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Universal Health Insurance and High-Risk Groups in West Germany: Implications for U.S. Health Policy

Jere A. Wysong and Thomas Abel
The Milbank Quarterly
Vol. 68, No. 4 (1990), pp. 527-560
Published by: Wiley on behalf of Milbank Memorial Fund
DOI: 10.2307/3350193
Stable URL: http://www.jstor.org/stable/3350193
Page Count: 34
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Universal Health Insurance and High-Risk Groups in West Germany: Implications for U.S. Health Policy
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Abstract

Access to West Germany's broad-based health-insurance system is geared to the country's occupational structure. People who qualify, however, may seek coverage from alternative sources, including local "sickness funds." The changing nature of the German job market is leading to concentration of high-risk groups in the local funds, some of which could in turn face serious financial problems. Proponents of a universal health-insurance program for the United States need to take account of the growing segmentation of risk groups in the current German experience, which may ultimately threaten the concept of solidarity on which the system is founded.

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