Cui bono? – Die Bürgerversicherung und die Beihilfe

The health policy debate in Germany rotates around the question whether Germany’s two pillar insurance system should be dissolved and replaced by universal coverage under the roof of the public system (so called citizen insurance, “Bürgerversicherung”). Most of the time, such a reform is argued from the perspective of the 90 percent of the German population which are already insured by a sickness fund. Rarely, the consequences of currently privately insurants are analysed. However, especially German civil servants are of great interest in this regard, as they are most times partly insured in the private scheme while the other part of their benefits is directly paid by the taxpayer. As the scheme for civil servants is more generous than the public scheme, the question of compensation arises when talking about the Bürgerversicherung reform. The analysis shows that if civil servants are only partly compensated by their employers (federal and state governments), the reform has a short-run negative fiscal impact.