Adverse selection in the German Health Insurance System - the case of civil servants
Copyright © 2020 Elsevier B.V. All rights reserved..
At the beginning of their career, civil servants in Germany can choose between the social health insurance (SHI) system and a private plan combined with a direct reimbursement of the government of up to 70 percent. Most civil servants chose the latter, not only but also because they have to cover all contributions in the social system themselves, while regular employees get nearly 50 percent from their employers. The city state of Hamburg decided to change the system by paying half of the contributions if civil servants choose the social plan. We use a stochastic microsimulation model to analyse which socio-economic types of civil servants could benefit from the Hamburg plan and if this changes the mix of insured persons in the SHI system. Our results show that low income and high morbidity types as well as families have a substantially higher incentive to choose SHI. This reform might thereby increase the adverse selection of high risk cases towards SHI.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:124 |
|---|---|
| Enthalten in: |
Health policy (Amsterdam, Netherlands) - 124(2020), 8 vom: 24. Aug., Seite 888-894 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bührer, Christian [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adverse selection |
|---|
| Anmerkungen: |
Date Completed 28.07.2021 Date Revised 28.07.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.healthpol.2020.04.006 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM311787320 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM311787320 | ||
| 003 | DE-627 | ||
| 005 | 20231225143014.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.healthpol.2020.04.006 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1039.xml |
| 035 | |a (DE-627)NLM311787320 | ||
| 035 | |a (NLM)32600664 | ||
| 035 | |a (PII)S0168-8510(20)30091-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bührer, Christian |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Adverse selection in the German Health Insurance System - the case of civil servants |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.07.2021 | ||
| 500 | |a Date Revised 28.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier B.V. All rights reserved. | ||
| 520 | |a At the beginning of their career, civil servants in Germany can choose between the social health insurance (SHI) system and a private plan combined with a direct reimbursement of the government of up to 70 percent. Most civil servants chose the latter, not only but also because they have to cover all contributions in the social system themselves, while regular employees get nearly 50 percent from their employers. The city state of Hamburg decided to change the system by paying half of the contributions if civil servants choose the social plan. We use a stochastic microsimulation model to analyse which socio-economic types of civil servants could benefit from the Hamburg plan and if this changes the mix of insured persons in the SHI system. Our results show that low income and high morbidity types as well as families have a substantially higher incentive to choose SHI. This reform might thereby increase the adverse selection of high risk cases towards SHI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adverse selection | |
| 650 | 4 | |a Civil servants | |
| 650 | 4 | |a Health insurance | |
| 650 | 4 | |a Microsimulation | |
| 700 | 1 | |a Fetzer, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Hagist, Christian |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Health policy (Amsterdam, Netherlands) |d 1984 |g 124(2020), 8 vom: 24. Aug., Seite 888-894 |w (DE-627)NLM083840788 |x 1872-6054 |7 nnns |
| 773 | 1 | 8 | |g volume:124 |g year:2020 |g number:8 |g day:24 |g month:08 |g pages:888-894 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.healthpol.2020.04.006 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 124 |j 2020 |e 8 |b 24 |c 08 |h 888-894 | ||