Knieps Franz
Abteilung Gesundheitsversorgung, Gesetzliche Krankenversicherung, Pflegesicherung im Bundesministerium für Gesundheit, Berlin/Bonn.
Z Evid Fortbild Qual Gesundhwes. 2009;103(10):615-9; discussion 619-20. doi: 10.1016/j.zefq.2009.10.001.
Over the last 20 years strategies introducing regulated competition have gradually been implemented in the corporatistically structured German healthcare system. In particular, this applies to the structure of health insurance organisation where the corporatively organised allocation system has deliberately been transformed to ensure health insurance choice. Accordingly, the laws governing membership, health insurance premiums and health benefits have been adapted and new rules for public finance including a risk structure compensation scheme encompassing the different kinds of health insurances have been established. The options for competition arising in the area of health service provision do not only affect the health insurance companies themselves, but also the relations to the providers of healthcare as well as their relationship with each other. This holds especially true of the role and function of the (regional) physicians' associations. The relation between collective agreements and individual contracts is still unclear. With the further development of strategies introducing regulated competition the possibilities and limitations of competition will have to be explored and many details--such as, for example, the implementation of the responsibility for ensuring the provision of healthcare services--need to be resolved.
