WEEK5

Question 1

Individual’s LTC insurance choice

Answer 1

• Underinsure
• Complex insurance products
• Uncertainty about need
• Uncertainty about coverage

Question 2

3 rationing mechanisms

Answer 2

1) Eligibility
‘Are older people with limitations better off when they receive nursing home care instead of home care?’

2) Waiting lists
‘Does waiting longer for a nursing home lead to worse health outcomes?’
- needs-based triage
- urgency and unobserved health
- hospital admissions
- shortages in the nursing home

3) Co-payments
- provided by municipalities
- abolishment of income-dependent co-payment

Question 3

Health insurances in Germany

Answer 3

PHI: Private Health Insurance
SHI: Statutionary Health Insurance

Question 4

SHI

Answer 4

Compulsory > annual salary < 69.300
Voluntary > annual salary > 69.300 or self-employed

Question 5

2 institutes

Answer 5

1) Institute for Quality and (Economic) Efficiency
- focuses on specific interventions/procedures
- goal 1: provide independent and evidence-based evaluations
- goal 2: provide information to consumers on health prevention

2) Institute for Quality Assurance and Transparency in Health Care
- focuses on hospital inpatient care
- goal: support the availability of high-quality comprehensible and solidarity-based patient care

Question 6

Is private insurance a problem? (GER)

Answer 6

• PHI recipients tend to be higher income individuals
• PHI sickness funds can discriminate based on pre-existing health
• Providers can ask for higher fees

Question 7

Consequences
- PHI
- SHI
(GER)

Answer 7

PHI:
- use less care because they are healthier
- use less care because it costs them more
- use more care because they are preferentially treated

SHI:
- use more care because they are less healthy
- use less care because of low access to it