Die enttäuschende Systemeffizienz des deutschen Gesundheitswesens

The German healthcare system falls short in international comparisons of system efficiency. Costs seem disproportionate to outcomes. This article identifies the lack of a functioning market for innovative care management as a key cause. The lack of functionality in this market can be explained largely by two legal provisions which are problematic from an economic perspective. The first allows service providers to exercise market power when negotiating care programmes. The second, without any convincing need, restricts the setting of premiums that may be paid to insured persons for their participation in such programmes and the associated waiver of their freedom to choose their own doctor.