IDEAS home Printed from https://ideas.repec.org/a/jns/jbstat/v227y2007i5-6p603-620.html
   My bibliography  Save this article

Kapitaldeckung in der Gesetzlichen Krankenversicherung: Wer bezahlt den Übergang? / Funding Social Health Insurance: Who Pays for the Transition?

Author

Listed:
  • Felder Stefan

    (Institut für Sozialmedizin und Gesundheitsökonomie, Leipziger Str. 44, 39120 Magdeburg, Germany)

  • Fetzer Stefan

    (Wissenschaftlicher Beirat der Betrieblichen Krankenversicherung, Kronprinzenstraße 5-7, 45128 Essen, Germany)

Abstract

The double ageing of the population leads to income redistribution from future to present generations as net payments to social health insurance are negative at young age and positive at old age. Economists arguing in favour of flat health insurance premiums combined with ageing provisions often neglect the transition from the pay-as-you-go to funded system. Using a generational accounting approach we analyze a reform to funded premiums, taking into account the transition. Furthermore, we implement a tax-transfer scheme designed to protect low income persons facing higher payments in the premium scheme.Our calculations reveal that under the current pay-as-you-go system German social health insurance burdens future generations by almost 30 percent of GDP. Funding could reduce this burden to 5 percent of GDP but would involve higher payments up to 700 Euro p.a. for the present generations. A delay of the reform would increase the burden for future generations again and benefit baby boomers born before 1970. We conclude from a public-choice perspective that it will be difficult to implement even a delayed reform to a more funded health insurance system.

Suggested Citation

  • Felder Stefan & Fetzer Stefan, 2007. "Kapitaldeckung in der Gesetzlichen Krankenversicherung: Wer bezahlt den Übergang? / Funding Social Health Insurance: Who Pays for the Transition?," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 603-620, October.
    • Handle: RePEc:jns:jbstat:v:227:y:2007:i:5-6:p:603-620
    DOI: 10.1515/jbnst-2007-5-612
    as

    Download full text from publisher

    File URL: https://doi.org/10.1515/jbnst-2007-5-612
    Download Restriction: no
    File URL: https://libkey.io/10.1515/jbnst-2007-5-612?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. repec:bpj:pewipo:v:1:y:2000:i:4:p:383-405:n:2 is not listed on IDEAS
    2. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1991. "Generational Accounts: A Meaningful Alternative to Deficit Accounting," NBER Chapters, in: Tax Policy and the Economy, Volume 5, pages 55-110, National Bureau of Economic Research, Inc.
    3. Grabka, Markus M. & Andersen, Hanfried H. & Henke, Klaus-Dirk & Borchardt, Katja, 2003. "Kapitaldeckung für die GKV? Zur Berechnung der finanziellen Auswirkungen eines Umstiegs vom Umlage- auf das Kapitaldeckungssystem," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 123, pages 265-283.
    4. repec:bla:scandj:v:94:y:1992:i:2:p:303-18 is not listed on IDEAS
    5. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1994. "Generational Accounting: A Meaningful Way to Evaluate Fiscal Policy," Journal of Economic Perspectives, American Economic Association, vol. 8(1), pages 73-94, Winter.
    6. Breyer, Friedrich & Felder, Stefan, 2006. "Life expectancy and health care expenditures: A new calculation for Germany using the costs of dying," Health Policy, Elsevier, vol. 75(2), pages 178-186, January.
    7. Breyer Friedrich & Ulrich Volker, 2000. "Gesundheitsausgaben, Alter und medizinischer Fortschritt: Eine Regressionsanalyse / Ageing, Medical Progress and Health Care Expenditures: A Regression Analysis," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 220(1), pages 1-17, February.
    8. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
    9. Stefan Felder, 1997. "Vom "Deficit Accounting" zum "Generational Accounting ": Eine Anwendung für die Schweiz," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 133(III), pages 497-512, September.
    10. Okunade, Albert A. & Murthy, Vasudeva N. R., 2002. "Technology as a 'major driver' of health care costs: a cointegration analysis of the Newhouse conjecture," Journal of Health Economics, Elsevier, vol. 21(1), pages 147-159, January.
    11. Friedrich Breyer, 2000. "Kapitaldeckungs‐ versus Umlageverfahren," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 1(4), pages 383-405, November.
    12. Cassel, Dieter & Oberdieck, Veit, 2002. "Kapitaldeckung in der gesetzlichen Krankenversicherung," Wirtschaftsdienst – Zeitschrift für Wirtschaftspolitik (1949 - 2007), ZBW - Leibniz Information Centre for Economics, vol. 82(1), pages 15-22.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Henke Klaus Dirk, 2007. "Zur Dualität von GKV und PKV / The Future of Private and Public Health Insurance in Germany," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 502-528, October.
    2. Stefan Fetzer & Stefan Moog, 2021. "Indicators for Measuring Intergenerational Fairness of Social Security Systems—The Case of the German Social Health Insurance," Sustainability, MDPI, vol. 13(10), pages 1-18, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hagist, Christian & Klusen, Norbert & Plate, Andreas & Raffelhüschen, Bernd, 2005. "Social health insurance: The major driver of unsustainable fiscal policy?," FZG Discussion Papers 1, University of Freiburg, Research Center for Generational Contracts (FZG).
    2. repec:jns:jbstat:v:227:y:2007:i:5-6:p:578-602 is not listed on IDEAS
    3. Christian Hagist & Norbert Klusen & Andreas Plate & Bernd Raffelhüschen, 2005. "Social Health Insurance - the Major Driver of Unsustainable Fiscal Policy?," CESifo Working Paper Series 1574, CESifo.
    4. Stefan Fetzer & Stefan Moog, 2021. "Indicators for Measuring Intergenerational Fairness of Social Security Systems—The Case of the German Social Health Insurance," Sustainability, MDPI, vol. 13(10), pages 1-18, May.
    5. Fabio Pammolli & Francesco Porcelli & Francesco Vidoli & Monica Auteri & Guido Borà, 2017. "La spesa sanitaria delle Regioni in Italia - Saniregio2017," Working Papers CERM 01-2017, Competitività, Regole, Mercati (CERM).
    6. Postler Andreas, 2010. "Gesundheitspolitik – Grundrisse einer nachhaltigen und gerechten Finanzierung der Gesetzlichen Krankenversicherung / Health policy – outline for a sustainable and fair financing of Germany’s statutory," ORDO. Jahrbuch für die Ordnung von Wirtschaft und Gesellschaft, De Gruyter, vol. 61(1), pages 267-286, January.
    7. Laurence J. Kotlikoff, 2005. "Who’s Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," Working Papers id:286, eSocialSciences.
    8. Caravaggio, Nicola & Resce, Giuliano, 2023. "Enhancing Healthcare Cost Forecasting: A Machine Learning Model for Resource Allocation in Heterogeneous Regions," Economics & Statistics Discussion Papers esdp23090, University of Molise, Department of Economics.
    9. Borchardt, Katja & Farhauer, Oliver, 2003. "Kapitaldeckung als Antwort auf die demographische Herausforderung?," Discussion Papers 2003/6, Technische Universität Berlin, School of Economics and Management.
    10. Maciej Lis, 2016. "Age or time-to-death – what drives health care expenditures? Panel data evidence from the OECD countries," IBS Working Papers 04/2016, Instytut Badan Strukturalnych.
    11. Stefan Fetzer & Christian Hagist & Bernd Raffelhüschen, 2004. "Was bringen Bürgerversicherung und Gesundheitsprämie wirklich?," ifo Schnelldienst, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 57(15), pages 03-07, August.
    12. André Decoster & Xavier Flawinne & Pieter Vanleenhove, 2014. "Generational accounts for Belgium: fiscal sustainability at a glance," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 41(4), pages 663-686, November.
    13. Hagist, Christian & Fetzer, Stefan, 2004. "GMG, Kopfpauschalen und Bürgerversicherungen: Der aktuelle Reformstand und seine intergenerativen Verteilungswirkungen," Discussion Papers 114, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    14. Hagist, Christian & Raffelhüschen, Bernd & Weddige, Olaf, 2006. "Brandmelder der Zukunft: Die Generationenbilanz 2004," FZG Discussion Papers 12, University of Freiburg, Research Center for Generational Contracts (FZG).
    15. Christian Hagist & Laurence J. Kotlikoff, 2009. "Who’s going broke? Comparing growth in Public healthcare expenditure in Ten OECD Countries," Hacienda Pública Española / Review of Public Economics, IEF, vol. 188(1), pages 55-72, March.
    16. Christian Hagist & Laurence Kotlikoff, 2005. "Who's Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," NBER Working Papers 11833, National Bureau of Economic Research, Inc.
    17. Cristophe Borgmann & Pascal Krimmer & Bernd Raffelhüshen, 2001. "Rentenreformen 1998–2001: Eine (vorläufige) Bestandsaufnahme," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 2(3), pages 319-334, August.
    18. Maynou, L. & McGuire, A. & Serra-Sastre, V., 2019. "Exploring the Impact of New Medical Technology on Workforce Planning," Working Papers 19/07, Department of Economics, City University London.
    19. Marco Bassetto, 2009. "The Research Agenda: Marco Bassetto on the Quantitative Evaluation of Fiscal Policy Rules," EconomicDynamics Newsletter, Review of Economic Dynamics, vol. 10(2), April.
    20. Raffelhüschen, Bernd & Hagist, Christian & Moog, Stefan & Vatter, Johannes, 2009. "Ehrbare Staaten? Die deutsche Generationenbilanz im internationalen Vergleich," Argumente zur Marktwirtschaft und Politik 107, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.
    21. Raffelhüschen, Bernd & Seuffert, Stefan, 2020. "Ehrbarer Staat? Wege und Irrwege der Rentenpolitik im Lichte der Generationenbilanz," Argumente zur Marktwirtschaft und Politik 148, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:jns:jbstat:v:227:y:2007:i:5-6:p:603-620. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Peter Golla (email available below). General contact details of provider: https://www.degruyter.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.