Academic literature on the topic 'Insurance (Sickness), Germany'
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Journal articles on the topic "Insurance (Sickness), Germany"
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Hoffman, Beatrix. "Scientific Racism, Insurance, and Opposition to the Welfare State: Frederick L. Hoffman's Transatlantic Journey." Journal of the Gilded Age and Progressive Era 2, no. 2 (April 2003): 150–90. http://dx.doi.org/10.1017/s1537781400002450.
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Frederick Ludwig Hoffman, statistician and insurance executive, was a formidable opponent of the emerging welfare state during the Progressive Era. As a vice president of the Prudential Insurance Company of Newark, New Jersey, Hoffman led a relentless campaign against proposals for government-ran compulsory health insurance between 1915 and 1920. While he acted in the interests of his insurance company employer, Hoffman's opposition also arose from his ardent beliefs about the nature of welfare states. Social insurance and other forms of state-organized assistance, Hoffman claimed, represented “alien governmental theories” based on “paternalism and coercion,” especially since they originated in autocratic Germany, where in 1885 Chancellor Otto von Bismarck had created the world's first sickness insurance system. “In so far as our right to oppose compulsory health insurance is concerned,” explained Hoffman, “it [is] the duty of every American to oppose German ideas of government control and state socialism.” In the anti-German atmosphere engendered by the First World War, his arguments had particular resonance.
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Glazer, Jacob, and Thomas G. McGuire. "Contending with Risk Selection in Health Insurance Markets in Germany." Perspektiven der Wirtschaftspolitik 7, Supplement (May 2006): 75–91. http://dx.doi.org/10.1111/j.1465-6493.2006.00217.x.
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Abstract In many countries, competition among health plans or sickness funds raises issues of risk selection. Funds may discourage or encourage potential enrollees from joining, and these actions may have efficiency or fairness implications. This article reviews the experience in the U.S., and comments on the evidence for risk selection in Germany. There is little evidence that risk selection causes efficiency problems in Germany, but risk selection does lead to an inequality in contribution rates. A simple approach to equalizing contribution rates that does not involve risk adjustment is presented and discussed.
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Breyer, Friedrich. "Was spricht gegen Zwei-Klassen-Medizin?" Zeitschrift für Wirtschaftspolitik 67, no. 1 (May 1, 2018): 30–41. http://dx.doi.org/10.1515/zfwp-2018-0005.
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Abstract: In Germany, there is a lively debate on a so-called „two-class-medicine“, meaning that privately insured persons get better medical treatment than sickness fund members. As an economist, the author is not in a position to judge whether this is true. However, the co-existence of social and private health insurance (GKV and PKV) constitutes a „two-class-health insurance“, which leads to severe inequities in the distribution of the financial burden of illness. In this article it is shown that there are legal ways to address and eliminate these inequities without abolishing the private health insurance system altogether. The instruments are the inclusion of private health insurance in the risk adjustment scheme of the sickness funds and the transformation of the GKV contributions into flat per-person amounts, independent of earnings, accompanied by a tax-financed compensation for families with below-average income, as in Switzerland and the Netherlands. Interestingly, this second reform proposal has been vigorously opposed by all leftist parties ever since, who fight for the chimaera of a „people's insurance“, which sounds good but cannot be implemented in a legal way and, moreover, would not even eliminate „two-class-medicine“.
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Angelin, Anna, Håkan Johansson, and Max Koch. "Patterns of institutional change in minimum income protection in Sweden and Germany." Journal of International and Comparative Social Policy 30, no. 2 (June 2014): 165–79. http://dx.doi.org/10.1080/21699763.2014.937584.
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Germany is generally regarded as a case of qualitative “change” in minimum income protection (MIP) schemes, while Sweden is perceived as one of institutional “inertia”. This paper seeks to qualify this view by embedding developments in MIP in wider policy and governance trends. Empirically, it is based on document analysis and qualitative expert interviews in the two countries. Theoretically, the paper applies recent institutional approaches that address patterns of change in more complex ways. In Sweden, an exclusive focus on formal continuity regarding social assistance would disguise its change in function from temporary security system of last resort into one that permanently provides income protection when neighboring policy fields, unemployment and sickness insurance, are downsized. Conversely, in Germany a merger of social assistance and unemployment assistance took place. Yet an exclusive focus on the Hartz reforms would downplay the degree of continuity that nevertheless exists in the unemployment insurance.
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Georgiadou, Elena, Lena Fanter, Alina Brandes, Boris Ratsch, Heiko Friedel, and Axel Dignass. "Perianal fistulas in adult patients with Crohn’s disease in Germany – a retrospective cross-sectional analysis of claims data from German sickness funds." Zeitschrift für Gastroenterologie 57, no. 05 (March 14, 2019): 574–83. http://dx.doi.org/10.1055/a-0857-0778.
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Abstract Introduction Perianal fistulas (PF) are presumably a frequent extraintestinal manifestation of Crohn’s disease (CD), causing significant functional impairment. This study aims to gain representative data on the prevalence, characteristics, and treatment of CD patients suffering from PF in Germany. Materials and methods A retrospective cross-sectional analysis of claims data from several German company health insurance funds included adult patients with CD and PF in 2015. The dataset comprised in- and outpatient services with diagnoses, drug prescriptions, and other patient data. It is representative for age, gender, and region and allows extrapolation to the total German statutory health insurance (SHI) population. A systematic literature review was conducted to discuss these results in the international context. Results A CD prevalence of 299 per 100 000 and a PF prevalence in CD patients of 3.4 % was observed in this cross-sectional study. PF are most prevalent in young age groups (< 24 to 39). One-third of patients with PF received biologics and surgery. Surgical procedures were performed in 31.3 % of PF patients in the inpatient setting and in 4.4 % of PF patients in the outpatient setting. All complicated perianal fistula patients received at least 1 inpatient surgery and 44.8 % received biologic therapy. Discussion This claims data analysis in German patients estimates a CD prevalence in the SHI population that corresponds well to previously reported data. The prevalence rate for PF in CD patients is comparable with a previous cross-sectional German claims data analysis but is markedly lower than cumulative risks reported in longitudinal cohort studies. PF patients are young and treatment intensive with one-third requiring biologic treatment or inpatient surgery.
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Hünert, Matthias. "Rechtliche Bewältigung der Haftung für Massenschäden im Deutschen Recht." European Review of Private Law 7, Issue 4 (December 1, 1999): 459–80. http://dx.doi.org/10.54648/256438.
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The law on civil liability and civil procedure in force in Germany are in general designed to deal with the compensation of individual harm, and may not deal so adequately with mass torts. Because of this in many areas a corresponding reform of or addition to the legal rules is required. The law on civil liability is primarily called upon to provide the basis for an appropriate compensation for damage. A failure to satisfy this function should not therefore be accepted. Nor is this fundamental mission affected by the fact that the compensation for damage, which is determined by the rules of civil liability, in many areas intersects with systems for collective insurance and collecting measures for dealing with damage, such as for example liability, sickness and social insurance; for even in these cases as soon as one deals with the subrogated claim against the defendant, reference is made to the normal rules of civil liability, so that these must contain rules appropriate to mass torts.
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Polikowski, Marc, and Brigitte Santos-Eggimann. "How comprehensive are the basic packages of health services? An international comparison of six health insurance systems." Journal of Health Services Research & Policy 7, no. 3 (July 1, 2002): 133–42. http://dx.doi.org/10.1258/135581902760082436.
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Objectives: Interest in the composition of the health care menu has grown. Its outwardly comprehensive nature is as rhetorical as the slogans of universal access and affordability. This paper summarizes the international part of a report to the Swiss government, in which we explored the basic package of services covered by social health insurance in France, Germany, Israel, Luxembourg, The Netherlands and Switzerland. The aim of the initial report was to check the appropriateness of the Swiss catalogue, with special attention to the risk of unequal access to health care by rationing of effective services. In this paper, we highlight the major differences in service coverage between the countries and address the possible factors explaining those differences. Methods: The contents of the basic packages of the six countries were compared using data from government ministries and sickness funds. Results: Coverage is most comprehensive in Germany and Switzerland; these are also the countries with the greatest total health expenditure. Three countries separated nursing care from other types of health care by creating an independent insurance scheme. Some health care benefits are also covered under the heading of social care. High out-of-pocket payments are increasingly used as hidden rationing instruments. Conclusions: The present comparison highlights the multi-factorial character of the choices made in six countries in order to keep their health care menu within the possibilities offered by available resources.
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Ghiani, Marco, Evi Zhuleku, Anja Dillenseger, Ulf Maywald, Andreas Fuchs, Thomas Wilke, and Tjalf Ziemssen. "Data Resource Profile: The Multiple Sclerosis Documentation System 3D and AOK PLUS Linked Database (MSDS-AOK PLUS)." Journal of Clinical Medicine 12, no. 4 (February 10, 2023): 1441. http://dx.doi.org/10.3390/jcm12041441.
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Real-world evidence in multiple sclerosis (MS) is limited by the availability of data elements in individual real-world datasets. We introduce a novel, growing database which links administrative claims and medical records from an MS patient management system, allowing for the complete capture of patient profiles. Using the AOK PLUS sickness fund and the Multiple Sclerosis Documentation System MSDS3D from the Center of Clinical Neuroscience (ZKN) in Germany, a linked MS-specific database was developed (MSDS-AOK PLUS). Patients treated at ZKN and insured by AOK PLUS were recruited and asked for informed consent. For linkage, insurance IDs were mapped to registry IDs. After the deletion of insurance IDs, an anonymized dataset was provided to a university-affiliate, IPAM e.V., for further research applications. The dataset combines a complete record of patient diagnoses, treatment, healthcare resource use, and costs (AOK PLUS), with detailed clinical parameters including functional performance and patient-reported outcomes (MSDS3D). The dataset currently captures 500 patients; however, is actively expanding. To demonstrate its potential, we present a use case describing characteristics, treatment, resource use, and costs of a patient subsample. By linking administrative claims to clinical information in medical charts, the novel MSDS-AOK PLUS database can increase the quality and scope of real-world studies in MS.
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Mueller, S., M. Khalid, H. Patel, T. Wilke, and A. Dittmar. "P662 A retrospective claims analysis on the prevalence and incidence of ulcerative colitis in Germany and the frequency of advanced therapy use." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S587—S588. http://dx.doi.org/10.1093/ecco-jcc/jjab076.782.
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Abstract Background Ulcerative colitis (UC) is a chronic inflammatory bowel disease that requires continuous medical treatment. Current epidemiological data about UC in Germany are lacking, and in particular, it is unknown how many patients are treated with advanced therapies. This study aimed to investigate the prevalence and incidence of UC in Germany and describe the frequency of advanced therapy use in this population. Methods We used claims data from a regional German sickness fund (AOK PLUS). Continuously insured persons from 01/01/2015 until 31/12/2019 or death with at least 2 outpatient diagnoses documented by a specialist in 2 quarters within 12 months or one inpatient diagnosis (ICD-10: K51.-) were defined to be UC prevalent. Patients were defined to be incident in 2019 if the respective selection criteria could be observed in 2019, but no UC diagnosis was documented in the previous 4 years. Age- and gender-standardized point prevalence was calculated on 01/01/2019, cumulative incidence was evaluated for the year 2019. Standardization was based on the age/gender distribution within the entire population of the German statutory insurance (KM-6 statistic), which covers about 90% of the whole German population. Main characteristics and comorbidity status were assessed at the index date based on diagnoses documented in the 12-month pre-index period (index: 01/01/2019 or date of incident diagnosis in 2019). The proportion of prevalent patients receiving advanced therapies (infliximab, adalimumab, golimumab, vedolizumab, tofacitinib) was evaluated in 2019, considering both out- and inpatient treatments. Results The standardized incidence in 2019 was 0.36 cases/1,000 persons. Incident patients were, on average, 59.7 years old (SD: 21.6; 95% CI: 58.2–61.1), and 56.1% were females. The mean Charlson Comorbidity Index (CCI) was 2.7 (SD: 3.1; 95% CI: 2.5–2.9). The standardized prevalence at 01/01/2019 was 5.29 cases/1,000 persons. In 2019, 12,736 prevalent patients were observed (12,510.8 person-years), with 56.2% of the patients being female. The mean age was 60.6 years (SD: 18.8; 95% CI: 60.2–60.9), and the mean CCI was 2.3 (SD: 2.8; 95% CI: 2.2–2.3). 827 patients (6.5%) were treated with advanced therapy in 2019. These patients were considerably younger (44.9 (95% CI: 43.9–46.0) versus 61.7 years (95% CI: 61.3–62.0)) and less comorbid (CCI: 1.2 (95% CI: 1.0–1.3) vs. 2.4 (95% CI: 2.3–2.4)) than patients who have not been treated with an advanced therapy. Conclusion Our analysis showed a considerable UC incidence and a high disease burden in Germany, with a prevalence surpassing 0.5%. Advanced therapies were prescribed only in a minority of UC patients, who were generally younger and less comorbid.
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Picker, N., B. Bokemeyer, T. Wilke, L. Rosin, and H. Patel. "P404 Healthcare utilization and expenditures for patients with Ulcerative Colitis on advanced therapies in Germany." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S411—S412. http://dx.doi.org/10.1093/ecco-jcc/jjab076.528.
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Abstract Background Ulcerative Colitis (UC) is a chronic inflammatory condition, which significantly impacts patients’ health-related quality of life and burdens healthcare budgets. Our objective was to provide an overview of the healthcare resource use (HCRU) for the treatment of moderate to severe UC in Germany. Methods A retrospective analysis was conducted using claims data from a German sickness fund (AOK PLUS). Patients were included if they had ≥2 outpatient diagnoses in different quarters and/or one inpatient UC diagnosis (ICD-10: K51), were aged ≥18 years and initiated an advanced therapy (anti-TNFs, vedolizumab, tofacitinib) between 01/01/2015-30/06/2019. HCRU associated with UC treatment was assessed in terms of outpatient visits, work-related sick leave days, and UC caused hospitalizations. Direct UC-related costs (inpatient, outpatient and medication costs based on pharmacy sales price at prescription date) were calculated from the perspective of the German statutory health insurance. All patients were followed from the start of treatment until the end of the study period, or loss to follow-up. In case of treatment discontinuation or change of index therapy, patient follow-up was censored 90 days after the last prescription of index therapy. UC-related HCRU and cost were reported per observable patient-year (PY) and stratified according to prior use of advanced therapies (naïve vs. experienced). Results 574 patients were included (adalimumab: 230, infliximab: 172, golimumab: 56, vedolizumab: 113, tofacitinib: 3). Mean age was 41.9 years; 53.5% were female. On average, 2.5 outpatient visits per PY were billed by general practitioners and 1.4 by gastroenterologists. 27.0% of patients had at least one UC-related hospitalization (mean length of stay: 11.2 days). The mean number of documented UC-related sick leave days amounted to 13.1 per PY. HCRU was similar in therapy-naïve vs. experienced patients (Table 1). Inpatient costs for any cause amounted on average to €4,522/PY, with UC accounting for €3,190/PY (70.5%). Total UC costs amounted to €34.068/PY (Table 2). Expenses for prescribed UC-related drugs amounted to €28,885/PY (95.6% of total drug costs), and outpatient treatment to €511/PY with only €123/PY for Gastroenterologists’ visits (0.4% of total UC-costs/PY). In addition, indirect cost resulting from sick leave due to UC were estimated at €2,979/PY. Conclusion Our study indicates a high economic burden in UC patients who initiated treatment with advanced therapies. UC-related medication was identified as the main cost driver. Furthermore, a substantial proportion of UC patients required hospitalization in the first 12 months after starting new advanced therapy.
Dissertations / Theses on the topic "Insurance (Sickness), Germany"
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Katzmann, Lynne Susan. "The German Sickness Insurance Programme 1883-1911 : its relevance for contemporary American health policy." Thesis, London School of Economics and Political Science (University of London), 1992. http://etheses.lse.ac.uk/1296/.
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This study describes and analyzes the German Sickness Insurance Programme in the years between its enactment in 1883 and its recodification in 1911, as part of Germany's comprehensive social insurance system. It traces the evolution of health policy between 1883 and 1911 and discusses the impact that this landmark policy had on the well-being of the German population. Although the antecedents to modern German health policy may be traced to the sixteenth century, the period between 1800 and 1911 is a watershed period. The purpose of the study is twofold: 1) to provide a detailed description of the German model for countries1 without a national health service or national health insurance programme and 2) to study the changing roles of consumers and providers and the effect these changes have on access to care and cost containment, two issues which face policy makers throughout the world. As a social political analysis, this study explores proximate rather than definitive sources and causes for policy decisions. It attempts to delineate and explicate the issues surrounding the need for and enactment of the German Sickness Insurance Act of 1883: Where did the substantive ideas originate. Were they accepted or challenged. By whom. What is the relationship between policy objectives and policy output. How was quality of life affected. The infrastructure of medical services on which the programme relied at its inception is described as are legislative precedents for the Sickness Insurance Act of 1883. The operational aspects of the sickness insurance programme (for example, eligibility criteria, benefit design and programme financing) at the time of its implementation in 1884 are detailed. The study then focuses on the evolution of the programme (that is, changes in eligibility, benefit design and provider reimbursement) and the political and social forces which caused those changes. The interplay between consumer and provider concerns, as well as the changing level of organized input into the policy making process from these two groups is highlighted. The study concludes with an analysis of the programme's impact on the German citizenry, their access to health care and health insurance and the programme's ability to contain costs while expanding access. The analysis specifically assesses the impact that changing roles of consumers and providers have on achieving the goals of access and cost containment. The preconditions for effective implementation of a similarly structured programme elsewhere, specifically the United States, are noted. The limited intervention of the German government in both the financing or administration of the sickness insurance programme as well as its use of a multiple payer system, enhances its political appeal for American legislators and therefore the likelihood that the model could be replicated in the United States.
Books on the topic "Insurance (Sickness), Germany"
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Garland, David. 3. Birth of the welfare state. Oxford University Press, 2016. http://dx.doi.org/10.1093/actrade/9780199672660.003.0003.
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‘Birth of the welfare state’ describes the embryonic version of the welfare state in Germany with Chancellor Bismarck’s social insurance laws in the 1880s. A decade later governments in Denmark, New Zealand, and Australia launched the first old age pension schemes. In the early 1900s Liberal governments in Britain introduced workmen’s compensation, old age pensions, labour exchanges, and a system of National Insurance for sickness, invalidity, and unemployment. In the 1930s President Roosevelt established the American welfare state with the ‘New Deal’ legislation. The new welfare states were expanded post-war and by 1960 every developed nation had a core of welfare state institutions and every government had accepted responsibility for managing its national economy.
Book chapters on the topic "Insurance (Sickness), Germany"
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Kerschen, Nicole. "Migrants’ Access to Social Protection in Luxembourg." In IMISCOE Research Series, 285–98. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-51241-5_19.
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Abstract For over 100 years, Luxembourg has been an immigration country. In 2019, 93% of the resident population are European citizens. Luxembourg nationals represent 53% of the entire population, nationals from other European Union (EU) Member States 40% and non-EU foreigners 7%. These three groups have different rights regarding residence and access to work in Luxembourg. All persons engaged in a professional activity in Luxembourg, whatever their nationality or residence, are covered by a compulsory social security system. The essence of the Welfare State, whose origins date back to the Customs Union with Germany, is Bismarckian. It protects workers against the following social risks: unemployment, sickness and maternity, long-term care needs, family, invalidity and old age. Family members are entitled to derived rights. Regarding health-care and old age pensions, it is possible to subscribe a voluntary insurance under specific conditions. A guaranteed minimum income, recently reformed, is accessible to everybody residing legally in Luxembourg under specific conditions. For non-EU foreigners, a residence for at least 5 years during the last 20 years or the possession of a long-term resident status is required.
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Williamson, John B., and Fred C. Pampel. "Germany." In Old-Age Security in Comparative Perspective, 22–42. Oxford University PressNew York, NY, 1993. http://dx.doi.org/10.1093/oso/9780195068597.003.0002.
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Abstract In 1889 Germany became the first nation in the world to enact a national compulsory old-age and invalidity pension system. This scheme was one of several social insurance programs introduced in Germany during the 1880s, starting with enactment of sickness insurance in 1883 and industrial accident insurance in 1884. In view of its being the world’s first national old-age pension scheme and in view of the impact this program has had on subsequent developments in other nations, we will want to take a close look at the structure of the original program and the factors contributing to its enactment.
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Anderson, Elisabeth. "Restoring Solidarity and Domesticity." In Agents of Reform, 151–92. Princeton University Press, 2021. http://dx.doi.org/10.23943/princeton/9780691220895.003.0008.
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This chapter considers Otto von Bismarck as a well-known figure in the birth of the modern welfare state, which was the driving force behind Germany's pathbreaking accident, sickness, and old-age insurance programs of the 1880s. In 1873, Germany, along with the rest of Europe and the United States, was plunged into a depression that lasted more than a decade, and Bismarck vehemently opposed any worker protections that might slow recovery. The chapter focuses mainly on the political maneuvering of a high-ranking bureaucrat in the Prussian Ministry of Commerce, Theodor Lohmann, the architect and prime mover behind Germany's factory inspection law. The chapter describes Lohmann as an emblematic of a new breed of bureaucratic specialist in whom the Prussian state increasingly invested toward the end of the nineteenth century.
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Fishback, Price. "Market and Government Provision of Safety Nets and Social Welfare Spending in Historical Political Economy." In The Oxford Handbook of Historical Political Economy, C43.P1—C43.N2. Oxford University Press, 2023. http://dx.doi.org/10.1093/oxfordhb/9780197618608.013.43.
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Abstract The safety nets in high-income countries before 1900 and in low-income countries today were based on savings and aid from extended family, friends, charities, churches, and small amounts from local governments. Mutual societies and eventually insurance companies offered insurance against lost earnings from sickness, injury, death, and old age. Germany led the way in mandating that employers provide benefits. Since 1900, higher-income nations have sharply increased public and private social welfare expenditures to well over 20 percent relative to GDP. A large share of this rise has come in increases in aid to the elderly and healthcare expenses, often in the form of contributory social insurance financed by payroll taxes on workers and employers. Meanwhile, noncontributory transfer programs for the poor have risen relatively little. In most countries, the employer’s share of payroll taxes is higher than the worker’s share. Some major countries have followed a path of reliance on private programs, which are largely financed by employers. Probably the most striking feature of social welfare programs worldwide is the very large variation in expenditures relative to GDP, in the categories of spending, and in the mix of taxation, private programs, and government programs.
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"Chapter I. Guilds and sickness funds. Solidarity during the Ancien Régime." In Two Centuries of Solidarity German, Belgian and Dutch social health insurance 1770-2008, 29–38. Amsterdam: Amsterdam University Press, 2009. http://dx.doi.org/10.1515/9789048521289-005.
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