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Was spricht gegen Zwei-Klassen-Medizin?

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  • Breyer Friedrich

    (Universität Konstanz, FB Wirtschaftswissenschaften, Postfach 135, 78457 KonstanzGermany, Tel.: (07531) 88–2568)

Abstract

In Germany, there is a lively debate on a so-called „two-class-medicine“, meaning that privately insured persons get better medical treatment than sickness fund members. As an economist, the author is not in a position to judge whether this is true. However, the co-existence of social and private health insurance (GKV and PKV) constitutes a „two-class-health insurance“, which leads to severe inequities in the distribution of the financial burden of illness. In this article it is shown that there are legal ways to address and eliminate these inequities without abolishing the private health insurance system altogether. The instruments are the inclusion of private health insurance in the risk adjustment scheme of the sickness funds and the transformation of the GKV contributions into flat per-person amounts, independent of earnings, accompanied by a tax-financed compensation for families with below-average income, as in Switzerland and the Netherlands. Interestingly, this second reform proposal has been vigorously opposed by all leftist parties ever since, who fight for the chimaera of a „people's insurance“, which sounds good but cannot be implemented in a legal way and, moreover, would not even eliminate „two-class-medicine“.

Suggested Citation

  • Breyer Friedrich, 2018. "Was spricht gegen Zwei-Klassen-Medizin?," Zeitschrift für Wirtschaftspolitik, De Gruyter, vol. 67(1), pages 30-41, May.
  • Handle: RePEc:lus:zwipol:v:67:y:2018:i:1:p:30-41:n:5
    DOI: 10.1515/zfwp-2018-0005
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    References listed on IDEAS

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    1. Hendrik Schmitz & Nicolas R. Ziebarth, 2017. "Does Price Framing Affect the Consumer Price Sensitivity of Health Plan Choice?," Journal of Human Resources, University of Wisconsin Press, vol. 52(1), pages 88-127.
    2. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536, Elsevier.
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    1. Bofinger, Peter & Feld, Lars P. & Schmidt, Christoph M. & Schnabel, Isabel & Wieland, Volker, 2018. "Vor wichtigen wirtschaftspolitischen Weichenstellungen. Jahresgutachten 2018/19 [Setting the Right Course for Economic Policy. Annual Report 2018/19]," Annual Economic Reports / Jahresgutachten, German Council of Economic Experts / Sachverständigenrat zur Begutachtung der gesamtwirtschaftlichen Entwicklung, volume 127, number 201819, February.

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