Greater Efficiency through More Competition in the Health Care Sector?
Ingmar Kumpmann
WSI-Mitteilungen,
No. 4,
2012
Abstract
More competition among health insurers is often recommended as a means towards enhancing efficiency in the health care sector. In this paper the effects of competition among health insurers on costs and quality of medical services are discussed. It is argued that if insurers competed with each other, costs would not decrease - on the contrary, they would increase since competing organisations are less capable of counterbalancing the strong market position of health care providers than the state or a cartel of health insurers. In addition, competition may lead to a segmentation of the market: on the one hand insurers with low premiums who only offer access to rather unpopular physicians. On the other hand insurers who guarantee free choice of medical practitioners but have higher premiums. A restriction of the free choice of medical practitioners weakens competition among physicians for patients.
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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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