It seems to have gone a bit quiet in health policy, even if the “flare” a shift in the health fund in recent weeks in part, the reform debate has re-let are aware, are but there must be stated that health policy by the end of term and possibly beyond will probably not do much. This seems particularly surprising, especially since the health care system was still in short as fundamentally reformed.Should now be found with the SHI Competition Strengthening Act a workaround?
The contributions of the WSG are very numerous, and in this context is the following, the focus is placed on the fundamental issues of reform debate, the answer is so far not succeeded, despite some points of contact. Based on three fundamental issues of health care reform can be sketched out the problem areas.
The first question
Is aimed at the health system on the definition of a minimum supply Solidary. On the one hand to ensure a health care system, to maintain or restore the health of citizens. This is the primary task of the medical care provider. Be ensured on the other side must have the financial protection in health and care must be taken to ensure that these funds will be distributed to providers so that they can perform their tasks. Every health system has to solve so the tension, as on the one hand an adequate medical care are guaranteed, but without overwhelming the other hand, the economy with the demands of the healthcare system.
With the expansion of medical services associated increase in health spending leads to more and more other funds, also socially desirable areas such as education, culture, internal and external security be withdrawn. For this reason also no maximum in the health care possible, but each company must meet to decide how much resources as necessary for health services should be spent. From an economic point of view while the potential benefits outweigh the costs increase with the growth is crucial. A viable model for reform therefore needs an underlying model. This should settle the question of who decides within a society about what demand actually exists, what services are needed and how they perform and what innovations are actually carried out. The answer to these questions depends on what control mechanism is subject to the health care system, ie should be the role of individual citizens in the future.
Only if the citizens know the actual load and favoring the effects discussed financing systems, they can influence the development of SHI in a rational manner. It is therefore desirable that the policy sets out to increase the transparency of funding, so even if the currently prevailing “screws economy” should be abandoned. This premium models have the advantage on the one hand, that is with them a substantial decoupling of the contributions from wage income. On the other hand, increases the transparency and the financing of the SHI is more consistent with the different forms of financial responsibility of the patient must be brought. The specific design of the premium models, besides the economic rationality always a question of social acceptance. Nevertheless, it is important that the necessary competition for the alignment of risk premiums – whether in the form of upstream competition or premiums in the design of subsequent risk compensation mechanisms – are largely organized uniformly and without discrimination must. Forms of reduced premiums, for example through tax subsidies, are a viable option, but who makes the determination of the extent and development of the performance guarantee normally required.