Using Experiences from the U.S. to Implement Health Savings Accounts in German Statutory Health Insurance

This paper discusses suitable ways to implement Health Savings Accounts (HSAs) in German Statutory Health Insurance (SHI) building on the introduction of so-called Flexible Health Plans (“Wahltarife”) according to Sec. 53 para. 1 Social Security Code V in 2007, which allows insurers in SHI to offer greater variety of health plans. Our focus is on the adaptability of SHI. On the one hand, the possibility to offer products differing from universal health coverage for insurers in the SHI market provides an excellent opportunity to introduce HSAs. On the other hand, we strongly believe that HSAs can lead to significant improvements in SHI. Our approach can easily be implemented into the existing system, whereby introducing HSAs in combination with High-Deductible Health Plans (HDHPs) will tackle a significant number of current problems inherent to German SHI. The introduction of significant out-of-pocket payments will induce the insured to consume medical care in a more conscious way and thereby reduce the occurring costs.