Abstract
Due to the rapid progress in medical technology social insurance systems will soon no longer be able to grant health services without limits but must employ non-price rationing devices. This raises the question how these limits will be determined. Here we consider a direct democracy where the size of the social health insurance plan is determined in a popular referendum using simple majority rule. Moreover, two different kinds of rationing are distinguished according to whether additional private purchases of health care are allowed. For both systems we examine the size of the social insurance system in a political equilibrium, and we compare the results in particular with respect to their distributional effects.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Breyer F, Kliemt H (1994) Lebensverlängernde medizinische Leistungen als Clubg▵er? — Ein Beitrag zum Thema “Rationierung im Gesundheitswesen”. In: Homann K (ed) Wirtschaftsethische Perspektiven I: Theorie — Ordnungsfragen — Internationale Institutionen. Duncker & Humblot, Berlin, pp 131–158
Breyer F, Schulenburg J-M Graf v. d. (1987) Family structure and intergenerational transfers in social health insurance: A public choice model. In: Pethig R, Schlieper U (eds) Efficiency, institutions, and economic policy. Springer, Berlin Heidelberg New York, pp 63–80
Newhouse JP (1977) Medical-care expenditures: A cross-national survey. J Hum Res 12:115–125
Author information
Authors and Affiliations
Additional information
Funding for this research from the Norwegian Research Council under the Ruhrgas Scholarship Scheme and valuable comments by two anonymous referees are gratefully acknowledged.
Rights and permissions
About this article
Cite this article
Breyer, F. The political economy of rationing in social health insurance. J Popul Econ 8, 137–148 (1995). https://doi.org/10.1007/BF00166648
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00166648