IDEAS home Printed from https://ideas.repec.org/p/zbw/alufin/106.html
   My bibliography  Save this paper

Die Nachhaltigkeit der gesetzlichen Kranken- und Pflegeversicherung: Diagnose und Therapie

Author

Listed:
  • Fetzer, Stefan
  • Moog, Stefan
  • Raffelhüschen, Bernd

Abstract

Im Folgenden sollen die Konsequenzen des demographischen Wandels für die Nachhaltigkeit der gesetzlichen Kranken- und Pflegeversicherung mit Hilfe der Generationenbilanzierung und anhand ergänzender Beitragssatzprojektionen auf derzeitiger Gesetzesgrundlage quantifiziert werden. Ausgehend von der Diagnose des gesetzlichen Status quo soll dann aufgezeigt werden, ob und inwieweit spezifische Reformmaßnahmen eine echte Therapie darstellen und somit zukünftig mehr Nachhaltigkeit in der gesetzlichen Kranken und Pflegeversicherung generieren könnten. Im Ergebnis zeigt sich, dass für die Strukturreform der gesetzlichen Krankenversicherung (GKV) ein schlichtes Jetzt oder Nie gilt, will heißen: Aus einer Kombination von mehr Wettbewerb im stationären Sektor, absoluten Selbstbehalten in der ambulanten und medikamentösen Versorgung und der Privatisierung von zahnärztlichen Leistungen, der sogenannten Freiburger Agenda, kann wieder eine Nachhaltigkeit in das System getragen werden. Aus dem Selbstbedienungsladen heutiger zu Lasten zukünftiger Generationen könnte so wieder ein echter Generationenvertrag werden. Anders hingegen im Fall der gesetzlichen Pflegeversicherung (GPV). Sie war entgegen der ursprünglichen (Blüm’schen) Intention noch nie ein Generationenvertrag1 und sie kann angesichts der demographischen Entwicklung auch nicht nachhaltig reformiert werden. Einzig mögliche Handlungsalternative ist schlicht die sukzessive Abschaffung der Pflegeversicherung. Beide Gesundheitssysteme sollen im Folgenden nacheinander analysiert werden.

Suggested Citation

  • Fetzer, Stefan & Moog, Stefan & Raffelhüschen, Bernd, 2003. "Die Nachhaltigkeit der gesetzlichen Kranken- und Pflegeversicherung: Diagnose und Therapie," Discussion Papers 106, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    • Handle: RePEc:zbw:alufin:106
    as

    Download full text from publisher

    File URL: https://www.econstor.eu/bitstream/10419/56406/1/689289413.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Jurgen Jerger & Jochen Michaelis, 1999. "Profit Sharing, Capital Formation and the NAIRU," Scandinavian Journal of Economics, Wiley Blackwell, vol. 101(2), pages 257-275, June.
    2. Christian Keuschnigg & Mirela Keuschnigg & Reinhard Koman & Erik Lüth & Bernd Raffelüschen, 2000. "Public Debt and Generational Balance in Austria," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 27(3), pages 225-252, September.
    3. Jerger, Jurgen & Michaelis, Jochen, 1999. " Profit Sharing, Capital Formation and the NAIRU," Scandinavian Journal of Economics, Wiley Blackwell, vol. 101(2), pages 257-275, June.
    4. Bernd Raffelhuschen & Jan Walliser & Willi Leibfritz, 1999. "Unification and Aging in Germany: Who Pays and When?," NBER Chapters, in: Generational Accounting around the World, pages 277-298, National Bureau of Economic Research, Inc.
    5. Bernd Raffelhuschen & Laurence J. Kotlikoff, 1999. "Generational Accounting around the Globe," American Economic Review, American Economic Association, vol. 89(2), pages 161-166, May.
    6. Alan J. Auerbach & Laurence J. Kotlikoff & Willi Leibfritz, 1999. "Generational Accounting around the World," NBER Books, National Bureau of Economic Research, Inc, number auer99-1, March.
    7. Spermann, Alexander, 1996. "Das "Einstiegsgeld" für Langzeitarbeitslose," Wirtschaftsdienst – Zeitschrift für Wirtschaftspolitik (1949 - 2007), ZBW - Leibniz Information Centre for Economics, vol. 76(5), pages 240-246.
    8. Holger Bonin & Bernd Raffelhüschen & Jan Walliser, 2000. "Can Immigration Alleviate the Demographic Burden?," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 57(1), pages 1-21, September.
    9. Auerbach,Alan J. & Lee,Ronald D. (ed.), 2001. "Demographic Change and Fiscal Policy," Cambridge Books, Cambridge University Press, number 9780521662444.
    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. Fehr, Hans & Habermann, Christian, 2006. "Pension reform and demographic uncertainty: the case of Germany," Journal of Pension Economics and Finance, Cambridge University Press, vol. 5(1), pages 69-90, March.
    2. Melanie Arntz & Stephan L. Thomsen, 2010. "The Social Long-term Care Insurance: A Frail Pillar of the German Social Insurance System," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 8(2), pages 29-34, 07.
    3. Adam Hans, 2007. "Einkommenswachstum, steigende Gesundheitsausgaben und Finanzierung / Income Increase, Health Spending Growth and Financing," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 565-577, October.
    4. Spermann, Alexander & Arntz, Melanie, 2003. "Wie lässt sich die gesetzliche Pflegeversicherung mit Hilfe personengebundener Budgets reformieren?," ZEW Discussion Papers 03-58, ZEW - Leibniz Centre for European Economic Research.
    5. Häcker, Jasmin & Hackmann, Tobias & Raffelhüschen, Bernd, 2010. "Pflegereform 2010: Karenzzeiten in der Sozialen Pflegeversicherung," FZG Discussion Papers 46, University of Freiburg, Research Center for Generational Contracts (FZG).
    6. Melanie Arntz & Stephan L. Thomsen, 2010. "The Social Long-term Care Insurance: A Frail Pillar of the German Social Insurance System," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 8(02), pages 29-34, July.
    7. Noll Bernd & Wolf Sascha, 2019. "Altersrationierung im Gesundheitswesen – ein wirtschaftsethisch vertretbarer Weg?," Journal for Markets and Ethics, Sciendo, vol. 7(1), pages 1-20, June.
    8. Breyer, Friedrich & Franz, Wolfgang & Homburg, Stefan & Schnabel, Reinhold & Wille, Eberhard, 2004. "Reform der sozialen Sicherung: Kurzfassung," EconStor Books, ZBW - Leibniz Information Centre for Economics, number 92399, July.
    9. repec:ces:ifodic:v:8:y:2010:i:2:p:14566976 is not listed on IDEAS
    10. Christine Arentz & Ines Läufer & Steffen Roth, 2011. "Reform der gesetzlichen Pflegeversicherung: Teilkapitaldeckungsmodelle im Vergleich," Otto-Wolff-Institut Discussion Paper Series 04/2011, Otto-Wolff-Institut für Wirtschaftsordnung, Köln, Deutschland.
    11. 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.
    12. Raffelhüschen, Bernd & Schoder, Jörg, 2005. "Möglichkeiten und Grenzen der Integration von genossenschaftlichem Wohnen in die Freiburger Zwei-Flanken-Strategie," Arbeitspapiere 50, University of Münster, Institute for Cooperatives.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ehrentraut, Oliver & Fetzer, Stefan, 2003. "Wiedervereinigung, Aufholprozess Ost und Nachhaltigkeit," Discussion Papers 104, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    2. Raffelhüschen, Bernd, 2001. "Generational accounting: Quo vadis?," Discussion Papers 95, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    3. Alan J. Auerbach & Young Jun Chun & Ilho Yoo, 2005. "The Fiscal Burden of Korean Reunification: A Generational Accounting Approach," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 61(1), pages 62-97, March.
    4. Holger Bonin, 2002. "Eine fiskalische Gesamtbilanz der Zuwanderung nach Deutschland," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(2), pages 215-229.
    5. Auerbach, Alan J. & Hassett, Kevin, 2007. "Optimal long-run fiscal policy: Constraints, preferences and the resolution of uncertainty," Journal of Economic Dynamics and Control, Elsevier, vol. 31(5), pages 1451-1472, May.
    6. Gemma Abio Roig & Joan Gil Trasfi & Concepcion Patxot Cardoner, 2005. "La Ley de Estabilidad Presupuestaria en el largo plazo: efecto del ciclo demografico," Working Papers in Economics 126, Universitat de Barcelona. Espai de Recerca en Economia.
    7. Karin Mayr, 2004. "The fiscal impact of immigrants in Austria--a generational accounting analysis," Economics working papers 2004-09, Department of Economics, Johannes Kepler University Linz, Austria.
    8. Damla Haciibrahimoglu & Pinar Derin-Gure, 2013. "Generational Accounting in Turkey," ERC Working Papers 1301, ERC - Economic Research Center, Middle East Technical University, revised Jan 2013.
    9. F. J. H. Don & J. P. Verbruggen, 2006. "Models and methods for economic policy: 60 years of evolution at CPB," Statistica Neerlandica, Netherlands Society for Statistics and Operations Research, vol. 60(2), pages 145-170, May.
    10. Koskela, Erkki & Stenbacka, Rune, 2001. "Equilibrium unemployment with credit and labour market imperfections," Bank of Finland Research Discussion Papers 5/2001, Bank of Finland.
    11. Goerke, Laszlo, 2013. "Profit sharing and relative consumption," Economics Letters, Elsevier, vol. 118(1), pages 167-169.
    12. Mauro Mastrogiacomo & Rob Euwals & Raun van Ooijen, 2010. "Private wealth and planned early retirement: A panel data analysis for the Netherlands 1994-2009," CPB Discussion Paper 160.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    13. Akin Serife Nuray, 2012. "Immigration, Fiscal Policy, and Welfare in an Aging Population," The B.E. Journal of Macroeconomics, De Gruyter, vol. 12(1), pages 1-45, July.
    14. David E. Wildasin, 2003. "Fiscal Policy, Human Capital, and Canada-US Labor Market Integration," Public Economics 0309006, University Library of Munich, Germany.
    15. Kotlikoff, Laurence J., 2002. "Generational policy," Handbook of Public Economics, in: A. J. Auerbach & M. Feldstein (ed.), Handbook of Public Economics, edition 1, volume 4, chapter 27, pages 1873-1932, Elsevier.
    16. Andrew Mason & Ronald Lee & An-Chi Tung & Mun-Sim Lai & Tim Miller, 2009. "Population Aging and Intergenerational Transfers: Introducing Age into National Accounts," NBER Chapters, in: Developments in the Economics of Aging, pages 89-122, National Bureau of Economic Research, Inc.
    17. Koskela, Erkki & Stenbacka, Rune, 2003. "Equilibrium Unemployment Under Negotiated Profit Sharing," IZA Discussion Papers 840, Institute of Labor Economics (IZA).
    18. Philip Oreopoulos & Alan J. Auerbach, 1999. "Analyzing the Fiscal Impact of U.S. Immigration," American Economic Review, American Economic Association, vol. 89(2), pages 176-180, May.
    19. Erkki Koskela & Rune Stenbacka, 2004. "Profit Sharing, Credit Market Imperfections and Equilibrium Unemployment," Scandinavian Journal of Economics, Wiley Blackwell, vol. 106(4), pages 677-701, December.
    20. Ben-Gad, M., 2012. "On deficit bias and immigration," Working Papers 12/09, Department of Economics, City University London.

    More about this item

    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:zbw:alufin:106. See general information about how to correct material in RePEc.

    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.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with 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: ZBW - Leibniz Information Centre for Economics (email available below). General contact details of provider: https://edirc.repec.org/data/iffrede.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.