharmaceutical companies could help to better reap the benefits of competition, but the government will need to watch the results closely and adjust framework conditions if needed. Pérenniser le financement des dépenses de santé en Allemagne La réforme récente du secteur de la santé vise à assurer un financement plus viable des dépenses de santé en réduisant leurs effets négatifs sur l’emploi et en améliorant leur efficacité économique grâce à une concurrence accrue. Si l’augmentation prévue des contributions budgétaires se matérialise, elle permettra un certain découplage entre le financement du secteur de la santé et les revenus du travail. Une meilleure répartition des risques entre les assureurs pourrait réduire la tendance à une sélection des risques, si bien que la concurrence pourrait en fait conduire à une plus grande efficacité économique. Cela étant, la segmentation du système de santé dans un marché où cohabitent assurance privée et assurance publique continuera de poser des problèmes d’équité et d’efficacité. Par sa conception même, le nouveau système de financement de l’assurance maladie publique limite et fausse les signaux transmis par les prix ; il faudra donc remédier à ce problème pour permettre à la concurrence de produire les résultats souhaités. Une plus grande liberté des relations contractuelles entre assureurs, prestataires de soins et laboratoires pharmaceutiques permettrait sans doute de tirer un meilleur parti de la concurrence, mais les autorités devront faire preuve de vigilance et adapter les conditions cadres le cas échéant.

Suggested Citation

  • Nicola Brandt, 2008. "Moving Towards more Sustainable Healthcare Financing in Germany," OECD Economics Department Working Papers 612, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:612-en
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1787/241647737261
    Download Restriction: no

    References listed on IDEAS

    as
    1. Alfonso Arpaia & Karl Pichelmann, 2007. "Nominal and real wage flexibility in EMU," International Economics and Economic Policy, Springer, vol. 4(3), pages 299-328, November.
    2. Filippo Altissimo & Michael Ehrmann & Frank Smets, 2006. "Inflation persistence and price-setting behaviour in the euro area – a summary of the IPN evidence," Occasional Paper Series 46, European Central Bank.
    3. Werner Roeger, 2005. "International oil price changes: impact of oil prices on growth and inflation in the EU/OECD," International Economics and Economic Policy, Springer, vol. 2(1), pages 15-32, June.
    4. Maurice Obstfeld & Kenneth S. Rogoff, 1996. "Foundations of International Macroeconomics," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262150476, January.
    5. Romain Duval & Lukas Vogel, 2012. "How Do Nominal and Real Rigidities Interact? A Tale of the Second Best," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 44(7), pages 1455-1474, October.
    6. Sack, Brian & Wieland, Volker, 2000. "Interest-rate smoothing and optimal monetary policy: a review of recent empirical evidence," Journal of Economics and Business, Elsevier, vol. 52(1-2), pages 205-228.
    7. Clarida, Richard & Gali, Jordi & Gertler, Mark, 1998. "Monetary policy rules in practice Some international evidence," European Economic Review, Elsevier, vol. 42(6), pages 1033-1067, June.
    8. Jordi Galí & Tommaso Monacelli, 2005. "Monetary Policy and Exchange Rate Volatility in a Small Open Economy," Review of Economic Studies, Oxford University Press, vol. 72(3), pages 707-734.
    9. Patrick J. Kehoe & Andrew Atkeson, 1999. "Models of Energy Use: Putty-Putty versus Putty-Clay," American Economic Review, American Economic Association, vol. 89(4), pages 1028-1043, September.
    10. Michael Woodford, 2001. "The Taylor Rule and Optimal Monetary Policy," American Economic Review, American Economic Association, vol. 91(2), pages 232-237, May.
    11. Christoffel, Kai & Linzert, Tobias, 2005. "The role of real wage rigidity and labor market frictions for unemployment and inflation dynamics," Working Paper Series 556, European Central Bank.
    12. James Bullard & Kaushik Mitra, 2007. "Determinacy, Learnability, and Monetary Policy Inertia," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 39(5), pages 1177-1212, August.
    13. Erceg, Christopher J. & Henderson, Dale W. & Levin, Andrew T., 2000. "Optimal monetary policy with staggered wage and price contracts," Journal of Monetary Economics, Elsevier, vol. 46(2), pages 281-313, October.
    14. Rajeev Dhawan & Karsten Jeske, 2007. "Taylor rules with headline inflation: a bad idea," FRB Atlanta Working Paper 2007-14, Federal Reserve Bank of Atlanta.
    15. Donald L. Kohn, 2007. "Inflation Modeling: A Policymaker's Perspective," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 39(s1), pages 181-186, February.
    16. Backus, David K. & Crucini, Mario J., 2000. "Oil prices and the terms of trade," Journal of International Economics, Elsevier, vol. 50(1), pages 185-213, February.
    17. Olivier J. Blanchard & Jordi Gali, 2007. "The Macroeconomic Effects of Oil Shocks: Why are the 2000s So Different from the 1970s?," NBER Working Papers 13368, National Bureau of Economic Research, Inc.
    18. T. Le_barbanchon, 2007. "The Changing response to oil price shocks in France : a DSGE type approach," Documents de Travail de la DESE - Working Papers of the DESE g2007-07, Institut National de la Statistique et des Etudes Economiques, DESE.
    19. Pierdzioch, Christian & Kamps, Christophe, 2002. "Monetary Policy Rules and Oil Price Shocks," Kiel Working Papers 1090, Kiel Institute for the World Economy (IfW).
    20. Dieter Gerdesmeier & Barbara Roffia, 2004. "Empirical Estimates of Reaction Functions for the Euro Area," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 140(I), pages 37-66, March.
    21. A. Campolmi, 2005. "Which inflation to target? A small open economy with sticky wages indexed to past inflation," Working Papers 553, Dipartimento Scienze Economiche, Universita' di Bologna.
    22. Fiorella de Fiore & Giovenni Lombardo & Viktors Stebunovs, 2006. "Oil Price Shocks, Monetary Policy Rules and Welfare," Computing in Economics and Finance 2006 402, Society for Computational Economics.
    23. Gerdesmeier, Dieter & Roffia, Barbara & Eleftheriou, Maria, 2006. "Monetary policy rules in the pre-EMU era: Is there a common rule?," Working Paper Series 659, European Central Bank.
    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. Bauhoff, Sebastian & Fischer, Lisa & Göpffarth, Dirk & Wuppermann, Amelie C., 2017. "Plan Responses to Diagnosis-Based Payment: Evidence from Germany’s Morbidity-Based Risk Adjustment," Annual Conference 2017 (Vienna): Alternative Structures for Money and Banking 168123, Verein für Socialpolitik / German Economic Association.
    2. Eiji Tajika & Jun Kikuchi, 2012. "The roles of public and private insurance for the health-care reform of Japan," Public Policy Review, Policy Research Institute, Ministry of Finance Japan, vol. 8(2), pages 123-144, July.
    3. Bauhoff, Sebastian, 2012. "Do health plans risk-select? An audit study on Germany's Social Health Insurance," Journal of Public Economics, Elsevier, vol. 96(9-10), pages 750-759.

    More about this item

    Keywords

    accès aux marchés; gestion publique; health care; public sector efficiency; santé;

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H73 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Interjurisdictional Differentials and Their Effects
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:oec:ecoaaa:612-en. 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: http://edirc.repec.org/data/edoecfr.html .

    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 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.

    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.