>> Professor Reinhardt, why does the health system - regardless of the country - usually not work as it should?
There are several reasons. First, there may be a lack of political consensus on how a country's health system should function. The liberals in Germany have completely different ideas than, for example, the members of the SPD. In America the range of opinions on this matter is even greater. Second, even when there is a consensus about how the health care system should ideally work, the real system is often derailed by perverse incentives. And this doesn't just happen in the healthcare system. This happens in some sectors of the economy.

Which one do you have in mind?
Let’s take a look at the banking industry. In principle, banks have two economic tasks: to efficiently funnel money from savers into productive investments and to create a market for risk transfer, through which Mercedes Benz, for example, shifts the risk of a change in the dollar-euro exchange rate to other people or institutions through foreign exchange options can. In addition, over the last two decades, banks have had great financial incentives to build a huge, global casino and play in it themselves; with the money of savers. And in doing so, they almost caused economies around the world to collapse. Not a single country's health system has ever managed such nonsense. If you look at the balance sheet of a bank before 2007 and see that it only has three percent equity capital, you should - assuming a little common sense - not do business with such a bank. But that's exactly what happened. And why? Because everyone hoped and actually knew that in the worst case scenario, if everything went wrong, the taxpayer would be asked to pay in order to take the hot potatoes out of the fire for the banks. This so-called “moral hazard” gave the bank bosses completely wrong incentives. In short: It's useful to constructively criticize health systems, which we do all the time, but compared to the banking industry, health systems everywhere are actually pretty good guys.

In Germany, much of what comes from the USA is often seen as an innovative step forward. You, on the other hand, are quite critical of the health care system in America, which has been improved by Obama. What reasons led to this major healthcare reform, the Affordable Care Act, which is often referred to as “Obamacare”?
For many years, the providers had>> Professor Reinhardt, why does the health system - regardless of the country - usually not work as it should?
There are several reasons. First, there may be a lack of political consensus on how a country's health system should function. The liberals in Germany have completely different ideas than, for example, the members of the SPD. In America the range of opinions on this matter is even greater. Second, even when there is a consensus about how the health care system should ideally work, the real system is often derailed by perverse incentives. And this doesn't just happen in the healthcare system. This happens in some sectors of the economy.

Which one do you have in mind?
Let’s take a look at the banking industry. In principle, banks have two economic tasks: to efficiently funnel money from savers into productive investments and to create a market for risk transfer, through which Mercedes Benz, for example, shifts the risk of a change in the dollar-euro exchange rate to other people or institutions through foreign exchange options can. In addition, over the last two decades, banks have had great financial incentives to build a huge, global casino and play in it themselves; with the money of savers. And in doing so, they almost caused economies around the world to collapse. Not a single country's health system has ever managed such nonsense. If you look at the balance sheet of a bank before 2007 and see that it only has three percent equity capital, you should - assuming a little common sense - not do business with such a bank. But that's exactly what happened. And why? Because everyone hoped and actually knew that in the worst case scenario, if everything went wrong, the taxpayer would be asked to pay in order to take the hot potatoes out of the fire for the banks. This so-called “moral hazard” gave the bank bosses completely wrong incentives. In short: It's useful to constructively criticize health systems, which we do all the time, but compared to the banking industry, health systems everywhere are actually pretty good guys.

In Germany, much of what comes from the USA is often seen as an innovative step forward. You, on the other hand, are quite critical of the health care system in America, which has been improved by Obama. What reasons led to this major healthcare reform, the Affordable Care Act, which is often referred to as “Obamacare”?
For many years the providers had

Citation information: doi: 10.24945/MVF.02.14.1866-0533.1928

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