Many health economists demand more competition in the health care system. They focus on the competition between … sickness funds for insured and the competition between health care providers for contracts with sickness funds. But they … neglect the competition between health care providers for patients which is crucial for medical quality. This third field of …

This paper investigates competition between health insurance companies under different financing regulations. We … consider two alternatives advanced in recent German health care reform discussions: competition by contribution rates (health … contributions) and by fees (health premia). We find that contribution rate competition yields lower company profits and higher …