University of Duisburg-Essen, Essen, Germany.
J Health Econ. 2009 Sep;28(5):911-23. doi: 10.1016/j.jhealeco.2009.06.005. Epub 2009 Jun 16.
A current proposal for reforming the German statutory health insurance suggests replacing earnings-related contributions by per-capita health premia. Combining a computable general equilibrium analysis with abundant empirical data on heterogenous household types, we investigate both the distributional and allocative impact of such a reform proposal. Our results indicate efficiency gains in terms of GDP and employment. This is because employed households of all skill types would increase their labour supply. Yet, while these household types would benefit from introducing health premia, others, such as those including pensioners or unemployed individuals, may suffer in terms of equivalent variations, despite tax-financed compensating transfers to these low-income households. Nonetheless, such transfers are an essential part of the reform proposal in order to mitigate redistributional effects. By comparing two different compensation schemes, we find that higher transfers go along with higher GDP and employment. This result may indicate that more redistribution comes at no efficiency costs.
目前，德国法定健康保险改革的一项提议建议用人均健康保险费来替代与收入相关的缴费。我们结合可计算一般均衡分析和大量关于异质家庭类型的经验数据，研究了这一改革提议的分配和配置影响。我们的结果表明，在 GDP 和就业方面会有收益。这是因为所有技能类型的就业家庭都会增加劳动力供应。然而，尽管这些家庭类型从引入健康保险费中受益，但其他家庭类型，如包括退休人员或失业人员的家庭，可能会在等价变化方面受到影响，尽管这些低收入家庭会得到税收资助的补偿性转移。然而，为了减轻再分配的影响，这些转移是改革提议的一个重要组成部分。通过比较两种不同的补偿方案，我们发现较高的转移支付伴随着较高的 GDP 和就业。这一结果可能表明，更多的再分配不会带来效率成本。
