[Is there any obligation to maintain and promote health?]

The aim of prevention is to protect and maintain health. Several legally enforced preventive measures (e.g., use of safety belts) go undisputed mainly because of a high level of risk perception (of traffic accidents) in the population. On the other hand, obligatory measures for the prevention of chronic disease are mostly perceived as unwanted limitation of individual freedom. Due to demographic changes, pressure for technical innovation and declining revenues chronic disease, however, has become a major problem for solidarity-based health insurance schemes. In this context, new models have recently been proposed in Germany. This paper argues that these are either unpractical (risk surcharges) or directly unfair (increased financial burden on the chronically ill who did not attend free screening).