Lars Bluma/Stefan Schulz/Jochen Streb

Prinzipal-Agenten-Probleme in der knappschaftlichen Krankenversicherung: Die Bekämpfung des „Simulantentums“ durch Anreize und Kontrolle

The Knappschaften grew out of medieval miner’s efforts to insure themselves against the consequences of their dangerous jobs. By the late nineteenth century the Knappschaften were self-run sickness (and invalidity) funds with compulsory membership. Bismarck’s social-insurance legislation used them as a model for similar funds in other industries, and as such they remain the model for German social insurance today. However, late nineteenth-century observers noted that Knappschaften experienced strong growth in the number of days their members claimed to be sick. Contemporaries blamed this development on moral hazard that is feigning illness or malingering. Using the concepts of principal-agent theory, we explain how the Knappschaften tried to reduce sick days per member by establishing a more and more complex system of incentives and control mechanisms.

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