Mystery Shopping in der Gesetzlichen Krankenversicherung – Einsatz von Testkäufern zur Qualitätssicherung

Because of raising costs, modified legal regulations and a changed self-perception of many insurants, compulsory health insurance funds have to cope with an intensified competition on their market. Management instruments like Mystery Shopping, as a method for a hidden inspection of ex ante defined quality standards, enter the health care system. This study's aim is to assess the utilisability of this instrument for compulsory health insurance funds.Basing on a literature analysis and the conducted Mystery Shopping-study in cooperation with a German company health insurance fund, it is assessed, that there are already existing successful approaches of using Mystery Shopping in health insurances and further health care sector. Like in the present study, previous existing applications occur primarily in the evaluation of advisory services (primary in those by telephone). Via Mystery Shopping it is possible to identify relevant factors influencing customer's contentment as well as fund's strengths and weaknesses in an objective and detailed manner. Together with conventional customer satisfaction analyses, potential need for action can be revealed. Besides the evaluation of solely service aspects, prospective applications in the further health care system are introduced.     

Pluralität in der sozialen Sicherung

This paper recommends more plurality in social security provison, particularly in retirement and health insurance. Plurality is necessary, just because of such pragmatic reasons as population aging. The demographic changes to come will threaten the current monolithical public pay-as-you-go systems in their very substance. Moreover, more plurality makes sense because it opens new degrees of freedom, e.g., by better distributing the aging burden intertemporally. Finally, more plurality can be realized because the transition problem is soluable as we show in a simulation exercise for the German public retirement system.     

Zur theorie der stabilität statistischer Reihen

Abstract

Wie ist die auffallende Gesetzmässigkeit der auf Massenbeobachtungen beruhenden statistischen Zahlen zu erklären? Wie sind deren Schwankungen rationell zu deuten? Diese Fragen bilden den eigentlichen Kernpunkt jeder Theorie der Statistik, die mehr sein will, als ein buntes Nebeneinander von technischen Regeln über den Modus procedendi beim Sammeln und Ordnen der Massenbeobachtungen.     

Telemedizin – Angebote,Chancen und Kosteneffektivität

Digitalisation of the health care system proceeds. Therefore it is to be expected that telemedicine applications will also be introduced into health care. Currently, the number of telemedicine applications in Germany is low and it is also scarce in comparison to foreign countries. This is striking because it is usually supposed that telemedicine applications have got a great potential to improve health care and reduce expenditures. Hence, this publication discusses offers, chances and the cost-effectiveness of telemedicine.     

EIOPA – Eine Überschreitung des europäischen Rechtsrahmens und die sich daraus ergebenden praktischen Konsequenzen

The EIOPA (European Insurance and Occupational Pension Authority) is a regulatory EU-body, which was founded on the 1st of January, 2011. The EIOPA was established as a result of the financial crisis that took place in 2007/2008, and it is part of a newly created EU-financial system. This essay deals with questions around the legality of the EIOPA, and looks into its legal basis and the scope of its authorities, which are limited by the case law of the European Court of Justice, as well as European and constitutional principles. When considering these aspects, the regulation, on which the EIOPA is based, seems to be partly incorrect. This essay therefore deals with the legal consequences of such faultiness.     

Aufsichtsrats- bzw. Diversitätsmerkmale und Profitabilität von deutschen und österreichischen Versicherungsunternehmen

This paper focuses on supervisory boards and investigates various board characteristics for the largest German and Austrian insurance companies. Furthermore, the study examines the link between diversity policies and financial performance.The study reveals some differences between the two aforementioned countries, which are mainly driven by size effects. In addition, the analysis shows that larger and stock listed insurance companies have better diversity management policies and a higher proportion of female directors. There is no significant correlation between gender diversity measures and profitability.     

Online-Aktivität als moderierender Effekt der Wirkung Convenience instrumentalisierender Attribute auf Kundengewinnung im Versicherungsneugeschäft

Digitization’s increasing influence on the Germans’ everyday lives leads to changes in their buying behavior. In the internet age, customer orientation means, inter alia, to actually understand the changes in the consumers’ expectations. This raises the question how the shift of customer activity from the analogue to the digital world changes the effect of certain exogenous, convenience exploiting attributes on a supplier’s predefined response variables (e.?g. customer acquisition). This article focuses on the insurance industry and, theoretically, deals with the question, whether doing business online can be considered as moderating effect of the relationship between convenience attributes (controllable by insurers) and customer acquisition as target figure in insurance business. Based on the example of contracting a new motor insurance policy it can be derived hypothetically that “digital customers” have different expectations in terms of speed of processing (as convenience attribute) than those signing a policy together with their agent.     

Versicherbarkeit und ihre Grenzen: Logik — Realität — Konstruktion

The approach presented here is characterized by the fundamental questions: what kinds of knowledge structures and statements can be there in the field of ?Insurability and its Limits“, of which quality are they, how can they be obtained and upon which criteria can they be assessed. By this, a framework for systematizing the many heterogenous structures and statements and for generating homogenous systems of structures and statements shall be made available. At the end of this article possible applications — in the field of insurance studies as well as in the field of insurance business, method-oriented as well as content-oriented — are shown. Three approaches are drawn upon as working hypotheses (construction of 2^nd order): On the basis of the 1^st approach (rationalistic-idealistic approach; Logic of Insurability) ideal, logical structures shall be obtained by logical reasoning (i. e. by deducing from axioms). The adequate criterion is pure logical correctness. So far research has shown that only ?if-then“-relations can be obtained, but no absolute limits of insurability. On the basis of the 2^nd approach (empiristic-realistic approach; Reality of Insurability) real structures shall be obtained by sense perception. The criterion is empiristic truth. Objects are the existing practice in the insurance industry itself on one hand, and existing representations (as for instance in publications) on the other hand. Apart from the registration of these objects (formal-methodical aspect) the content of such representations can be examined with regard to its relation to reality (content-oriented critical aspect). On the basis of the 3^rd approach (constructivistic-instrumentalistic approach; Construction of Insurability) new structures shall be generated via construction (of 1^st order). These structures shall be instrumental with regard to certain objectives or standards. And this instrumentality (be it for the scientific world, the industry or other institutions) of these structures is the criteron of this approach. An example is the constructed frame of reference for the identification of factors of insurability in the different phases of the insurance business on the basis of systems theory. The article ends with an outlook to the constructed concept of ?Insurability Policy“ and ?Insurability Management“.     

Informationsmängel im deregulierten Kraftfahrzeugversicherungsmarkt?

Since 1994 the duty for the German insurers to file contracts by the supervisory authority was abolished. In automobile-, health- and life insurance the firms are now able to calculate tariffs without any restrictions. Especially in the motor vehicle insurance many insurers introduce their own rating systems. Practical experts fear that individuals are unable to find their best insurer. This paper analyzes what it means to choose the appropriate insurer. Secondly, I used this concept in an experiment with students who had to decide between 16 firms. Finally, I employed a Logit-model to evaluate the determinants of the appropriate decisions.     

Schöpft die PKV den Rahm ab? Eine spieltheoretische Analyse der Effekte der PKV auf die Medikamentenqualität

Quality of medical treatment is a major goal of Germany’s statutory health insurance system. According to our game theoretic approach, existing price-discrimination between statutory and private health insurance leads to higher quality of innovative drugs. Hence, a move into the direction of a national health service system (so-called citizen insurance) should result in a reduction of innovative drugs’ quality. Moreover and in the case of citizens insurance’s implementation, innovative drugs’ price level should increase for patients with statutory health insurance. Furthermore, a similar effect is caused by the Act on the Reform of the Market for Medicinal Products (AMNOG) which leads to reduced prospects for pricediscriminations between the statutory and private health insurance system. In summary, the existence of private health insurance in Germany does not cause unfavourable cream-skimming. Rather the split-up of the German health care sector (statutory vs. private health insurance) results in eligible higher drug quality at lower prices for patients with statutory health insurance.     

Why do auditors fail? What might work? What won’t?†

Auditing failures and scandals have become commonplace. In response, reformers (including the Kingman Review in the U.K. and a recent report of the U.K.’s Competition and Market Authority) have proposed a variety of remedies, including prophylactic bans on auditors providing consulting services to their clients in the belief that this will minimize the conflicts of interest that produce auditing failures. Although useful, such reforms are already in place to a considerable degree and may have reached the point of diminishing returns. Moreover, this strategy does not address the deeper problem that clients (or their managements) may not want aggressive auditing, but rather prefer a deferential and perfunctory audit. If so, auditors will realize that they are marketing a ‘commodity’ service and cannot successfully compete based on their quality of services. Rationally, they would respond to such a market by seeking to adopt a cost-minimization strategy, competing by reducing the cost of their services and not investing in new technology or higher-priced personnel.

What could change this pattern? Gatekeepers, including auditors, serve investors, but are hired by corporate management. To induce gatekeepers to better serve investors, one needs to reduce the ‘agency costs’ surrounding this relationship by making gatekeepers more accountable to investors. This might be accomplished through litigation (as happens to some degree in the U.S.), but the U.K. and Europe have rules that discourage collective litigation. Thus, a more feasible approach would be to give investors greater ability to select and remove the auditor. This paper proposes a two part strategy to this end: (1) public ‘grading’ of the auditor by the audit regulator in an easily comparable fashion (and with a mandatory grading curve), and (2) enabling a minority of the shareholders (hypothetically, 10%) to propose a replacement auditor for a shareholder vote. It further argues that both activist shareholders and diversified shareholders might support such a strategy and undertake it under different circumstances. Absent such a focus on agency costs, however, reformers are likely only re-arranging the deck chairs on the Titanic.     

Determinanten der Liquidität in der deutschen Schaden- und Unfallversicherungsindustrie: Bedeutung,Erklärungskraft und Auswirkung der Finanzkrise

The aim of this paper is to analyze the corporate liquidity and its determinants for the German property-liability insurance industry using company-level data for the period 2002–2014. We first investigate the differences in cash holdings across insurers. We then quantify the relative importance of firm-level determinants compared with macroeconomic determinants in explaining insurers’ cash holding choices. In addition, we examine whether the financial crisis of 2008 has an impact on the liquidity situation of insurers. Our results indicate that cash holdings vary significantly across German property-liability insurers. The firm-level determinants size, group affiliation and reinsurance utilization explain more than 50% of the variation. We also find that macroeconomic conditions appear to have negligible effects on the liquidity situation of insurers. In addition, we do not find evidence that the liquidity of German property-liability insurers is influenced by the financial crisis of 2008. The proportion of cash remains relatively stable at 6% of the total assets.     

Wandel der Beratungsqualität auf dem Versicherungsvermittlungsmarkt: Eine ökonomische Analyse der Veränderungen aufgrund der Anforderungen der EU-Vermittlerrichtlinie

The EU-Directive on insurance mediation has introduced an important and sustainable change to the insurance brokerage market with special regard to the quality of the consulting services. The restructuring is necessary due to the increased administration costs of the business accreditation in conjunction with the increased workload. Dependent on the remuneration system—a commission system vs. a fee vs. a mixed commission—, different scenarios for the market organization are possible. This has consequences for the distribution policy. In this situation, the most obvious model seems to be the one, where the insurance brokers specialize and provide only selected type of consulting services. Furthermore, the analysis shows possible influences of further regulation of the insurance brokerage market, which could result in an increase of brokerage costs. This paper continues the actual political discussions regarding the form and basis of remuneration.     

Controlling der fakultativen Rückversicherung — in einem international tätigen professionellen Rückversicherungsunternehmen

During the last years the need for a high sophisticated ControllingConcept in respect of the international facultative reinsurance business has grown substantially. Facultative business is becoming more and more a strategic business unit or at least a profit centre on it’s own, which has to provide it’s contribution to the companies Return on equities. This (new) way of running international facultative reinsurance business requires a strong and powerful support from the controlling side. Controllers today are acting more as in-house Consultants servicing their clients, the management. The strategic portfolio view becomes more important and is beginning to dominate the (classic) operative controlling attitude, which can easily be taken of by modern and sophisticated IT-solutions.     

Why Don’t Oil Shocks Cause Inflation? Evidence from Disaggregate Inflation Data

This paper uses disaggregate U.S. inflation data to evaluate explanations for the breakdown of the relationship between oil price shocks and consumer price inflation. A data set with measures of inflation, energy intensity, labor intensity, and sensitivity to monetary policy is constructed for 97 sectors that make up core CPI inflation. A comparison of the 1973–85 and 1986–2006 time periods reveals that substitution away from energy use in production and monetary policy were both important, with approximately two‐thirds of the change in response of inflation to oil shocks being due to reduced energy usage, and one‐third to monetary policy. We find no evidence that other factors, such as changes in wage rigidities or changes in the persistence of oil shocks, played a role.     

Litteraturanmälningar

Abstract

Dödlighetsintensiteten för enbart tuberkulos är som bekant en kurva, vilken huvudsakligen kan anses bestå av två skilda delar (se exempelvis diagrammet i denna tidskrift för år 1923, sid. 242). Dels består den av en tydligt toppig kurva med maximum vid omkring 23 år (den egentliga tuberkulospuckeln), dels av en långsamt avtagande kurva, som stracker sig ända in i den högsta ålderdomen och vilken jag skulle vilja beteckna som ålderdomsdödligheten i tuberkulos. De långdragna sjukdomsfallen med stationäreller inkapslad process råka stundom under senare åldrar ut för svaghetstillstånd, som hos dem reaktiverar, resp. aggraverar tuberkulosen, under det att en annan persons organism kanske under samma förutsättningar skulle regagera på en annan svag punkt. Den långsamt fallande komponenten av tuberkulosdödlighetensammanhänger med andra ord med de tuberkulösas dödlighetefter längre sjukdomsduration (ehuru naturligtvis även i högre åldrar fall av färsk tuberkulos a priori kunna tänkas existera). Schematiskt kan man alltså (i första approximationen) tänka sig saken så, att insjuknandeintensiteten i tuberkulos är en mycket toppig kurva av samma utseende som tuberkulosdödlighetens första komponent, samt att de smittades dödlighet är mycket hög i början av sjukdomstiden, men avtager hastigt. över denna de tuberkulöst smittades dödlighet av tuberkulos lagrar sig sedan den vanliga dödligheten av andra orsaker, vilken emellertid under de tidiga åldersåren vid jämförelse med dödligheten av tuberkulos är nästan negligeabel.