Krank oder Simulant? Das Identifikationsproblem der Krankenkassen aus wirtschaftshistorischer Perspektive

摘要

Es gehört zum Selbstverständnis des modernen Sozialstaats, seine Bürger vor den schwerwiegendsten Folgen der Unwägbarkeiten des Lebens zu schützen. Im Mittelpunkt stehen dabei meist die wirtschaftlichen Konsequenzen: Die möglicherweise drastischen ökonomischen Auswirkungen von Krankheit und Behinderung, welche die von ihnen Betroffenen am vollen Einsatz im Arbeitsleben und somit am Erzielen von Einkommen hindern, stellen eines der herausragenden Motive für staatliches Eingreifen dar.%Economic-historical findings attest that already in the nineteenth century the economic implications of Moral Hazard in health insurance were very well understood and that attempts were made to overcome them with the help of various incentive and control mechanisms. This article shows that the health insurance schemes run by the historical miners' guilds, by reason of their monopoly in the sector and their relatively wide room for maneuver in the politics of the business, are particularly well suited to an empirical analysis of the problems connected with Moral Hazard. We conclude that the economic-historical perspective here adopted can be extended beyond the analysis of Moral Hazard in health insurance to answer other present-day questions. The most important finding of an empirical analysis based on data concerning historical miners' guilds is that the level and duration of daily sickness pay created a strong incentive to feign illness.