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Can Insurance Cause Medical Care Spending to Grow too Rapidly?

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  • Mark V. Pauly

Abstract

Im Mittelpunkt dieses Beitrags steht die Frage, ob wettbewerbsfähige Krankenversicherungsmärkte und wettbewerbsfähige Märkte für medizinische Leistungen zu effizienten Wachstumsraten von qualitätsverbessernden, aber kostensteigernden Technologien führen. Der Beitrag zeigt, dass es auf der einen Seite vielerlei Gründe gibt, warum diese Wachstumsraten unter dem Optimum liegen können. Andererseits ist es schwierig, ökonomische Modelle zu entwickeln, die ein übermäßiges Wachstum und die damit verbundenen Kosten gleichzeitig abbilden. Wenn Krankenkassen es ablehnen können, neue Leistungen zu versichern, werden neue Technologien, die zu einer Wohlfahrtsminderung führen, nicht eingeführt. Dies trifft auch dann zu, wenn die Krankenkassen durch gesetzliche oder administrative Regelungen dazu verpflichtet werden, die gleiche Selbstbeteiligung für alle von der Versicherung abgedeckten Leistungen anzubieten. Die Folge ist, dass der relativ hohe technologiebedingte Kostenanstieg in weniger regulierten Gesundheitssystemen (wie dem der USA) mit einer größeren Wirtschaftlichkeit verbunden sein kann als geringere Wachstumsraten in staatlich regulierten Gesundheitssystemen wie den europäischen.

Suggested Citation

  • Mark V. Pauly, 2002. "Can Insurance Cause Medical Care Spending to Grow too Rapidly?," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 468-476.
    • Handle: RePEc:diw:diwvjh:71-40-9
    DOI: 10.3790/vjh.71.4.468
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    References listed on IDEAS

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    1. Martin Gaynor & Deborah Haas-Wilson & William B. Vogt, 2000. "Are Invisible Hands Good Hands? Moral Hazard, Competition, and the Second-Best in Health Care Markets," Journal of Political Economy, University of Chicago Press, vol. 108(5), pages 992-1005, October.
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    5. Martin Gaynor & Deborah Haas-Wilson & William B. Vogt, "undated". "Are Invisible Hands Good Hands? Moral Hazard, Competition, and the 2nd Best in Health Care Markets," GSIA Working Papers 1999-E30, Carnegie Mellon University, Tepper School of Business.
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    Cited by:

    1. Holst, Jens, 2010. "Patient cost sharing: Reforms without evidence. Theoretical considerations and empirical findings from industrialized countries," Discussion Papers, Research Group Public Health SP I 2010-303, WZB Berlin Social Science Center.

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