title: Risk structure compensation in Germany's statutory health insurance.
abstract: In 1996 insurees in Germany's statutory health insurance system were given a right to choose their sickness fund. To ensure that all funds had an equal starting position, a risk structure compensation scheme based on income and average expenditure by age and sex was introduced. From an analysis of expenditure and transfers, data on sickness fund membership and a published survey, the following effects can be identified: sickness funds merged, with a reduction in number from 1,221 to 420 between 1993 and 2000; the risk compensation scheme narrowed differences in contribution rates; insurees left the more expensive funds for cheaper ones; and increasing transfer sums indicate further risk segregation. Thus, the compensation mechanism will have to be retained permanently, although modifications are likely.
authors: European Observatory on Health Care Systems, Madrid Hub, c/o Escuela Nacional de Sanidad, Sinesio Delgado 8, 28029 Madrid, Spain. rbusse@isciii.es
authors: R
authors: R
authors: Busse
mesh_terms: D002755:Choice Behavior; D017281:Cost of Illness; D005858:Germany; D005102:Health Expenditures; D006801:Humans; D007182:Income; D015271:Insurance Pools / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D020379:Risk Adjustment / Q000191:economics*