Sind vor dem Virus alle gleich? Gerechte Gesundheitsversorgung in der Krise

Im Rahmen der COVID-19-Pandemie wird die Frage nach einer gerechten Gesundheitsversorgung anhand verschiedener Interventionsebenen diskutiert. Menschen mit niedrigem sozioökonomischem Status weisen aufgrund ihrer höheren Exposition zum Virus ein höheres Infektionsrisiko auf. Intergenerationale Gerechtigkeit, beispielsweise im Kontext der Impfpriorisierung, ist ebenfalls in der Diskussion. Menschen, die nicht an COVID-19 erkrankt sind, nehmen Gesundheitsleistungen seltener in Anspruch. Um eine gerechtere Gesundheitsversorgung zu gewährleisten wird vorgeschlagen, dass eine sozial gerechte Grundstruktur nicht die gleichmäßige Verteilung von Ressourcen bedeutet, sondern dass eine gleiche Ausgangslage für alle den Ausschlag für mehr Gerechtigkeit in der Krise gibt. Abstract: Is the Virus a Respecter of Persons? Fair Provision of Health-Services in the Current Crisis. In the context of the COVID-19 pandemic the issue of a fair provision of health-services is being raised on different layers of intervention. People with a low socio-economic status face a higher risk of infection because of increased exposure to the virus. Intergenerational fairness is under discussion, for instance in the context of the prioritization of inoculation. People that suffer from other diseases than COVID-19 take less advantage of the health-care system. For ensuring a more suitable distribution of resources it is being suggested that not equality in the distribution of resources but equity in initial positions will ensure more justness in a crisis.

Indicators for Measuring Intergenerational Fairness of Social Security Systems—The Case of the German Social Health Insurance

The issue of fiscal sustainability is often labelled as a synonym for intergenerational fairness; however, pay-as-you-go schemes such as the German Social Health Insurance (SHI) involve a “natural” amount of intergenerational redistribution from younger net payers to older net beneficiaries. We calculate intertemporal balance sheets of SHI and compare two generational accounting approaches (GAC and GAIB) with an alternative measure of intergenerational fairness, SM, which we derive from Settergren and Mikula (2005). Our results indicate that the SM concept leads to similar implications concerning the amount of intergenerational redistribution as classical measures of fiscal sustainability. For the SM approach, the balance sheet of SHI shows a rate of unfunded benefits of 25 percent. Closing this gap requires an increase of the contribution rate by 30 to 40 percent. This total effect can be separated into an effect due to the current population structure (10 p.p.), the increase in life expectancy (10 p.p.), and medical technical progress (about 10 to 20 p.p.).

Intergenerational equity, equality and reciprocity in economically and politically turbulent times: narratives from across generations

The concept of intergenerational fairness has taken hold across Europe since the 2008 financial crisis. In the United Kingdom (UK), focus on intergenerational conflict has been further sharpened by the 2016 ‘Brexit’ vote to take the UK out of the European Union. However, current debates around intergenerational fairness are taking place among policy makers, the media and in think-tanks. In this way, they are conversations about, but not with, people. This article draws on qualitative interviews with 40 people aged 19–85 years and living in North-East England and Edinburgh, Scotland's capital city, to explore whether macro-level intergenerational equity discourses resonate in people's everyday lives. We find widespread pessimism around young people's prospects and evidence of a fracturing social contract, with little faith in the principles of intergenerational equity, equality and reciprocity upon which welfare states depend. Although often strong, the kin contract was not fully ameliorating resentment and frustration among participants observing societal-level intergenerational unfairness mirrored within families. However, blame for intergenerational inequity was placed on a remote state rather than on older generations. Despite the precariousness of the welfare state, participants of all ages strongly supported the principle of state support, rejecting a system based on family wealth and inherited privilege. Rather than increased individualism, participants desired strengthened communities that encouraged greater intergenerational mixing.

Putting a price tag on emissions and resources: An economist’s view on policy interventions for intergenerational fairness and sustainability

Modern economies are confronted with major problems: the exhaustion of natural resources, the degradation of the environment and the financing of the needs of an aging population ‐ all challenge the welfare of both present and future generations. This paper discusses a proposal which is designed to bring about a double dividend. On the one hand, a virgin resource tax could stimulate the reduction of natural resource use by making sustainable technologies economically profitable. On the other hand, it could provide a way to finance the pension system.

The effect of an instantaneous dependency rate on the social equitability of hybrid PAYG public pension schemes

The defined convex combination (DCC) pay-as-you-go public pension systems recently introduced in the literature are a form of hybridization between defined benefit (DB) and defined contribution (DC) designed to maintain intergenerational social equitability by reacting to demographic shocks in an optimal way. In this paper, we augment DCC schemes with the assumption that the dependency ratio between pensioners and workers is driven by an exogenously modelled instantaneous stochastic rate of change. This assumption enjoys support from the empirical data and allows explicit solutions for the contribution and replacement rate processes which make transparent the nature of the dynamic evolution of a DCC system, as well as the role of the variables involved. The analysis of intergenerational social equitability measures under the assumption of an instantaneous dependency rate confirms the view expressed in previous literature that neither DB nor DC achieves social fairness, and that DCC plans have the potential to improve on both. We perform a calibration test, and our findings seem to indicate that in ageing economies the DC system might indeed be superior to the DB one in terms of intergenerational fairness.