The guiding ideas behind the recommendations

This section sets out to sum up concisely the ideas that guide the recommended reforms of the economic mechanism on the demand side. Later, the proposals will be broken down systematically and the details and necessary qualifications discussed.

Health services are divided into two parts: basic and supplementary care. All citizens should have access to basic care. This right has to be enshrined in law. Apart from that, the state should ensure, economically and organizationally, that this legal guarantee is upheld.

Supplementary care, in contrast, has to be purchased by patients. There should be the legal and organizational conditions for this to develop legally under conditions of commercial purchase and sale.

The main source of financing for basic care is the tax paid by citizens and/or the compulsory contributions levied on them like a tax. In other words, basic care is financed out of public money. This is the dominant, if not the exclusive source.

The main financing source for supplementary care is the individual's or family's own money. Another important source might be a voluntary employer contribution (over and above the employer's health-care contribution required by law). In both cases, the source is private money.

Where is the dividing line between basic and supplementary care? The discussion will return to this several times. Suffice it to say here in advance that the dividing line is not health-care needs or medical possibilities, which are insatiable.