Professor Christian Hagist gives expert testimony in the Bundestag
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Professor Christian Hagist and his team at the Chair of Economic and Social Policy deal with socially relevant issues and develop scientifically sound and at the same time practically relevant answers. The main research areas, which are examined with great methodological diversity, include intertemporal fiscal policy and, in particular, the sustainability of social insurance financing, health economics, and applied economic and social policy.
On these topics, Professor Hagist regularly serves as an expert in committees of the German Bundestag as well as individual state parliaments and is a welcome expert and guest speaker in the media and at public events.
Some of the research questions the chair is working on include:
- What are the long-term consequences of the "double halfway line" in the statutory pension insurance system?
- Who benefits from health insurance reform plans?
- What are the benefits and risks of introducing health apps into statutory health insurance?
- What are the preferences and willingness to co-pay regarding midwifery services?
- What benefits do data and analytics bring to healthcare providers?
- How does increasing life expectancy affect future disease burden?
- What are the long-term consequences of the Second Care Strengthening Act?
- Why do young people want to work in health care but not as nurses?
- What are the implications of the Hamburg model for social security for civil servants?
The Chair of Economic and Social Policy Team:


Regine Keller
Personal Assistant
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Jessica Rheindorf, M.Sc.
Research Assistant/Doctoral Candidate
+49 (0)261 6509 257
Room G-212
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Leonhard Friedel
Research Assistant/Doctoral Candidate
+49 (0)261 6509 256
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Ramadan El-Hayek, MBA
Research Assistant/Doctoral Candidate
+49 (0)261 6509 258
Room H-215
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Fabian Franke, M.Sc.
External Doctoral Candidate

Valeska Hofbauer-Milan, M.A.
External Doctoral Candidate

Jannik Pieper, M.Sc.
External Doctoral Candidate

Felix Rochlitz, M.Sc.
External Doctoral Candidate

Dr. Philip Jonas von Wedel
Research Associate

Dr. Christian Bührer
Alumnus

Alexandra Heidel (formerly Lange), M.A.
Aumna

Dr. Katharina Saunders
Alumna
Read the news from our Chair –
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Covering topics on social policy, health economics and more –
Take a look at our recent publications.
Perspektiven der Wirtschaftspolitik
Doppelte Haltelinie und steigende Pflegebeitragssätze–ein impliziter Bundeszuschuss zur Pflegeversicherung der RentnerInnen
Christian Hagist, Stefan Seuffert
BMC Public Health
Healing, surviving, or dying? – projecting the German future disease burden using a Markov illness-death model
Valeska Milan, Stefan Fetzer, Christian Hagist
The health policy debate in Germany rotates around the question whether Germany’s two pillar insurance system should be dissolved and replaced by universal coverage under the roof of the public system (so called citizen insurance, “Bürgerversicherung”). Most of the time, such a reform is argued from the perspective of the 90 percent of the German population which are already insured by a sickness fund. Rarely, the consequences of currently privately insurants are analysed. However, especially German civil servants are of great interest in this regard, as they are most times partly insured in the private scheme while the other part of their benefits is directly paid by the taxpayer. As the scheme for civil servants is more generous than the public scheme, the question of compensation arises when talking about the Bürgerversicherung reform. The analysis shows that if civil servants are only partly compensated by their employers (federal and state governments), the reform has a short-run negative fiscal impact.
At the beginning of their career civil servants in Germany can choose between the social health insurance system and a private plan combined with a direct reimbursement of the government up to 80%. Most civil servants chose the latter, also because they have to cover all contribution payments to the social system themselves, while normal employees get nearly 50% from their employers. The state of Hamburg decided to change the system by paying a share of the contributions if civil servants choose the social plan. Using a comparison of internal rates of return in both schemes, we show that this celebrated reform will not change the decision calculus for the average civil servant household and will probably thereby increase the adverse selection of high risk cases towards the social health insurance.
Aim: The German E-Health law is supposed to improve efficiency, quality and accessibility of the German healthcare system. This study analyzes the preferences of patients regarding digital health services and compares these to the priorities of the lawmaker.
Method: Two discrete choice experiments (DCE) were executed to reveal preferences and willingness to pay of patients concerning digital health information and telemedicine. Results German patients clearly prefer the storage of a comprehensive electronic health record followed by emergency data on their health-insurance card. A medication plan appears to be by far the least preferred option. Considering telemedical care, communication via E-Mail instead of online video consultations or text-chats is preferred
Conclusion: The results of this study reveal significant discrepancies between priorities of the E-Health law and the preferences of patients in Germany. This clearly questions adoption of the services by patients and hence the desired positive effects of the law.
In this paper we apply the method of Generational Accounting to analyse whether today’s government policy burdens future generations with a heavier load than current generations. We analyse pay-as-you-go pension systems and their reforms in Norway, Poland and Germany. Our results show that, through these reforms, pension systems in all three countries became more intergenerationally balanced as the implicit debt to be paid by future generations was reduced. However, the burden is shared differently: in Norway
current pensioners have to contribute to enhancing the financial sustainability of the pension system while Poland and Germany seem to protect current pensioners at the expense of younger generations.
The emergence and spread of antimicrobial resistance (AMR) is still an unresolved problem worldwide. In intensive care units (ICUs), first‐line antibiotic therapy is highly standardized and widely empiric while treatment failure because of AMR often has severe consequences. Simultaneously, there is a limited number of reserve antibiotics, whose prices and/or side effects are substantially higher than first‐line therapy. This paper explores the implications of resistance‐induced substitution effects in ICUs. The extent of such substitution effects is shown in a dynamic fixed effect regression analysis using a panel of 66 German ICUs with monthly antibiotic use and resistance data between 2001 and 2012. Our findings support the hypothesis that demand for reserve antibiotics substantially increases when resistance towards first‐line agents rises. For some analyses the lagged effect of resistance is also significant, supporting the conjecture that part of the substitution effect is caused by physicians changing antibiotic choices in empiric treatment by adapting their resistance expectation to new information on resistance prevalence. The available information about resistance rates allows physicians to efficiently balance the trade‐off between exacerbating resistance and ensuring treatment success. However, resistance‐induced substitution effects are not free of charge. These effects should be considered an indirect burden of AMR.
Our study compares mortalities of long-term care (LTC) patients who are covered by statutory LTC insurance with regard to gender, age and distribution of care levels. The analysis is based on claim data which was provided by an East-German statutory LTC fund (AOK Plus). We show for both genders a distribution which is skewed to the right. Therefore 50 % of all female (male) LTC patients are dead after 45 (26) months while the average duration in the LTC system is 52 (37) months. The associated costs given these distributions are 64,541 (42,905) Euro in present value terms. The analysis of care levels via a multinomial logistic model shows for our data set a compression of LTC patients’ morbidity. Given rising life expectancy a higher care level (associated with a more severe LTC condition) is therefore more unlikely for both genders.
Digitalization has opposing effects on labor markets. Although the overall pie might grow bigger, severe structural changes and therefore challenges for society at large will definitely occur. For this reason, we want to address the following questions: How will digitalization change the division of work? Which jobs are at stake? And will demography be a factor in this regard? In economic textbooks, we normally assume that new technology drives growth and therefore has also a net positive impact on employment. For the past, this was certainly true, as the replacement of the typewriter by personal computers still required a person behind a desk, which now however could offer more and better services. This relationship between technology and the labor market might be about to change in our digitalization era. Already today, some news are written by the computer itself—without human fingers typing. The new feature of this technological change is therefore that not only muscle but also brain work will be replaced by robots—given it is not only technological feasible but also cost-efficient. In addition to the general change by digitalization of work processes, it could be the case that societies have to react differently to this ongoing process given their demographic transition and their education system. Research suggests that the conflict will not only evolve between capital and labor but also between young and old workers, as rationing will disproportionately affect the young. Perplexedly, it might even be the case that rapid aging countries like Japan or Germany will have less problems regarding the labor market.
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Regine Keller
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regine.keller(at)whu.edu