Wysong J A, Abel T
State University of New York, Fredonia.
Milbank Q. 1990;68(4):527-60.
Access to West Germany's broad-based health-insurance system is geared to the country's occupational structure. People who qualify, however, may seek coverage from alternative sources, including local "sickness funds." The changing nature of the German job market is leading to concentration of high-risk groups in the local funds, some of which could in turn face serious financial problems. Proponents of a universal health-insurance program for the United States need to take account of the growing segmentation of risk groups in the current German experience, which may ultimately threaten the concept of solidarity on which the system is founded.
西德广泛的医疗保险体系的覆盖范围与该国的职业结构相适应。然而，符合条件的人可以从其他渠道寻求保险，包括当地的“疾病基金”。德国就业市场性质的变化导致高风险群体集中在当地基金中，其中一些基金可能反过来面临严重的财务问题。美国全民医疗保险计划的支持者需要考虑到当前德国经验中风险群体日益细分的情况，这最终可能威胁到该体系所基于的团结理念。
