GDP, Wages, Employment, and Demography: What drives the Financing of Health Insurance? Factor Analysis of the German Statutory Health Insurance 1996-2016

For the German statutory health insurance (SHI), the development of health spending and of the contribution relevant income is analyzed between 1996 and 2016 with respect to the relevant economic and demographic driving factors. The analysis allows identification and quantification of the main drivers of the contribution rate (CR) being the percentage of income that has to be paid as contribution to SHI. It turns out that the most dominant driver for an increasing CR is the aging of the insureds. Additionally, the growing employment also had a pushing effect on the CR as the number of contribution paying SHI members did not grow in equal measure. Only a moderate contribution can be ascribed to the reduced growth of the contribution relevant income.