Economic Impacts Of Health Insurance Systems On European Societies – AI technologies can empower people, for example by helping citizens to be informed and make healthy decisions, and by supporting doctors in diagnosis and treatment decisions. Estimating the impact of AI on European healthcare is important to advance the current discussion about the role that AI can and should have in healthcare.
This course covers AI applications that can be used throughout the patient journey. Eight categories of applications were mapped: wearables, imaging, laboratory applications, physiological monitoring, real-world data, virtual health care, personal applications and robotics.
Economic Impacts Of Health Insurance Systems On European Societies
Socioeconomic health is measured through health outcomes, financial resources and time spent by healthcare professionals (HCPs). By estimating the number of lives saved, cost savings and hours freed for HCPs, it is possible to calculate the potential impact of AI on the European healthcare system.
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First, every year 380,000 to 403,000 people can be saved. Wearable AI applications can have a huge impact, saving up to 313,000 lives. This is followed by AI application in monitoring (42,000 lives) and prediction (41,000 lives). Second, € 170.9 to 212.4 billion can be saved annually, including the potential cost of the HCP period. Wearable AI devices can have a huge impact with 50.6 billion savings. Add to the AI applications in monitoring (€ 45.7 billion) and real world data (€ 38 billion).
Finally, AI applications have the potential to free up 1,659 million to 1,944 million hours each year. These AI-driven applications in virtual health care (VHA) can save up to 1,154 million hours per year. Other savings through AI applications include robotics (367.5 million hours) and wearables (336.1 million hours). This would allow HCPs to devote more time to high-priority activities.
AI can have a huge social and economic impact on healthcare by improving patient outcomes and access, and optimizing the use of resources. However, in order to reach its full potential there are a series of obstacles that must be addressed by public and private stakeholders:
In order to unlock the full potential of AI in health care, the European health systems and the wider ecosystem need to improve in several areas, including the ways in which technologies are evaluated and returned, staff skills and training, and data interoperability and ownership. These obstacles can be overcome by the cooperation of all stakeholders in the ecosystem: policy makers at all levels (EU, national and regional), healthcare providers, academics, industry and citizens. With this broad partnership, AI innovation and adoption can contribute to high-quality security for European citizens and put the EU at the forefront of the innovation industry.
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: official insurance provided by 109 non-profit “health funds,” covering 88% of the population.
Sickness fees: compulsory wage contributions are shared equally between employers and employees and allocated to the sickness fund using risk-adjusted capitation; additional contributions in accordance with the amount paid directly to the sickness fund; more tax. Personal insurance: individual premiums.
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Health fund enrollees purchase premiums or supplements that cover limited benefits not covered by SHI, including additional copays and private hospital rooms.
Covered medicines: 10%, with a EUR 5.00 (USD 56.60) minimum and a EUR 10.00 (USD 112.21) maximum (or the price of the medicine), plus the difference between the price and the reference price.
The cost of hospitalization is 28 days a year. Total medical expenses amount to 2% of household income; 1% of income goes to people with chronic diseases.
Private customers who pay through the FFS negotiated states pay up to a certain amount of service per quarter. Generally there is no gatekeeping and patient registration is not required, but sickness funds are required to provide an option to register in the family doctor model with gatekeeping.
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A mix of public and private non-profits, some for-profits. Reimbursement through case-based DRG payment, with additional fees for specialized and expensive services and technologies (eg, chemotherapy).
Health insurance is compulsory in Germany. About 86 percent of the population is enrolled in formal health insurance, which provides inpatient, outpatient, mental health, and drug coverage. Administration is carried out by private insurers known as sickness funds. The government has not done anything in providing direct health care. Sickness benefits are financed through general contributions (14.6%) and a dedicated, additional contribution (1% of salary, on average), both shared by employers and employees. Copayments apply to inpatients and drugs, and sickness funds provide a maximum deductible. Germans earning more than $68,000 can opt out of SHI and opt for private health insurance instead. There is no government subsidy for private insurance.
Chancellor Otto von Bismarck’s Health Insurance Act of 1883 created the first national health insurance system. Initially, health insurance coverage was limited to blue-collar workers. In 1885, 10 percent of the population was insured and entitled to benefits in the event of illness (50% of wages for 13 weeks), death, or childbirth. Although initially limited, the coverage gradually increased. The last stage of universal health coverage took place in 2007, when health insurance, whether official or private, was mandated for all citizens and permanent residents. The current system provides coverage for all people, as well as generous benefits.
Health insurance is provided by two categories: official health insurance (SHI), which includes competitive, not-for-profit, non-governmental health insurance programs known as sickness funds; and private health insurance.
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Unlike those in many other countries, sickness funds and private health insurances, as well as long-term insurances, use the same providers. In other words, hospitals and doctors treat all patients regardless of whether they have SHI or private insurance.
Government role: Germany’s health care system is characterized by the distribution of decision-making powers between the federal government and the state and autonomous organizations of payers and providers (see the exhibit).
Within the German legal system, the federal government has considerable regulatory power over healthcare but is not directly involved in care. The Federal Joint Committee, which is chaired by the Federal Ministry of Health, selects the services that will be covered by the sickness benefit. To the extent possible, coverage decisions are based on evidence from comparative-effectiveness reviews and health technology (benefit-risk) analyses.
The Federal Joint Committee also sets provider quality standards and organizes ambulatory care capacity (the number of SHI-accredited practicing physicians), using needs-based population-physician ratios.
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The Federal Joint Committee has 13 voting members: five representatives from sickness fund associations, five from donor associations, and three non-affiliated members. Five patient representatives have an advisory role but no vote. However, representatives of patient organizations have the right to participate in some decision-making bodies, including subcommittees of the Federal Joint Committee.
The Federal Association of Sickness Funds is working with the Federal Association of Statutory Health Insurance Physicians and the German Hospital Federation to develop a sickness fund plan and a disease-related group (DRG) catalogue, which will be adopted by the two joint committees. . The German state governments also play an important administrative role. Sixteen national governments monitor hospital capacity and hospital investment. States also monitor public health services.
Regional organizations of contracted SHI doctors are required by law to ensure the availability of ambulatory services for all specialties in urban and rural areas. These regional associations also negotiate rates for doctors’ fees and sickness benefits.
The role of public health insurance: In 2017, total health expenditure made up 11.5 percent of gross domestic product (GDP). Of this health spending, 74 percent was publicly funded, and most of that spending (57% of the total) went directly to SHI.
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About 88 percent of the population receives primary care through sickness funds, and 11 percent through private insurance. There were 109 disease cases in January 2019.
From 2019, all working citizens (and other groups such as pensioners) earning less than EUR 60,750 (USD77,985) per year are covered by SHI.
Individuals whose total earnings exceed the threshold, as well as self-employed individuals who were previously covered by SHI, can choose to remain in a publicly funded plan (such as 75%) or purchase replacement health insurance. Civil servants are exempt from SHI; their private insurance premiums are reimbursed together with their employer. Members of the military, police, and other government employees are covered under smaller programs separate from the SHI. Tourists are not covered through the German SHI. Refugees and undocumented immigrants are covered by social security in cases of critical illness and pain, as well as pregnancy and childbirth.
Sickness benefits funded by compulsory wage contributions are deducted as a percentage of gross income up to a ceiling. Dependents (unmarried spouses and children) are covered free of charge. As of 2016, the legally mandated uniform contribution has been 14.6 percent of gross income, distributed equally.
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