Täglich sieht man etwas, erlebt etwas, liest etwas, hört man von etwas, das man nicht versteht. Insbesondere die Presse wirft mit ihren Artikeln oft mehr neue Fragen auf, als das sie alte Fragen beantworten.

07 August 2006

Fusionen für nichts gut?

Heute in der FAZ:
"Rürup: Kassenfusionen sparen keine Verwaltungskosten"

Herr Rürup ist ja nun nicht irgendjemand. Der Mann hat Erfahrung und Einfluss. Bericht über Herrn Rürup bei Wikipedia:
http://de.wikipedia.org/wiki/Rürup

In einem Interview sagte er: "Er warnte vor der Annahme, allein mit Fusionen ließen sich Verwaltungskosten einsparen. „Wenn diese These zutreffen würde, dann müssten die Verwaltungskosten mit zunehmender Kassengröße abnehmen.“ Die Empirie belege das nicht. Die Kosten stiegen."

Leider liefert der Bericht keine Anhaltspunkte, warum das so sein soll.
In der Wirtschaft werden oft und gerne Fusionen oder Übernahmen damit begründet, dass dadurch Synergie-Effekte (http://de.wikipedia.org/wiki/Synergieeffekt) erreicht werden können. Das dies nicht immer so funktioniert, wie sich das Management es denkt, lernt jeder BWL Student schon im Grundstudium. Und jeder Arbeitnehmer, der in seiner Firma mal solch einen Zusammenschluss live erleben durfte, in der Praxis.

Das der Hochregulierte Markt für gesetzliche Krankenkassen in Deutschland nicht unbedingt zu 100 % den üblichen Marktbedingungen folgt, glaube ich auch gerne. Aber das durch Fusion von Krankenkassen keine Ersparnis bei den Verwaltungskosten eintreten soll, ist mir unverständlich. Selbst wenn die ganzen Hirachen in den Krankenkassen und die ganzen Chefs in den Aufsichtsgremien anderweitig versorgt und neue Pöstchen bekommen, sollte doch das ein oder andere Potential übrig bleiben. Ich denke da nur mal an Call-Center, Kundenservice, Abrechnung, Verträge und Genehmigungen für Leistungen die mit den Krankenkassen abgerechnet werden sollen (Stichwort: Kassenärztliche Zulassung). Das soll keine Einsparung bringen? Von Dinge wie EDV zusammenlegen, gemeinsames Marketing, Personalbetreuung, wollen wir mal gar nicht von reden. Wenn die Krankenkassen anfangen würden, sich auf ihre Kernaufgabe zu konzentrieren, könnten die Verwaltungskosten deutlich gesenkt werden.

Warum es in Deutschland mehr als 200 gesetzliche Krankenkassen gibt, ist mir eh unverständlich. Die Leistungen sind festgeschrieben, mit allen Berufsverbänden (Ärzten, Optikern, Apothekern und was es da alles gibt) existieren Vereinbarungen, die regelmäßig von allen Krankenkassen gleich angewendet werden. Um Risiken in der Versichertengruppe auszugleichen gibt es den Risikostrukturausgleich. Zitat aus Wikipedia: "Im Jahr 2004 wurden durch den Risikostrukturausgleich ca. 16,1 Mrd. € zwischen den Krankenkassen umverteilt."
Warum braucht man dann so viele Krankenkassen? Mein Vorschlag: Alle einstampfen, eine Einheitskasse und gut ist. Bei der Rente (nicht ganz, aber ziemlich) und bei der Arbeitslosenversicherung gibt es auch kein Schein-Wettbewerb.

Einige mögen jetzt einwenden, dass die Arbeitslosenversicherung kein gutes Beispiel wäre, ich weiß, gerade dort gibt es Bestrebungen mehr Wettbewerb einzuführen. Doch muss man hier trennen zwischen der originären Aufgabe der Arbeitsagentur (nämlich das Einsammeln des Arbeitslosenversicherungsbeiträge und deren Auszahlung an Empfänger von Arbeitslosengeld) und den sonstigen Leistungen, die nicht zwingend von einer Behörde erbracht werden müssen, wie Vermittlung oder Förderung.

Vielleicht wird das Interview der FAZ mit Herrn Rürup von anderen Medien aufgegriffen und ich werde in einem anderen Artikel erfahren, warum Herr Rürup denkt, dass nicht unbedingt Einsparungen zu erwarten sind.

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