What draws young people to work in the health-care sector, but not as nurses or orderlies? Does certification give health professionals legitimacy? What consequences will digitalization hold for the health sector? How will we finance health care in the future? Who benefits from plans for health insurance reforms?
These are just some of the research questions under scrutiny at the Chair of Intergenerational Economics, launched in 2014 and supported by Die Famlilienunternehmer Association. Professor Christian Hagist and his young team use their inquisitive minds, solid expertise, and a diverse range of methodologies in their efforts to answer these questions, remembering to always consider social relevance and impact.
The Chair is well connected with renowned scientists in both Germany and abroad, co-authoring a number of research papers with academics from various institutions around the world. For example, in recent years papers have been written in collaboration with Laurence Kotlikoff (Boston University), Alistair McGuire (The London School of Economics), and Stefan Fetzer (Hochschule Aalen), to name a few.
The Chair of Intergenerational Economic Policy Team:
Fabian Franke, M.Sc.
External Doctoral Candidate
Dr. Christian Bührer
Dr. Katharina Saunders
Read the news from our Chair –
Keep up with our latest research and activities.
Discussion witht Prof. Hagist in SWR2 Forum.Read more
Proposals to reform long-term care insurance discussed in the German BundestagRead more
Proposals for fighting old-age poverty discussed in the German BundestagRead more
Covering topics on finance, corporate governance and more –
Take a look at our recent publications.
Cui bono? – Die Bürgerversicherung und die Beihilfe.
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.
Das Hamburger Beihilfemodell – Ein Vergleich der internen Renditen von GKV und PKV.
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.
Die Digitalisierung der Arzt-Patienten Beziehung in Deutschland: Ein Discrete Choice Experiment zur Analyse der Patientenpräferenzen bezüglich digitaler Gesundheitsleistungen.
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.
Pension and Intergenerational Balance - A case study of Norway, Poland and Germany using Generational Accounting.
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.
Resistance Elasticity of Antibiotic Demand in Intensive Care.
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.
Pflegeverläufe im Spiegel von Routinedaten der GKV: Eine Analyse für die Jahre 2003 bis 2010.
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.
Generationengerechte Politik? Eine Analyse der aktuellen Politik der Bundesregierung anhand der Generationenbilanz.
Zur Akzeptanz der Verbeamtung - eine Barwertbetrachtung.
Societal savings in patients with advanced non-squamous non-small-cell lung cancer receiving bevacizumab-based versus non-bevacizumab-based treatments in France, Germany, Italy, and Spain.
Die fiskalische Nachhaltigkeit der Zuwanderung in Deutschland - Eine Analyse anhand der Generationenbilanzierung.
The Fiscal Outlook in Austria - An Evaluation with Generational Accounts.
How Regional Differences in Taxes and Public Goods Distort Life Cycle Location Choices.
Konjunktur und Generationenbilanz - eine Analyse anhand des HP-Filters.
Optional deductibles in social health insurance systems: Findings from Germany.
GMG, Kopfpauschalen und Bürgerversicherungen: Der aktuelle Reformstand und seine intergenerativen Verteilungswirkungen.
The Effect of Digitalization on the Labor Market .
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.
Einkommensabhängiger Zusatzbeitrag in der GKV: Verteilungs- und Anreizwirkungen.
Das Wohneigentum in der Riester-Förderung - Empirie und Reformoptionen der Eigenheimrente.
Die Methode der Generationenbilanzierung - Messung intergenerativer Verteilung und fiskalischer Nachhaltigkeit.
A generational accounting analysis of Sweden.
Von Worthülsen und Messkonzepten - Generationengerechtigkeit vs. Nachhaltigkeit.
Finanzielle und soziale Nachhaltigkeit unter den Bedingungen des demografischen Wandels.
Wettbewerb in der GKV: Die Freiburger Agenda.
Public Debt and Demography An international comparison using Generational Accounting.
Ehrbare Staaten? Die deutsche Generationenbilanz im internationalen Vergleich.
Volkswirtschaftliche Auswirkungen von Hautkrebs eine dynamische Analyse .
Die Generationenbilanz: Brandmelder der Zukunft, Update 2007: Demografie trifft Konjunktur.
Brandmelder der Zukunft - Die aktuelle Generationenbilanz.
Wer gewinnt hier eigentlich was? – Die Ausweitung der Midijob-Grenze im Rentenpaket.
Richtige und falsche Wege für eine gerechte Altersvorsorge.
Quo Vadis Soziale Sicherung? - Eine Bestandsaufnahme.
Adverse Selection in the German Health Insurance System – The Case of Civil Servants.
Series Germany’s second LTC strengthening act and its intergenerational implications.
Das Hamburger Beihilfemodell - Ein Vergleich der internen Renditen von GKV und PKV.
Ausgabenprojektion und Reformszenarien der Beamtenversorgung in Deutschland.
Ausgabenprojektion und Reformszenarien der Beamtenversorgung in Bremen.
Ausgabenprojektion und Reformszenarien der Beamtenversorgung in Nordrhein-Westfalen.
Ausgabenprojektion und Reformszenarien der Beamtenversorgung in Baden-Württemberg.
Wer gewinnt hier eigentlich was? – Die Ausweitung der Midijob-Grenze im Rentenpaket, 01.08.2018.
Der Einstieg in den Ausstieg aus den Schröderschen Rentenreformen, 29.01.2018.
Riester-Freibetrag als beste aller Second-Best-Lösungen, 20.05.2016.