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Freie Kassenwahl und Preiswettbewerb in der GKV: Effekte und Perspektiven

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  • Stefan Greß

Abstract

Mitte der 90er Jahre wurde in der GKV die freie Kassenwahl für alle Versicherten - flankiert durch den Risikostrukturausgleich (RSA) - eingeführt. Der Preiswettbewerb zwischen den Kassen soll die Anreize für die Krankenkassen verstärken, eine möglichst wirtschaftliche und qualitativ hochwertige Versorgung für ihre Versicherten zuerreichen. Die Versicherten nehmen ihre Wechseloption in zunehmendem Maße wahr. Das Wechselverhalten ist abhängig vom Beitragssatz der Krankenkassen. Allerdings wechseln schlechte Risiken weniger häufig als gute Risiken. Dadurch wird der Trend zur Risikoentmischung in der Gesetzlichen Krankenversicherung (GKV) verstärkt, der durch den RSA nur unvollständig kompensiert wird. Darüber hinaus haben Krankenkassen nur wenig Möglichkeiten, aufdie Qualität der Gesundheitsversorgung Einfluss zu nehmen. Um die Anreize für einen regulierten Wettbewerb in der GKV weiterzuentwickeln, müssen der RSA um eine Morbiditätskomponente erweitert und die Möglichkeit zur selektiven Kontrahierung mit Leistungsanbietern vergrößert werden. Erst dann kann der Preiswettbewerb zwischen Krankenkassen eine wirkungsvolle Funktion wahrnehmen.

Suggested Citation

  • Stefan Greß, 2002. "Freie Kassenwahl und Preiswettbewerb in der GKV: Effekte und Perspektiven," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 490-497.
    • Handle: RePEc:diw:diwvjh:71-40-11
    DOI: 10.3790/vjh.71.4.490
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    References listed on IDEAS

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    1. Johannes Schwarze & Hanfried H. Andersen, 2001. "Kassenwechsel in der gesetzlichen Krankenversicherung: welche Rolle spielt der Beitragssatz?," Discussion Papers of DIW Berlin 267, DIW Berlin, German Institute for Economic Research.
    2. Gerlinger, Thomas, 2002. "Zwischen Korporatismus und Wettbewerb: Gesundheitspolitische Steuerung im Wandel," Discussion Papers, Research Group Public Health P 02-204, WZB Berlin Social Science Center.
    3. Francesca Colombo, 2001. "Towards More Choice in Social Protection?: Individual Choice of Insurer in Basic Mandatory Health Insurance in Switzerland," OECD Labour Market and Social Policy Occasional Papers 53, OECD Publishing.
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    1. Bettina Becker & Silke Uebelmesser, 2010. "Health Insurance Competition in Germany - the Role of Advertising," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 130(2), pages 169-194.
    2. Robert Nuscheler, 2004. "Krankenkassenwettbewerb in der GKV: Evidenz für Risikoselektion?," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 73(4), pages 528-538.

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