Abstract :
This paper analyses the influence of recent German health care
reforms, the Statutory Health Insurance Modernization Act 2004 and the
Statutory Health Insurance Competition Strengthening Act 2007, on different
dimensions of access and choice. More specifically, we look at and discuss the
effects of these policies on the availability, reachability and affordability of
health care as well as on their impact on consumers’ choice of insurers and
providers. Generally, patients in Germany enjoy a high degree of free access
and a lot of freedom to choose, partly leading to over- and misuse of health
services. Concerning choice of insurers, one result of our analysis is that in the
statutory health insurance system, the introduction of a greater variety of
benefit packages will develop into an additional parameter of choice. In
contrast to that, insurees more and more accept certain restrictions of choice
and direct access to providers by enrolling into new forms of care (such as
gatekeeping-, disease management- and integrated care programmes).
However, they might benefit from better quality of care and more options for
products and services that best fit their needs.
