Folgen des Wettbewerbs zwischen Krankenversicherungen für die Kosten im Gesundheitswesen
Ingmar Kumpmann
Gesundheitspolitik, Wettbewerb und Gesundheitssystemforschung. DIBOGS-Beiträge zur Gesundheitsökonomie und Sozialpolitik Bd. 3,
2009
Abstract
In this study it is argued that competition among health insurers can bring about higher costs in the health care sector. Medical services are inhomogeneous goods; thus the competition between physicians can be modeled by Chamberlins concept of monopolistic competition. The physicians have a strong bargaining power face to face a multitude of competing health insurers acting as purchasers of health care services. The costs can be lower if the physicians’ strong position is compensated by a monopolistic health insurer. Two case studies show the applicability of the argument. A regression analysis confirms the correlation between (public) monopolistic health insurer and lower costs in the health care sector.
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The Standing of the East German Cities within the German System of Cities: An Interim Review on the Basis of Economic Indicators 20 Years after the German Unification
Peter Franz
Wirtschaft im Wandel,
20 Jahre Deutsche Einheit - Teil 1 -
2009
Abstract
The hopes of the East German citizens coupled with the unification in 1990 were not only directed to their personal fortune, but also concerned the amelioration of the living conditions in their cities. Twenty years after this date, we can strike an interim balance how far these hopes have been become true. For this purpose, the thirteen largest East German cities (without Berlin) are compared to cities of similar size in three West German regions (South, North, Center represented by North Rhine/Westphalia). The indicators chosen rely to the cities’ economic and fiscal conditions. The indicators paint a differentiated picture: The average income per capita in the East German cities is still lower than in the West German cities and unemployment rates are still above the West German level. With respect to future growth potential, the East German cities show a relatively good endowment with qualified human capital, with public universities and research institutions. In contrast to that, the small size of the firms and the small number of firm headquarters are unfavourable for a dynamic growth in the future. Another persistent difference between East and West is the low level of public revenues, which keeps the East German cities dependent on Federal grants. The city officials were successful in cutting payroll costs and reducing the number of civil servants. In spite of the diverse depicted economic problems still to be solved, the East German cities over the years have shown impressive endurance in catching-up.
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German Economy Drawn into the World Recession
Wirtschaft im Wandel,
1. Sonderausgabe
2009
Abstract
In spring 2009, the world economy is in a deep recession. The intensification of the financial crisis in autumn has caused a sharp contraction of demand. The reaction of monetary and fiscal policy was substantial, but up to now (April 2009), it has not succeeded in restoring confidence of economic agents. Although some leading indicators point to a stabilization of production in the coming quarters, the downturn will not come to an end before next winter, because the financial crisis will continue to put strain on the real economy for some time to come.
The German economy is in its deepest recession since the foundation of the Federal Republic. Germany is particularly affected, because at the core of the economy is the production of those goods for that world demand has collapsed most: capital goods and high-quality consumer durables. While exports and private investment activity will continue to shrink this year (albeit at a slower rate), private consumption will be a stabilizing factor for some time, as will public investment activity in the second half of the year. Later in 2009 and in 2010, rising unemployment will depress consumption, while in this forecast, it is assumed that exports and investment slowly recover in 2010, because the financial turmoil will calm down.
For economic policy, a recapitalization of the banking sector should have priority. The ECB should lower its key interest rate to 0.5%. Given the sharply increasing fiscal deficits, a new, third fiscal program would be counterproductive. Only if monetary policy fails to stabilize the economy, further fiscal measures, coordinated at a European level, should be considered.
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Shadow Budgets, Fiscal Illusion and Municipal Spending: The Case of Germany
Peter Haug
IWH Discussion Papers,
No. 9,
2009
Abstract
The paper investigates the existence of fiscal illusion in German municipalities with special focus on the revenues from local public enterprises. These shadow budgets tend to increase the misperception of municipal tax prices and seem to have been neglected in the literature. Therefore, an aggregated expenditure function has been estimated for all German independent cities applying an “integrated budget” approach, which means
that revenues and expenditures of the core budget and the local public enterprises are combined to one single municipal budget. The estimation results suggest that a higher relative share of local public enterprise revenues might increase total per capita spending as well as spending for non-obligatory municipal goods and services. Empirical evidence for other sources of fiscal illusion is mixed but some indications for debt illusion, renter illusion or the flypaper effect could be found.
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Business Cycle Forecast 2009: World Financial Crisis Triggers Deep Recession in Germany
Wirtschaft im Wandel,
No. 1,
2009
Abstract
At the beginning of 2009, the major industrialized economies are in recession. The financial turmoil has developed into a crisis of confidence to and solvency of the financial sector, raising financing costs and lowering the value of assets for firms and households. Monetary and fiscal policies have reacted strongly, but they will not succeed in ending the recession until the financial sectors in the US and in Western Europe have stabilized. This forecast is made under the assumption that stabilization will start in the second half of 2009 because the continued protection of important financial institutions by governments will restore confidence – albeit at a low level – and because at this time, the fall of US-house prices will start to fade off.
The German economy is hit particularly hard, because the financial crisis depresses worldwide investment demand and the sectors producing investment goods are at the heart of the German economy. The recession will not end before the second half of 2009, and capacity utilization will decrease throughout the year. We expect a tentative revival to begin in a recovery of exports. While private investment will shrink markedly, consumption of private households and the government as well as public investment will dampen the downturn. GDP will shrink by 1.9% in Germany and in East Germany by 1.5% because this region is less dependent on exports.
Economic policy has to help restoring confidence, and this can only be achieved if it behaves in a consistent and predictable way.
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Business Cycle Forecast, Summer 2008: Price Hikes and Financial Crisis Cloud Growth Prospects
Wirtschaft im Wandel,
No. 7,
2008
Abstract
In the summer of 2008 the turmoil on financial markets and that on the markets for energy dim the prospects for the world economy. The acceleration of the oil price hike during the first half of the year has led to an increase in expected inflation and to higher interest rates on capital markets, while stock prices are going down. At the same time, the financial crisis is far from over, and banks in the US and in Western Europe continue in their efforts to consolidate their balance sheets. Thus, the expansion of credit supply will be scarcer in the next quarters. All this means that demand will slow in the developed economies during the next quarters. However, the massive fiscal stimulus will help the US economy to stabilize, and the world economy still benefits from the high growth dynamics in the emerging markets economies. All in all, the developed economies will not reach their potential growth rate before the second half of 2009. In Germany, the upswing comes to a temporary halt during summer of this year. Slowing foreign demand and the oil price hike induce firms to postpone investments, and private consumption, the soft spot of the upswing in Germany, is still sluggish due to high inflation rates that impair purchasing power. For the end of 2008, chances are good that growth in Germany accelerates again, because German exporters are still penetrating emerging markets as competitiveness does not diminish. All in all, the German economy will grow by 2.3% in 2008 (mainly due to the very high dynamics at the beginning of the year) and by 1.3% in 2009. A main risk of this forecast is that monetary policy fails in easing the high inflationary pressures. As to fiscal policy, efforts to reach sustainable public finances should not weaken.
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On the Economics of Ex-Post Transfers in a Federal State: A Mechanism Design Approach
Martin Altemeyer-Bartscher, T. Kuhn
WWDP, 95,
No. 95,
2008
Abstract
As a common feature in many federal states grants-in aid are payed to jurisdictions ex post, i.e. after local policy measures have chosen. We show that the central government cannot offer grants ex ante in a federal states with informational asymmetries as well as inter-temporal commitment problems. Local governments’ incentives to provide public goods are distorted if they rely on federal grants-in-aid offered ex post. Furthermore it becomes obvious that local governments are apt to substitute tax revenue for higher grants-in-aid if relevant local data are unobservable for the central government. To which extend ex post transfers mitigate local governments’ incentives crucially depends on the information structure predominant in the federation.
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The German Upswing Takes a Break
Wirtschaft im Wandel,
2. Sonderausgabe
2007
Abstract
The world economy continues to expand healthily, but risks have increased during summer. The crisis of the housing sector in the US has deepened: A revaluation of mortgage backed assets has triggered turbulences on global financial markets. The institutes expect that financial markets will calm down during the coming months, but that the downswing in the US will slow the pace of the world economy. The economy in the euro area will, in addition, be dampened by the appreciation of the euro. The German economy is, in spite of a restrictive fiscal policy, in a robust upswing. Because wage setting and inflation continues to be moderate, there will be no need for a restrictive monetary policy. Thus the German economy will, due to slower demand from the US and higher costs of financing, lose momentum, but chances are good that the upswing will only take a break. In the coming year private consumption is expected to be the main contributor to growth, because wage incomes will expand strongly. Unemployment will continue to shrink, albeit at a smaller rate than during 2007. Fiscal policy will no longer be restrictive. Economic policy has improved the conditions for growth in Germany; there is, however, still much to do. Public finances have to be consolidated further, but at the same time, public investment has to be strengthened. This can be achieved if public consumptive expenditure growth is limited. The institutes suggest to increase public expenditure by 2% per annum over the cycle in nominal terms; this is, by less than by the trend growth rate of nominal GDP.
The institutes advise against a reversal of the recent labour market reforms. Instead, incentives for taking up jobs should be increased further.
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East German Economy: Demand Push Stronger than Structural Deficiencies
Wirtschaft im Wandel,
No. 7,
2007
Abstract
In 2006, growth of production was surprisingly strong in Eastern Germany. The structural deficiencies there would have suggested a slower pace. In particular, linkages with national and international business cycles have been underestimated. To a large part, the reason why output grew by 3 per cent did not come from Eastern Germany itself, but from the Old Länder and from abroad. In the New Länder, the strong upward swing in investment activity stimulated the economy. However, owing to a small increase in total income of private households, their purchasing power lagged behind.
The improved ability of East German firms to absorb cyclical impulses from exports and from Germany’s general investment activity proved to be a crucial factor. In particular, the endowment of workplaces with modern production facilities as well as the continued reduction in the disadvantages with respect to cost-competitiveness in the tradable goods sector were beneficial. The labour cost advantage compared to West German competitors increased further while the disadvantage compared to those from Central and Eastern Europe decreased.
Benefiting from these factors, economic activity in Eastern Germany will grow faster than in the Old Länder as long as the upswing in Germany and abroad remains strong. In 2007 and 2008, investments – especially in equipment – and exports will be the driving forces again. For exports, the strongly expanding markets in Central and Eastern Europe as well as in Russia will gain in importance. As income and employment prospects improve, private consumption will support the growth in production. Registered unemployment should decrease below the 1-million threshold.
Manufacturing will remain the primary force of the upswing; its advantages in production costs will not vanish as long as, even in presence of scarcity of skilled labour, salaries and wages do not increase more than in Western Germany. In the wake of robust economic growth, the New Länder will make further progress in catching up with respect to production and income.
Companies will regain support from the banking industry. Yet, investment capital still stems from public funding programmes to a non-negligible extent. In the medium run, access to credit will ease as a result of further improvements in the firms’ net worth position. However, dependency on internal funds remains high and exposes companies to comparatively strong cyclical risks. In an economic downturn, the structural deficiencies of the East German economy will impair economic expansion.
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Declining population and rising costs for municipal services
Peter Haug
Wirtschaft im Wandel,
No. 11,
2004
Abstract
Population decrease in many East-German towns and municipalities does not only increase the stock of empty residential buildings. It also makes provision of network-related goods and services more costly. Considering public water and sewerage services as example, the article investigates empirically how costs of provision per inhabitant depend on population number and -density. Diverging from similar studies, spatial differences in distribution costs per inhabitant are calculated within the area of a case study municipality. The calculations are based on cost accounting data of the local provider. A central problem is the choice of an appropriate spatial key figure to allocate costs. The results indicate cost advantages in providing densely populated quarters with network-related services. Consequently, rising per-capita costs should be taken into account to a greater extent for the city conversion programmes in East Germany than they have been up to now.
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