How is the health market

Health market

In the health economy: a market in which the supply and demand for goods and services meet, which serve, directly or indirectly, to promote, maintain and restore health and to alleviate ailments and pain caused by health impairments, including supplies and Intermediate services that are provided in order to be able to produce the actual health-related goods and services. In contrast to the conventional view of the health system or health system as part of the largely state-regulated social security system, the view of the health market primarily also includes the perspective of an economic sector that makes a significant contribution to the development of the entire economy. In the following overview, the health economy - including the labor market for the health industry - is structured into five sub-areas, which in turn are specified in more detail. The main aim of this comprehensive presentation is to focus on the real dimension of the health economy as part of the national economy with its diverse interdependencies with other sectors. Overview: Health economy: scope and structure1 • Core area of ​​outpatient and inpatient health care - Hospitals - Preventive care and rehabilitation facilities - Doctors' practices - Dental practices - Practices for non-medical medical professions - Pharmacies - Inpatient, semi-inpatient and outpatient care facilities • Wholesale and supplier industries: - Pharmaceutical industry - Medical products and medical technology - gerontology - biotechnology and genetic engineering - health craft - wholesale and specialist retail trade with medical and orthopedic products • peripheral areas of the health market - health and health system-related research institutions - training institutions for or for the health industry - health-related advice - health-related information offers - organizations and associations in of the health economy - health tourism - wellness • Neighboring branches of the health mar kte's and directly related industries - health-related sports and leisure activities - health-related information offers - production and distribution of functional food and nutritional supplements - catering and cleaning for or in companies in the health industry - advice to companies and institutions in the health industry - planning and construction services for the health industry • Labor market for the health sector - Labor market for health professions in the narrower sense - Labor market for social professions - Labor market for other professions and activities in the health market or in the health market environment The "Advisory Council for Concerted Action in Health Care" has this paradigm shift in particular initiated with his 1997 special report “Healthcare in Germany: Cost Factor and Industry of the Future” 2. There it says, among other things: The health system represents a significant economic and growth factor in the national economy. It not only serves to maintain, restore and promote health, but also contributes to the directly and indirectly around four million employees subject to social insurance contributions and those provided by them Services contribute to economic value creation and, above all, to desirable effects on the labor markets. Under new financing modalities and under competitive conditions, increasing sales, employment figures and profits can be seen as a success story under macroeconomic aspects also in the health care system. The emerging structural growth combined with the increasing proportion of older people is creating new professions and opening up new fields of activity. Welfare, growth and employment are the main target dimensions and effects of the health care system.3 The tenor of the health policy discussion, on the other hand, continues to be predominantly related to the health care system as part of the social security system or social insurance as well as due to the typical German social security system financing through employee and employer contributions Cost factor and thus determined as a burden for the development of the labor market and ultimately the economy as a whole. For example, the report “Economic Aspects of the Markets for Health Services” by the German Institute for Economic Research in October 2001 states that spending on health is primarily seen as a cost factor in the economic policy debate. A permanently increasing expenditure trend is often referred to as a particularly disadvantageous one. A retrospective view of this development in Germany seems to confirm this, as the contribution rates of statutory health insurance (GKV), but also the premiums for private health insurance, have risen sharply in the past In the narrower sense, it has never covered the entire market in which products and services are offered and in demand that are directly or indirectly related to health. There have always been health services that consumers have requested privately and financed out of their own pockets. The expanded view of the health market emphasizes the growth-promoting aspects of the health market and its strong interconnection with other sectors of the economy: Health services can contribute to growth in two ways. First, one can look at the contribution of health services to growth in terms of their share of GDP or the share of people employed in the health sector. Second, it should be noted that human capital is an important factor that indirectly affects growth. In addition to education, which is incorporated in human capital, physical performance is decisive for the economic production process. This efficiency is promoted through health services; In addition to the absorption and processing of knowledge, long-term productivity also requires physical performance.5 In addition, psychological performance should be added here. Hilbert et. al. defined the health economy in 2002 as follows: The extended health system concept also considers the interdependencies of the health economy with other economic sectors. In addition, the expanded understanding of the health economy emphasizes the productive character of health-related services, which - with a few exceptions - received too little attention in the health and social policy debate of recent years. Accordingly, in the onion model they have developed, the authors reckon “in addition to the personnel-intensive services in the field of outpatient and inpatient health care, also the capital and technology-intensive wholesale and supply industries as well as the peripheral areas and neighboring sectors with pronounced health connections” to the health economy. In the meantime, the Federal Statistical Office has also adopted an approach in the context of health reporting that takes account of this new dimension of the health market, even if the health market is still not part of the Office's national accounts in the true sense of the word. As defined by the Federal Statistical Office, the health expenditure recorded in health reporting includes “the financial expenses of a society for maintaining and restoring the health of its members” 8. According to the health expenditure calculation based on this definition, expenditure on health services in the Federal Republic of Germany in 2005 totaled 239.4 billion euros or 10.7 percent of the gross domestic product (GDP) 9. Per capita health expenditure in 2005 amounted to 2,902 euros10. In addition to spending on health services, a total of 60.8 billion euros in income benefits were added. The Federal Statistical Office understands this to mean transfer payments such as sick pay, early retirement in the event of occupational disability or continued wage payments11. In the health industry as defined by the Federal Statistical Office, a total of 4.31 million employees or 10.9 percent of all employees in Germany were employed in 200612. Around 53.4 percent of these employees worked in a health care profession (in particular doctors, medical assistants and nursing staff) and 7.9 percent in a social profession (especially geriatric nurses )13. The Economic Research department of Dresdner Bank used the same term for the delimitation of the health market as the Federal Statistical Office in its trend report “Health market - a growth factor?”, But pointed out that this was still necessary for a comprehensive understanding of the health market A relatively narrow term is: “If one takes the definition of the World Health Organization (WHO) for health as a basis, then there is a further delimitation for the health market than according to the health expenditure calculation. Because the WHO understands health as "the state of complete physical, mental and social well-being and not just the absence of illness or ailment". According to this, the entire wellness sector can be counted as part of the health market. ”14 The German health market is increasingly influenced by the interdependence with the health markets of other countries and the free movement regulations of the European internal market. Such interrelationships have long been a matter of course in the wholesale and supplier markets, but not in the core areas of medical and nursing care. These developments are expressed, for example, in the increased efforts of German hospitals to treat foreign patients, or in the fact that German statutory health insurance companies in other EU countries are setting up their own offices in locations where many German holidaymakers normally stay or where German pensioners are permanently take up residence. Also the legal stipulations of the latest health reform, according to which GKV insured persons can use outpatient medical services in other EU countries without the prior approval of their health insurance company and have a right to the reimbursement of costs up to the amount of the reimbursable costs in Germany, or that The right of the GKV-Kassen to conclude contracts for the provision of services in other EU countries for German insured persons shows the direction of development here.