Grenzen des Wettbewerbs im Gesundheitswesen
Ingmar Kumpmann
Sozialer Fortschritt,
2008
Abstract
Many health economists demand more competition in the health-care system. They focus on the competition between the individual health-insurance funds for those who want such insurance as well as on the competition between health-care providers for contracts with the health-insurance funds. However, they neglect the competition between health-care providers for patients; such competition is crucial for medical quality. This latter area of competition is in conflict with the two former ones. The empirical evidence on the effects of competition on cost and quality are also ambiguous. Thus, the mere appeal for „more competition“ does not do justice to the highly complex nature of the health-care system.
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Grenzen des Wettbewerbs im Gesundheitswesen
Ingmar Kumpmann
IWH Discussion Papers,
No. 1,
2008
Abstract
Many health economists demand more competition in the health care system. They focus on the competition between sickness funds for insured and the competition between health care providers for contracts with sickness funds. But they neglect the competition between health care providers for patients which is crucial for medical quality. This third field of competition is in conflict with the two former fields. The empirical evidence concerning the effects of competition on cost and quality is also ambiguous. Thus the mere claim for “more competition” does not do justice to the high complexity of the health care system.
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From University Town to Knowledge City: Strategies and Regulatory Hurdles in Germany
Peter Franz
Knowledge-Based Urban Development: Planning and Applications in the Information Era,
2008
Abstract
The trend of cities, serving as a location for universities and research institutes, to take into consideration new strategies utilizing this location factor for growth-oriented urban development can also be observed in Germany. An overview of the quantitative preconditions shows that many German cities dispose of favorite preconditions for such a knowledge city strategy. An analysis of the policy arena comes to the result that the political actors are confronted with the task of a complex multi-level-policy where networking skills become essential. A comparison with the policy conditions in the U.S. makes it quite clear that especially the German universities have the status of semi-autonomous actors complicating negotiating and coordinating activities between city and science representatives. First examples of deregulation show that these hurdles can be overcome in the future.
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Developing Collaborative Advantage: Preconditions and Restrictions for ‘Knowledge City’ Strategies in East Germany
Peter Franz
Institutions for Knowledge Generation and Knowledge Flows - Building Innovative Capabilities for Regions. Papers presented at the 10th Uddevalla Symposium 2007,
2007
Abstract
The trend of cities, serving as a location for universities and research institutes, to take into consideration new strategies utilizing this location factor for growth-oriented urban development can also be observed in Germany. An overview of the quantitative preconditions shows that many German cities dispose of favorite preconditions for such a knowledge city strategy. An analysis of the policy arena comes to the result that the political actors are confronted with the task of a complex multi-level-policy where networking skills become essential. A comparison with the policy conditions in the U.S. makes it quite clear that especially the German universities have the status of semi-autonomous actors complicating negotiating and coordinating activities between city and science representatives. First examples of deregulation show that these hurdles can be overcome in the future.
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The coalition treaty from a fiscal point of view
Kristina vanDeuverden
Wirtschaft im Wandel,
No. 12,
2005
Abstract
After weeks of negotiations the coalition finally agreed on the conditions for their political work. Not surprisingly, the coalition agreement is complex and intransparent – with a multitude of single measures far away from a precise definition. Quantifying the programme and estimating resulting cash flows is currently difficult; official calculations are – if at all – only partly available. Anyhow, the contract will form the basis for economic policy during the next four years; therefore its evaluation by now is indispensable. The thin red line of the agreement – not astonishingly when considering the precarious financial situation of the public sector – is consolidation. However, more than 80% of the consolidation volume results from the revenue side. Though one third of this is due to the cutback of tax exemptions, the lion’s share comes from raising tax rates, mainly the VAT standard rate. In contrast, cutting back public expenditure is minor and the agreement clearly comes short of the Koch/Steinbrück proposal; even new tax reliefs are created. The consolidation is almost completely borne by private households. Enterprises as a whole are barely hit. However, they have to wait until 2008 for a reform of company taxation – one of the most pressing problems in this legislative period. To reduce the companies tax burden until the reform starts the conditions for tax depreciation are temporarily relaxed. Anyway, from an international point of view the statutory tax rate is an important signal to enterprises deciding where to invest. Lowering effective tax rates by changing depreciation conditions is intransparent and, thus, will be less effective. Furthermore savings within the public sector are planned to accomplish consolidation; 10 billion Euro should result from efficiency gains and reduced expenditure. Consolidation measures mainly focus on the budget of the federal government. However, Länder and communities will participate in the additional tax revenues. In contrast, social securities will loose – and therefore also the share of employment that is subject to social insurance contribution. Particularly the unemployment insurance will be burdened by the decrease of its premium rate. Besides, the federal government will reduce its grants to the pension funds and most notably the health system. The contract is dominated by fiscal constraints. Cyclical requirements are considered only cursory and pressing structural reforms are put off. The reforms of company’s taxation, of fiscal federalism, of the health system as well as a proceeding reform of the labour market are only proposed. How and when measures in these fields are realised will determine whether fiscal policy can set a new course.
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Recent Developments and Risks in the Euro Area Banking Sector
Reint E. Gropp, Jukka M. Vesala
ECB Monthly Bulletin,
2002
Abstract
This article provides an overview of euro area banks’ exposure to risk and examines the effects of the cyclical downturn in 2001. It describes the extent to which euro area banks’ risk profile has changed as a result of recent structural developments, such as an increase in investment banking, mergers, securitisation and more sophisticated risk management techniques. The article stresses that the environment in which banks operated in 2001 was fairly complex due to the relatively weak economic performance of all major economies as well as the events of 11 September in the United States. It evaluates the effects of these adverse circumstances on banks’ stability and overall performance. The article provides bank balance sheet information as well as financial market prices, arguing that the latter may be useful when assessing the soundness of the banking sector in a forward-looking manner. It concludes with a review of the overall stability of euro area banks, pointing to robustness in the face of the adverse developments in 2001 and the somewhat improved forward-looking indicators of banks’ financial strength in early 2002.
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