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by scott00
188 days ago
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The key difference seems to be German private health insurance contracts are long-term affairs. Multi-year, or perhaps even lifetime? US health insurance contracts are typically a year at a time. So German companies have to reserve for costs projected to occur far in the future because they are liable for them, while US companies have no idea if their customer will still be around in 20 years. My guess would be there's a healthy dollop of regulation pushing the German insurance market into that shape, otherwise you would probably see short-term insurers outcompeting long-term insurers since they wouldn't have to do old-age reserves and could therefore charge lower premiums. Consumers tend not to be nearly as good at rationally planning for long term expenditures as are actuaries. |
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"Krankenversicherung nach Art der Lebensversicherung" (health insurance in the form of life insurance) and "Krankenversicherung nach Art der Schadenversicherung" (health insurance in the form of indemnity insurance).
The first one is basically an alternative to the state-mandated health insurance, while the latter one is mostly intended for more specialized health services like for example dental replacement.
There is a regulation that once you are in a "Krankenversicherung nach Art der Lebensversicherung", the health insurance company is not allowed to cancel the contract with you, but on the other hand for this restriction the health insurance company is allowed to "adjust" premiums (nearly always that means "increase premiums") if the medical costs for the agreed treatments rise (which they commonly do).
Thus having a (near-certain) cashflow over the lifetime of the whole insured person (who can only under very special circumstances get out of the insurance treaty) is quite attractive for the insurance company.
> otherwise you would probably see short-term insurers outcompeting long-term insurers since they wouldn't have to do old-age reserves and could therefore charge lower premiums
You must not compare the current premiums, but the amount of premiums that you will pay over the whole lifetime. Here, the situation is completely different.
I think considering the huge amount of money (for premiums and medical costs) that is involved here, it can only be explained with stupidity to just compare current premiums in the young age: it is very well-known that the whole actuarial reserve that the insurance company built up from the premiums of a huge part of your lifetime will be spent for medical costs in just the last few years of your life.
It is thus a really macabre truth that if we would just let patients with cancer or another expensive disease die instead of giving them expensive treatments for just few additional years it would save an insane amount of money in the health system.