(Health interests; 07-03; p.6)
So, employers will profit from the measures -
which is not astonishing, since that was one motivation for initiating
The government stays away from extra contributions - which as
well is explainable.
Private health insurances are profit oriented enterprises that
have to survive in the market. If they fail, they go bust - it
is up to the law maker to make sure that this will not work as
a disadvantage for public health insurances, e.g. in respect to
liability and balancing risk structures.
Patients have to make do with higher and more
extra payments, but they do get rights of information, e.g. to
inform themselves about spending patterns of their respective
The pharmaceutical industry has to give mandatory discounts and
will have to compete freely in the generic drugs market segment.
- According to Horst Seehofer, the respective losses for patients
and industry will be roughly equal (A statement given in a dispute
between him and B Rürup: Bayerischer Rundfunk, "Münchner
Runde" of 28/07/03.).
Doctors and hospitals will not suffer direct
losses, but establishing a payment system that is based on typical
case treatments rather than drugs prescribed and things done as
well as increased competition will foster "saving" behaviours.
A similar steering effect shall be brought about by limiting administrational
costs of public health insurances.
Employees eventually have to finance sickness
benefits alone in future times (currently, it is equally financed
by employers and employees). - Whether or not that will lead to
losses in real income depends on future wage and salary negotiations.
Reprising the classification by a hierarchy
of interests, one finds that up to now only private health insurances
have been let unhindered as cost increasers.
On the level of actors interested in cost cuts, so far weights
have been moved in favour of employers.
How overall costs of the health system will develop thereby remains
to be seen; however, by increased extra payments, transparency
in costs and competition all scientists and politicians involved
hope to achieve savings.
It has also to be said that the measures mentioned
cannot but have a short-term effect on costs of the health system.
In principle, a decision has to be made for one of the two branches
of the presented Y-model. - For several reasons, that should happen
"at best yesterday": every further slowdown increases
the problems, voters cannot as easily see the need for reforms
if the economic situation seemingly improves and politicians are
most capable to produce viable reforms as long as there are no
secure government majorities in parliament or party majorities
in the federal chamber, the Bundesrat.
(end of article)