Steuerungs- und Verteilungswirkungen der Praxisgebühr im Bereich der zahnmedizinischen Versorgung - eine Kosten-Nutzen-Analyse

Abstract

In the German Law on the Modernization of the Statutory Healthcare System of 19 November 2003 the legislator enacted payment of a so-called quarterly practice fee for ambulant medical and dental care. The legislator hopes that by the introduction of this fee the central "steering" function of the family doctor is strengthened and that medically unnecessary treatment will be reduced, thus reducing cost and consolidating health insurance funds. In public, however, the introduction of the practice fee as a steering instrument is very controversially discussed. The aim of the analysis is to balance the cost-effectiveness of a quarterly practice fee with regard to the specific features of the dental care system. Analysis of the allocative and distributive effects shows that the practice fee does not adequately take into account the specific features of the dental care sector and that the adverse effects prevail if seen under the aspect of health economics and social medicine. Neither on the micro-economic nor on the macro-economic level a noticeable medicine-term or long-term cost containment effect may be expected.