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Distributing medical resources

An application of cooperative bargaining theory to an allocation problem in medicine


Antje Köckeritz

Allocating scarce medical resources has become an important topic in public discussion. In the German statutory health system we are facing a situation of lacking adequate funds for all needs. The financial restrictions force us to use resources wisely. This emphasizes the need of general allocation rules and criteria applied in medical allocation situations. The purpose of this work is to implement and interpret properties of cooperative bargaining theory to special allocation situations in medicine. The author shows how the concepts of Nash and Kalai/Smorodinsky can be applied to a medical allocation problem and discusses implications of their properties and solutions for the German health system.


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2 Scarce resources in the German health system - an overview


23 2 Scarce resources in the German health system – an overview 2.1 Introduction to the German statutory system In Germany two health systems coexist – a privately and a publicly organized system. While each citizen can be a member in the statutory German health system which is publicly financed and organized, a private health insurance is restricted with income. If income is equal or above the cap of 3,750 Euros monthly income in 2010 (which equals 45,000 Euros yearly income), people may choose between a privately or publicly funded health system. In fact, 83.3% (68.5 million) insured have no choice due to the income restriction and are statutory members in the publicly funded health system. Of those who have the choice 10.5% (8.6 million) are privately insured while only 4.6% (3.8 million) decide for the statutory system. 1 Since this work is to show alternative methods in allocating medical resources we primarily focus on the statutory health system in Germany and give some basic information to understand the nature and functioning of that system. The German statutory health system is regulated by the fifth social security code (Fünftes Sozialgesetzbuch, abbr.: SGB V). According to the solidarity principle it aims to maintain, restore and improve the health state of all its insured members. Foremost we are interested in the allocation of medical resources such that we outline a scheme in figure 2.1 that reflects the path from collecting contributions to allocating medical services. Centerpiece of the German statutory health...

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