[Income reduction due to sickness benefits--when does sickness make you poor?].
OBJECTIVE
When absent from work due to sickness, most employees in Germany receive continued pay from their employer for six weeks. After this period, sick employees receive sickness benefits from their Statutory Sickness Fund. These sickness benefits are calculated in a rather complicated way as a percentage of gross and net salary. The paper focuses on two questions that have rarely been studied: which income groups show a particularly large difference between net salary and net sickness benefits? Which income groups move below the poverty line after receiving sickness benefits?


METHODS
We calculated how much sickness benefit is actually paid to the insured, for different income and tax groups. The definition for the poverty line is outlined as well. Due to methodological difficulties, the comparison between sickness benefits and poverty must be confined to single-person households.


RESULTS
In the income groups chosen here (gross salary up to 4000 Euro per month), net sickness benefits amount to about 77 % of net salary, for all insured. Financial problems can mainly be expected for the lower and the upper income groups. Expressed in absolute terms, the upper income groups experience a large reduction in net income. The lower income groups come close to the poverty line or fall below it.


CONCLUSIONS
Sickness benefits provide income in case of sickness; this is an important achievement of social policy. However, we should study the financial burden which sickness benefits could have for the insured. More in-depth analyses would require data that are not yet available (e. g. on the number of insured per income group and the income of other household members). The analyses presented here already show that sickness benefits could lead to severe financial problems for at least some insured. They point to the need for more studies in this neglected field.
Mielck
A
A
GSF, Forschungszentrum für Umwelt und Gesundheit, Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Neuherberg. mielck@gsf.de
Huber
C A
CA
D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005858:Germany / Q000453:epidemiology; D007182:Income; D019458:Insurance Coverage / Q000191:economics*; D008489:Medical Indigency / Q000191:economics*; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics*; D011203:Poverty / Q000191:economics; D012051:Reimbursement Mechanisms / Q000191:economics*; D018582:Sick Leave / Q000191:economics*; D018434:Sickness Impact Profile