揮別俾斯麥模式社會保險制度?
441
Far from Bismarckian Social Insurance?
—
An Observation of Twenty Years of German
Healthcare Reforms with a Review of
the Relevant Decisions of the German Federal
Constitutional Court
Nai-Yi Sun
National Chengchi University, College of Law
No. 64, Sec. 2, Zhinan Rd., Taipei 11605, Taiwan
E-mail:
Abstract
German statutory health care insurance
(
Die gesetzliche
Krankenversicherung
)
has undergone important changes over the
last twenty years. Today its framework is fairly different from the
traditional Bismarckian model, which is characterized by identity and
solidarity among employees and management manifested in plural
self-governmental bodies. The current health care system is con-
structed by the following means: legal instruments, including the
obligation for all citizens to be insured by public or private insurers,
with free choice of public insurers
—
the sickness funds
(
Krankenkasse
)
for insured persons which leads to more competition among sickness
funds; centralization of the plural federal self-governmental and joint
self-governmental bodies; introduction of a uniform contribution
rate for all sickness funds connected with supplementary premiums
for individual one.
This article will provide an overview of paradigmatic changes of
the German health care reform over the last twenty years, and of the
relevant legal issues, including the constitutionality of compulsory
insurance accompanied by legal modifications of private health care
insurance contracts, the consistency of competition mechanisms in
the social insurance scheme with the constitutional principle of social