(Health interests; 07-03; p.5)
Accordingly, profit interests of private health
insurances and the pharmaceutical industry function at any rate
as cost increasing factors within the health system, while the
profit interest of employers at any rate works as a cost decreasing
factor as well as that of employees at least in tendency.
Doctors and hospitals on the one hand have presumably a potential
interest in profits; on the other hand some other factors surely
have to be taken into account, namely a socially oriented attitude
in case of doctors choosing and pursuing this profession - catch
phrase: Hippocratic oath - and in case of hospitals their overwhelming
non-profit orientation - not even ten percent of all German hospital
beds are sited in private clinics (cf. Opielka).
The government eventually and the public health insurances do
have an interest in a financeable health system, but this does
not work as a separate cost increasing factor.
Patients cannot be ranked like this: on the
one hand they have an economic interest in low costs, on the other
hand one may presuppose an interest in high quality treatment
that demands its price.
Winners and losers
Regarding the changes agreed upon in the "Eckpunktepapier"
in their effect on actors mentioned, one can identify groups that
have to cope with losses and groups that profit. Thus, the following
modified figure emerges:
actors |
measures |
losses |
employers |
|
|
employees |
financing sickness benefits alone |
x |
government |
|
|
patients |
more extra payments, but right of transparency |
x |
doctors, hospitals |
case based payment, mandatory further qualification,
competition |
x |
public insurances |
limitation of administrational costs above
average |
x |
private insurances |
|
|
pharmaceutical industry |
mandatory discounts, no administered prices
for generic drugs |
x |
(read on here)