[Wishes and possibilities in the face of limited resources]

The main intention of health economic studies is to find out how to cope with the prevailing scarcity of resources. But scarcity is comparable to morbidity. As morbidity can not be finally cured by medical intervention, the problem of scarcity can only be solved relatively by economic research. It is evident, that the sensation of scarcity even aggravates with increasing prosperity. That is because human demands do in fact outrun economic potentials. The scarcity of resources therefore demands for setting of priorities. That is what economics in general and health economics in particular has set rules for. Priorities can be set by the state, the market or joint associations. The prevailing system in Germany is based on associations, the so called self-governing body. The scare financial resources are divided into budgets and allocated to service suppliers following predefined negotiation mechanisms within the joint self-administration. In recent years an increasing paternalism of the German government on the joint self-administration can be observed. Although Germany spends more on healthcare than ever before, the scarcity is noticed as threatening. The government currently interferes to cope with this problem. In opposition to that approach critics postulate more individual freedom in decisions for insurance holders, patients, health insurances and suppliers. The principal of subsidiarity intends to strengthen self-responsibility in the health care sector while in return the principle of solidarity within the legal health insurance is reduced.