ZEW - Centre for European Economic Research

01/12/2024 | Press release | Distributed by Public on 01/12/2024 04:43

Cost-Sharing Reduces Unnecessary Surgeries // ZEW Economist Nicolas Ziebarth on Statutory Health Insurance Reform

ZEW Economist Nicolas Ziebarth on Statutory Health Insurance Reform

Nicolas Ziebarth comments on the statutory health insurance reform by Minister Lauterbach.

Due to annual budget shortfalls amounting to billions, German Health Minister Karl Lauterbach aims to cut costs within the statutory health insurance. This includes reducing administrative costs but also eliminating services that lack demonstrable medical benefits. Nicolas Ziebarth, head of the "Labour Markets and Social Insurance" Unit at ZEW Mannheim and professor at the University of Mannheim, has commented on that matter:

"The reforms initiated by Minister Lauterbach are largely to be welcomed and point in the right direction. However, the ban on reimbursement of homeopathic services is, in my view, purely symbolic, restricts choices for the insured, and saves only little money. Moreover, alternative medicine provides a subjective high benefit to a relevant portion of the insured. Those who do not want to contribute to this should choose an insurer that does not reimburse such services.

At the same time, the minister's planned measures will not be sufficient to prevent future increases in contribution rates. Given the economic situation, however, it is imperative that the contribution rates for statutory health insurance do not rise further. Otherwise, available labour incomes would decrease, and employers' expenses for personnel would rise further. This would reduce the incentive to work or create jobs.

In international comparison, Germany has very high health expenditures with mediocre results, especially in the coordination of health services. Internationally common models where patients must always consult a general practitioner first could lead to improvements in treatment quality at lower costs. The right to choose a specialist directly should be maintained, but at higher contribution rates.

Higher co-payments are a market-based instrument to reduce unnecessary surgical interventions. For example, the majority of back surgeries are proven to be unnecessary and often harmful to patients. Such surgical treatments are also very expensive for contributors. At the same time, it is scientifically proven that higher co-payments reduce the use of such services. It is therefore Minister Lauterbach's duty to advocate for selective and transparent cost-sharing by patients in order to reduce the number of unnecessary and costly surgeries."