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Alles nur Selektion?: Der Einfluss von Selbstbehalten in der Gesetzlichen Krankenversicherung

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  • Andreas Werblow

Abstract

In Deutschland besteht seit einiger Zeit ein parteiübergreifender Konsens, dass Änderungen in der Gesetzlichen Krankenversicherung angesichts stetig steigender Ausgaben unausweichlich sind. Aus gesundheitsökonomischer Sicht bietet sich eine Option besonders an: die Beteiligung der Patienten an den Kosten medizinischer Leistungen. Dadurch entstünden finanzielle Anreize, vermehrt Krankheitsvorsorge zu betreiben und sich bei Erkrankung kostenbewusster zu verhalten. Die Arbeit untersucht den Einfluss von wählbaren Selbstbehalten auf das Verhalten der Versicherten in der Gesetzlichen Krankenversicherung der Schweiz. Im Gegensatz zu Schellhorn (2001, 2002a) zeigen unsere Ergebnisse einen signifikanten Effekt der Kostenbeteiligung auf die Nachfrage nach medizinischen Leistungen.

Suggested Citation

  • Andreas Werblow, 2002. "Alles nur Selektion?: Der Einfluss von Selbstbehalten in der Gesetzlichen Krankenversicherung," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 427-436.
    • Handle: RePEc:diw:diwvjh:71-40-3
    DOI: 10.3790/vjh.71.4.427
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    1. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456, July.
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    1. Martin Schellhorn, 2004. "W hlbare Selbstbehalte in der Krankenversicherung der Schweiz: Nachfragesteuerung oder Selektion?," Diskussionsschriften dp0402, Universitaet Bern, Departement Volkswirtschaft.
    2. Martin Schellhorn, 2002. "Auswirkungen wählbarer Selbstbehalte in der Krankenversicherung: Lehren aus der Schweiz?," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 411-426.
    3. Marcel Bilger & Jean-Paul Chaze, 2008. "What Drives Individual Health Expenditure in Switzerland?," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 337-358, September.
    4. Boris Augurzky & Samuel Berhanu & Silja Göhlmann & Sebastian Krolop & Andreas Liehr-Griem & Christoph M. Schmidt & Harald Tauchmenn & Stefan Terkatz, 2004. "Strukturreformen im deutschen Gesundheitswesen," RWI Materialien, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, pages 38, 02.
    5. Reichmann, Gerhard & Sommersguter-Reichmann, Margit, 2004. "Co-payments in the Austrian social health insurance system: Analysing patient behaviour and patients' views on the effects of co-payments," Health Policy, Elsevier, vol. 67(1), pages 75-91, January.
    6. Augurzky, Boris & Berhanu, Samuel & Göhlmann, Silja & Krolop, Sebastian & Liehr-Griem, Andreas & Schmidt, Christoph M. & Tauchmann, Harald & Terkatz, Stefan, 2004. "Strukturreformen im deutschen Gesundheitswesen," RWI Materialien 8, RWI - Leibniz-Institut für Wirtschaftsforschung.
    7. Stefan Greß & Ralf Kocher & Jürgen Wasem, 2004. "Wettbewerbsorientierte Reformen im Gesundheitssystem der Schweiz – Vorbild für regulierten Wettbewerb in der deutschen GKV?," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 5(1), pages 59-70, February.
    8. Drevs Florian & Nguyen Tristan, 2012. "Adverse Selektion light – Der Einfluss des Flat-Rate-Bias auf das Tarifwahlverhalten bei Krankenversicherungen / Adverse Selection Light – How can flat-rate bias influence insurance demand," ORDO. Jahrbuch für die Ordnung von Wirtschaft und Gesellschaft, De Gruyter, vol. 63(1), pages 365-382, January.
    9. Viktor Steiner, 2002. "Selbstbehalte und Nachfrage nach Gesundheitsleistungen: die Bedeutung der Selbstselektion ; Korreferat zu den Beiträgen von Martin Schellhorn: "Auswirkungen wählbarer Selbstbehalte in der Kranken," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 437-441.
    10. Karl-Michael Ortmann, 2011. "Optimal deductibles for outpatient services," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(1), pages 39-47, February.
    11. Rothgang, Heinz & Wasem, Jürgen & Greß, Stefan, 2005. "Kopfprämienmodelle in der GKV - Lohnt sich ein Systemwechsel? Aktualisierte und erweiterte Expertise für die Hans-Böckler-Stiftung," IBES Diskussionsbeiträge 140, University of Duisburg-Essen, Institute of Business and Economic Studie (IBES).
    12. Wasem, Jürgen & Greß, Stefan & Rothgang, Heinz, 2003. "Kopfprämien in der gesetzlichen Krankenversicherung: Eine Perspektive für die Zukunft?," Working papers of the ZeS 07/2003, University of Bremen, Centre for Social Policy Research (ZeS).
    13. repec:zbw:rwimat:008 is not listed on IDEAS
    14. Raffelhüschen, Bernd & Moog, Stefan, 2010. "Ehrbarer Staat? Die Generationenbilanz. Update 2010: Handlungsoptionen der Gesundheitspolitik," Argumente zur Marktwirtschaft und Politik 111, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.
    15. 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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