Tsung-Mei Cheng and Uwe E. Reinhardt, “Shepherding Major Health System Reforms,”

Question

Tsung-Mei Cheng and Uwe E. Reinhardt, “Shepherding Major Health System Reforms,” Health Affairs, April 8, 2008, w204-213.

https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.27.3.w204

1. What was the state of the health system when Schmidt took over as health minister?

2. What are the twin goals of German reform? How are these goals compatible?

3. How does Schmidt understand the role of competition in health care?

4. How did the 2007 reforms inject more competition into the system? What happens if a sickness fund runs a surplus or deficit?

5. How did the reform affect the private insurance market?

6. How does the individual insurance mandate work?

7. How are premiums determined?

8. What is reference pricing for pharmaceutical drugs? How does it work?

9. How can the German system provide quality health care at one-half the U.S. price?

Explanation / Answer

When Schmidt took over as health minister the health care system seen cuts at the hands of prior government had made and it was marred by a number of dubious decisions, such as cutting back on preventive care and rehabilitation due to which the copays were very high. Solidarity and affordability of a high-quality health care system are the twin goals German reform. They are compatible as both of them are aimed at giving access of medical care to every German and each one of them will be strengthening the other.

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