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Grenzen und Dysfunktionalitäten des Kassenwettbewerbs in der GKV: Theorie und Empirie der Risikolektion in Deutschland

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  • Höppner, Karin
  • Greß, Stefan
  • Rothgang, Heinz
  • Wasem, Jürgen
  • Braun, Bernard
  • Buitkamp, Martin

Abstract

Eine Funktionsbedingung für Kassenwettbewerb ist, dass Risikoselektion unterbunden wird. Denn Gegenstand des Kassenwettbewerbs sollen nicht bestimmte Merkmale von Versicherten sein (z.B. der Gesundheitszustand), vielmehr sollen die Anreize zur Verbesserung der Qualität und Effizienz der medizinischen Versorgung verstärkt werden. In einem wettbewerblichen Krankenversicherungssystem mit Risikoselektion werder die Interessen schlechter Risiken unzureichend berücksichtigt. Risikoselektion in der gesetzlichen Krankenversicherung (GKV) soll durch den Risikostrukturausgleich (RSA) verhindert werden. Seine Ausgestaltung muss bisher als unzureichend bezeichnet werden. Die Versichertenmerkmale Einkommen und Morbidität werder nicht hinreichend ausgeglichen. Theoretisch bestehen für die Krankenkassen also deutliche Anreize, Risikoselektion zu betreiben, was sich in der Empirie durch zahlreiche Beispiele belegen lässt.

Suggested Citation

  • Höppner, Karin & Greß, Stefan & Rothgang, Heinz & Wasem, Jürgen & Braun, Bernard & Buitkamp, Martin, 2005. "Grenzen und Dysfunktionalitäten des Kassenwettbewerbs in der GKV: Theorie und Empirie der Risikolektion in Deutschland," Working papers of the ZeS 04/2005, University of Bremen, Centre for Social Policy Research (ZeS).
    • Handle: RePEc:zbw:zeswps:042005
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    Cited by:

    1. 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.
    2. Kick, Markus & Littich, Martina, 2015. "Brand and Reputation as Quality Signals on Regulated Markets," EconStor Preprints 182503, ZBW - Leibniz Information Centre for Economics.
    3. Kick, Markus, 2015. "The Price Premium Induced by Branding: A Health Care Case Study," EconStor Preprints 182504, ZBW - Leibniz Information Centre for Economics.

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