Is risk aversion nature or care

Bought security. The precautionary behavior of citizens in the areas of old age, care and health

The importance of private services of general interest has increased through welfare state reforms. The essay explores the question of how individuals reconcile their commitment to provision in the socio-political areas of old-age security, nursing care and health care that have hitherto been primarily state-insured. With the help of the online survey “Debit and Credit 2013”, a strong tendency towards multiple coverage in the various security areas can be shown. Above all, people with affordable socio-economic resources tend to have additional private insurance in several areas. A tendency for a “trade-off”, in which the protection in one area is bought against the waiver of protection in another area, cannot be determined in any constellation - not even if low financial resources speak against a multiple exposure. Welfare-cultural and economic-sociological theoretical approaches refer to important explanatory mechanisms. On the one hand, there is a cultural familiarization with private pension arrangements. On the other hand, the social embedding of pension decisions means that financial advisors often equip pensioners with several products. As a consequence, there will be a diversification in the level of socio-political security.

1 Introduction and question[1]

When it comes to protecting against social risks, additional private provision has become the norm for large sections of the population - and not without reason. Thus, in the core areas of the provision of existence, financial self-commitment is increasingly required. Even if private supplementary provision played a role even in the heyday of welfare state coverage in the 1970s, it has now acquired a new quality. The focus is no longer on additional security, but on the need, which affects large sections of the population, to 'buy' security through provision products. This need can be seen in concrete terms in the areas of old age, care and - albeit less clearly - in the area of ​​health insurance.

The most intensely discussed is the change from the security systems to one Public-private-Mix (Gough / Adami 2012) in the field of Old-age insurance (e.g. Schmähl 2011). The establishment of a multi-pillar model at the turn of the millennium, which, in addition to the significant reduction in the wage replacement rate in the statutory pension insurance, provided for the establishment of state-sponsored private provision in the form of the so-called Riester pension, formed the framework for this mix (Nullmeier 2015). Since the reforms at the turn of the millennium, old-age savings have been embedded in a welfare market and are intended to maintain the established level of care through state regulation and funding (BMAS 2012; Köppe 2015). The private partial coverage of the care risk is less in the focus of scientific and media discussions - probably also because the one created in 1995 care insurance was conceived from the outset only according to the "partially comprehensive insurance principle" (Blüher / Stosberg 2005: 179). The private financing burden is considerable. More recent empirical data show that on average a third of all care costs are covered by private contributions (Rothgang et al. 2015: 125–127). Since the introduction of long-term care insurance, the private financing burdens have increased continuously. Rothgang / Jacobs (2013), for example, point out that the costs for care are rising faster than the insurance benefits, which leads to an increasing coverage gap. They estimate that in the period between 1999 and 2009 alone there was a decline in the level of state security by 14%. The performance improvements in the context of various legislative amendments have changed little in this fundamental trend. Accordingly, there is an increasing demand to secure care cases through targeted personal provision. In order to promote personal provision in a targeted manner, the introduction of state-regulated and subsidized long-term care insurance policies in the form of the so-called long-term care bahrs was decided in the Care Reorientation Act in 2013 (Rothgang / Jacobs 2013). So far, neither the supply landscape nor the interest in the population have indicated that broad-based coverage can be achieved with the existing funding instruments (Rothgang / Jacobs 2013). Even if in the field of health care In contrast to pensions and long-term care, no state-regulated welfare market with the normative expectation of additional private protection has been established and the claim to full coverage by the statutory health insurance (GKV) continues to exist, it is clear that there has been an increase in the last 25 years Own contribution came (Gerlinger 2013). On the one hand, there has been "a number of cost-control policies that restrict SHI [Social Health Insurance] coverage [which] have resulted in increased out-of-pocket expenses" since the 1990s (Lange et al. 2015: 4). There are areas in the health system in which a patient's own contribution is necessary in the event of treatment, such as dental care, visual aids, hospital stays and the supply of medication. On the other hand, more and more people are making use of additional offers that are subject to a charge and are securing the right to extra services through additional policies, such as the so-called IgeL (Gerlinger / Schmucker 2011). In short: In all three of the above-mentioned areas of social security, personal financial commitment is now common, and millions of citizens[2] try to mitigate cost burdens through appropriate pension products (see also section 4.2).

It is astonishing how little attention has been paid to the behavior of citizens in the various arrangements of private services of general interest in the academic discourse up to now. There are numerous references to the fact that individuals who are given room to maneuver but who are at the same time made socially responsible (Vobruba 2010; Lessenich 2012a) do not behave according to their intentions (e.g. Rieckhoff 2011; Wilke 2014), but there is little beyond that known about how people move in the new security worlds of a public-private shared responsibility (Maier-Rigaud 2015) and what consequences this has for the sustainability of a Public-private-Mix result. So far, the main question that remains unanswered is whether and how people reconcile responsibility in the individual security areas. The present article tries to close this gap by showing how individuals organize their private provision in the areas of old-age security, nursing care and health care, what connections arise between the three security worlds and under what circumstances a financial commitment occurs. The result shows a clear polarization in the area of ​​private provision: some remain without (additional) provision, others take out several provision products.

To set up: First, with the help of existing theoretical approaches, preliminary considerations are made as to how individuals move in the area of ​​private services of general interest. The research status is then processed. Then an evaluation of the debit and credit study from 2013 is presented (Spiegel QC 2013), from which the interplay of different forms of private services of general interest can be shown. Finally, the socio-political consequences of taking out private pension products are discussed.

2 Theoretical preliminary considerations

At the theoretical level, several constellations are conceivable as to how individuals link the individual security worlds of private services of general interest with one another. The fact that there is an interaction between them is solely due to the effects of private services of general interest on the householdbudget to go out. Resources that are used for old-age provision, for example, are no longer available for private engagement in other areas. In view of such financial restrictions, precautionary decisions in the individual security areas cannot be made completely independently of one another.

These budgetRestrictions are the determining element in the interplay between the individual security worlds if the research question is from the perspective of Rational choice is considered (Donges / Freytag 2009). In its basic variant, individuals divide the available resources according to their preference structure and conclude the appropriate products. Given the financial framework, the result is a 'Trade-off ‘ - In other words, a conflict of objectives in which the provision in one area restricts the provision options in other areas due to the associated costs. Accordingly, a negative correlation between individual pension products can be assumed.[3]

In an extended variant of the Rational choiceTheory, people are endowed with different degrees of risk aversion (Leland 1968). People with high risk aversion weight the loss in the event of a loss more heavily than risk-neutral people. A high risk aversion should accordingly be accompanied by a high willingness to take precautionary measures (similar to: Fuchs-Schündeln / Schündeln 2005). It follows that the 'Trade-off ‘-Effect can possibly only be observed after controlling the counteracting factor risk aversion.[4]

With recourse to welfare-cultural approaches - i.e. those that attribute a formative role to the welfare state reality to the cultural understanding and the norms prevailing in a society - it can be argued that the entry into private provision entails long-term changes in the understanding of social security draws (Ullrich 2008). The partial conversion of an area of ​​social security to private provision has the consequence that individuals get used to private security arrangements, i.e. these are increasingly considered 'normal', which leads to increased acceptance of further privatization (Blüher / Stosberg 2005; Bode 2007 ; Pfau-Effinger et al. 2008; Schmitz / Friedrich 2016). Correspondingly, welfare-cultural approaches suggest a strengthening influence between individual security worlds. Financial resources then play a subordinate role if individuals are of the opinion that they have to take care of their own provisions in all areas of life in order to receive adequate protection. The fundamental mechanisms identified are, on the one hand, changes in the attribution of meaning to the purpose and function of social policy programs, and, on the other hand, shifts in attitudes towards the welfare state. Either behavior adjustments (product termination) follow a change in attitudes towards such forms of security, or new institutional framework conditions create other 'normal states' and thus bring about changes in consciousness. The latter mechanism plays an important role in the literature on economization, the activation paradigm and the topic of personal responsibility in the welfare state (Sachweh et al. 2009; Lessenich 2012a). In all three research directions, the aspect of the internalization of new forms of self-management is always discussed, which, once established, also affects other areas of life (Bergmann 2012: 17–58).

Finally, the interplay of different security worlds can be analyzed from the perspective of modern economic sociology. The in Rational choice-Associated knowledge base about the alternative courses of action and their consequences critically questioned (Beckert 2013). When decisions - especially those in the area of ​​services of general interest - are highly complex and span a long period of time, i.e. have a high degree of uncertainty, then individuals try to create orientation through social embedding (similar: DiMaggio / Louch 1998). This tendency towards social embedding is further intensified, so it can be assumed that in the end it is not products but rather promises that are sold on the market for private services of general interest (Priddat 2012: 271). When it comes to social integration, recently the influence of network contacts from friends and family on pension decisions has moved into the focus of economic sociological research (international: Duflo / Saez 2003; Chang 2005; in relation to Germany: Bode / Wilke 2014a) . In contrast, the role of consultants was analyzed less frequently (e.g. by Schimank / Stopper 2012; Bode / Wilke 2014b). Access to products is usually organized via consultants - mainly commission-based in this country. If individuals seek guidance from counselors due to uncertainties (Schimank / Stopper 2012), it can be assumed that the latter use the specific interaction situation to shape the counseling process in their own way (Jungermann / Belting 2004; Bode 2006). A well-known thesis, especially in the area of ​​commission-based advice, concerns the so-called 'Cross Selling ‘ (Pfarr / Schneider 2011): Customer contacts are used to conclude further contracts in addition to existing or planned products. Regardless of this, many citizens try to establish a relationship with 'their' consultant through more or less regular customer contact, who knows the specific needs and helps with decision-making problems (Bode / Wilke 2014b). This puts them in a trust dilemma that underpins the influence of consultants: due to their lack of orientation, citizens have to confide in someone whom they do not trust in principle and whose good behavior they cannot control (Bode / Wilke 2014b). In short: If the dimension of social embedding is taken into account, it can be assumed that the consultant will have a reinforcing effect between individual security products.

If uncertainty, as assumed in economic sociological approaches, is a central reason why pension decisions are socially embedded, then it can be assumed that the influence of consultants also varies with the level of (financial) education. Financial education is regularly assigned an important role in prevention research (Bucher-Koenen 2009). The lower propensity to provide for provision of people with little financial education is explained by a lack of foresight or higher costs when searching for information, depending on the approach (Bucher-Koenen 2009). With the economic sociological approach, however, assumptions can also be made about the interaction between the individual security arrangements. If little (financial) education goes hand in hand with disorientation, there should be an increased tendency to trust counselors. Accordingly, an accumulation of pension contracts is to be expected, especially in the group of people with little (financial) education.

With the help of various sociological theoretical approaches, it is possible to make assumptions about how individuals organize their private services of general interest in different security worlds. The Rational choice-Perspective suggests (under control of risk aversion) a negative connection between the security worlds due to the rational allocation of existing resources. Welfare-cultural approaches, on the other hand, suggest a positive connection between the security worlds if the normative conviction of private provision is a necessity. The hypothesis of a positive correlation also follows from economic sociological approaches. The reasons for this, however, are the social integration of pension decisions and the need to confide in advisors.

3 state of research

Sociopolitical research in Germany and elsewhere hardly provides any information about how individuals come to terms with private services of general interest. It mostly focuses on state programs (Seeleib-Kaiser et al. 2012: 151). Only in the recent past has the state-centered perspective been increasingly broken. In particular, the strongly international debate on welfare markets, for Public-private-Mix and privatization studies have pointed to the close interlinking of public and private livelihoods (Taylor-Gooby et al. 2004; Berner et al. 2009; Gingrich 2011; Seeleib-Kaiser et al. 2012; Orenstein 2013; Köppe 2015). At the same time, however, it is noticeable that even in this work hardly any attention is paid to the micro level. The most important findings of empirical studies on private provision are summarized below. The results of international studies, which are marked as such, are used to support this.

Even if the reference to privatization developments and more or less assumed personal responsibility is now part of the standard repertoire of the German welfare state diagnosis (Lessenich 2012b: 107-133), the central question of how citizens in this country move in the new security worlds (similar: Köppe et al. 2016: 6). The beginnings of such research can be observed since the introduction of various forms of state-moderated private insurance. In the area of ​​old-age provision in particular, it is well documented which socio-structural characteristics go hand in hand with a private pension commitment (overview: Blank 2011).Several studies have shown that private old-age provision in the form of the Riester pension is more widespread among middle-aged people, from the new federal states, with high incomes and stable employment, as well as among those with pronounced financial knowledge - the level of education, on the other hand, has only a minor influence ( Börsch-Supan et al. 2008; Geyer / Steiner 2009; Blank 2011). If non-subsidized forms of old-age provision are also taken into account, the socio-structural stratification is significantly greater than that of the Riester pension (Pfarr / Schneider 2012). In addition to the use of private old-age provision, there are now initial studies that show which behavioral patterns stabilize in individual people over time, how contracts are serviced and when the contracts are terminated (Wels / Rieckhoff 2012; Ziegelmeyer / Nick 2012) . There are also studies for private health insurance (Gerlinger / Schmucker 2011; Grabka 2014). The socio-structural relationships have changed slightly for the spread of private supplementary health insurance. Grabka (2014) has shown for private supplementary health insurance, for example, that such forms of coverage are more common among women, middle-aged people and in higher income groups. In contrast to the pattern of private old-age provision, supplementary health insurance occurs mainly in West Germany and for people in good health, and there are also strong differences between the individual educational groups. So far, there are no robust findings on private coverage of the care risk in general and on “Pflege-Bahr” in particular (cf. Rothgang et al. 2014: 32–34).

It is noticeable that private pension commitments have so far only been considered in isolation in the literature - interactions between individual arrangements of private services of general interest are not considered. Discourses mostly take place within sub-disciplines such as age research (Rieckhoff 2011), health (Gerlinger / Schmucker 2011) or nursing sciences (Blüher / Stosberg 2005), so that there is no integrating perspective. Nevertheless, the first clues for a possible connection can be found in these studies: first in work on the use of products and Secondly in work on welfare state attitudes.

First: The studies by Pfarr / Schneider (2011) and Bode / Wilke (2014a: 240–266) analyze the use of Riester products. In both papers, a positive connection between taking out private health insurance and a Riester pension can be demonstrated. This connection is explained with the work of sales-oriented consultants as new socio-political actors. Based on this research, a whole series of other studies can be cited which attempt to work out the influence of advisors on investment decisions in general (e.g. international: Bluethgen et al. 2008 and Georgarakos / Inderst 2011). A clear finding of the studies mentioned is that advisory situations are used to sell products - for example, by placing additional products in advisory meetings about the requested products or by regular 'inventory reviews' leading to new product recommendations. A disadvantage of these studies is that they do not explicitly deal with the interaction of different forms of services of general interest. The findings mentioned can therefore only serve as indications.

Second: In attitude research - so far mainly in the area of ​​old-age provision - there are studies that analyze the support patterns of private provision (international: van Groezen et al. 2009; Jaime-Castillo 2013; with reference to Germany: Nüchter et al. 2008) . These either trace the development of acceptance for private arrangements over time or try to identify special groups of supporters. The first research approaches come to the result that private provision has gained acceptance in the course of its establishment in the welfare state (for example in Sweden: Edlund / Sevä 2013; but also in Germany: Schmitz / Friedrich 2016: 189–193). Many citizens now want a pension system in which private commitment is also necessary.[5] With regard to the support groups, the socio-structural situation and (party) political orientation have been examined so far. According to international studies, a favorable socio-economic starting position (income, education, male gender) tends to go hand in hand with a stronger preference for private provision (international: Edlund / Sevä 2013; for Germany: Bode / Wilke 2014a: 55–59). It is noticeable that in attitude research the same groups are identified as being open to private services of general interest who purchase corresponding products with an above-average frequency. A product conclusion triggered by attitudes and convictions does not seem unlikely (with regard to old-age provision: Lamping / Tepe 2009; for the USA: Bailey et al. 2004). However, how attitudes in one area of ​​private provision affect behavior in other areas has not yet been clarified.

4 empirical findings

4.1 Data and methods

Private services of general interest play in standardized Surveys hardly a role so far. Surveys do exist in which the possession of private health, old-age or long-term care insurance is recorded, but the simultaneous survey of all three areas of provision, which makes an analysis of the interaction possible, is rare. The debit and credit study from 2013 is an exception. This is one On-line- Survey of 4,913 people from the federal territory.[6] The selection of the sample is representative of the population with On-line-Access and took place via a quota-sample (Spiegel QC 2013: 10). The survey asked numerous questions about dealing with money as well as investment and pension behavior in various areas of life. In addition to product ownership, general settings and specific contractual partners are also asked for.

Even if On-line-If investigations are increasingly established as an accepted survey method (Zerback et al. 2009), they are subject to certain restrictions with regard to their scientific usability. This applies in particular to the present study. The first restriction is the availability. More than three quarters of the German population have internet access, but part of the population is still not on-line reachable (Wagner / Hering 2014: 661). However, since the working population is focused here, which has an above-average rate of internet access, only a slight bias is to be expected. Second is quoted by the sample from the paybackPanel no random sample in the narrower sense guaranteed. Both the quotation and the selective pre-selection of potential interview partners are associated with limitations in the statistical analysis (Baur / Florian 2009: 110–117). The scientific interest in knowledge could be disturbed by the specific interests on the part of the client, but also of the test persons. With the survey, the client did not pursue a primarily scientific interest, but sought a comprehensive description of the investment behavior. Despite this restriction, attention was paid to compliance with the standards of empirical social research when designing the questionnaire. In addition, upon successful completion of the investigation, the participants were credited with a quasi-monetary remuneration in the form of payback points. This increases the risk of a selective sample. In order to be able to estimate the range of possible distortions due to the mode of the survey, the descriptive findings are supplemented in the following by other data sources as far as possible. For the (multivariate) analysis of relationships, however, the restrictions mentioned are less relevant - studies have shown that On-line- Surveys allow a reliable estimate of measures of association despite the selection mechanisms mentioned (Alvarez 2003).

Some fundamental difficulties in developing the research object arise in the construction of the dependent variable. These problems also affect other studies on private pension provision - especially when they are based on surveys. First, there are considerable delimitation problems (cf. with regard to old-age provision: Wilke 2016: 191–193). In addition to the state-defined pension products, such as the Riester pension, there is a whole range of other products that can be used to provide coverage. And in fact, in the empirical attributions of people, there is a wide range of forms of provision that are usually not examined from the perspective of private provision (e.g. real estate or investment in education: Maicher 2012). Likewise, products that are sold as pension products can serve entirely different purposes (e.g. life insurance). Problems of demarcation are exacerbated by the fact that (at least old-age) provision is often a matter for couples and not a 'private matter' (with regard to Great Britain: Joseph / Rowlingson 2012). Studies that deal with private provision behavior inevitably have to accept this vagueness. Second, respondents often have little knowledge of the existing pension products. Since contracts were often concluded many years ago, certain policies are linked to others or simply have opaque marketing names, many people do not have an overview of their pension portfolio (with regard to old-age provision: Haupt 2014). Depending on the survey method, this sometimes results in considerable differences in the estimated distribution of pension products (see Section: 4.2).

In the debit and credit study, pension behavior was surveyed using a list of different products at the individual level with the questions "Which of these types of investments do you personally own?" And "Which insurance policies do you personally own?". The problems just outlined of the attribution and delimitation of provision products for securing one's livelihood from others become clear at this point. Since precaution can ultimately be implemented using different product (mixtures), a selective selection is necessary.[7] Among the possible answer categories, ownership of private pension insurance, private long-term care insurance, and supplementary health insurance are used as dependent variables. In all three areas, products for private security complement the state-organized basic provision.[8] In the multivariate analysis, logistic regression models are used (in general: Urban / Mayerl 2006), each of which is the same set of explanatory variables, supplemented by the varying indicators on private services of general interest. For the following analyzes, the sample is narrowed down to those aged 18 to under 65. (Early) retirees and people in training were excluded from the analysis, as were the self-employed and civil servants, as (partial) private insurance is assumed there. In order to rule out possible incorrect assignments in private supplementary health insurance, only people who are members of the statutory health insurance were taken into account. This reduces the sample to 3,491 respondents, of whom 2,814 are included in the multivariate analysis due to individual incorrect values.

4.2 Evaluation

The following table gives an initial overview of the spread of private services of general interest in the security worlds of old age, health and long-term care according to the information in the debit and credit study. In addition to the percentage distribution among the labor force, the distribution is differentiated according to various socio-structural characteristics. A little more than 40% of those surveyed state that they have private pension insurance. The proportion (not shown here) of people who can be identified as Riester savers, on the other hand, is below 30%. About a third of the respondents have supplementary health insurance. Significantly fewer (8%) have private long-term care insurance.

These data largely reflect the distribution that can be derived from the data of official statistics: According to the Federal Statistical Office (2012: 47) based on the 2011 microcensus, around 18 million people (approx. 22%) in Germany have private supplementary health insurance . The majority of these contracts are for people with full private health insurance (around 48% of 9.3 million versus 20% of 70 million people insured with GKV). Since this also includes pensioners and children with a lower probability of graduation, the prevalence among the workforce insured in the statutory health insurance is higher and, at around 28%, is close to the value shown in Table 1. According to the Association of Private Health Insurance (2014: 6), around 2.7 million people (3.4%) owned voluntary long-term care insurance in the 2013 survey year. This significantly lower value compared to the information in Table 1 reflects the experiences of others surveygestied studies, which also show a significantly higher distribution.[9] Among the long-term care insurances taken out, the state-sponsored “Pflege-Bahr” plays only a subordinate role with 350,000 contracts in 2013 (Rothgang et al. 2014: 32–34). For private pension insurance, there are only official data for concluded contracts, but not for the number of people covered. In the 2013 survey year, there were 16 million Riester contracts, with around 20% of the contracts being dormant (BMAS 2015). If, in addition to Riester pensions, non-subsidized policies are also considered, data from the General Association of the German Insurance Industry provide a rough guide. However, these only provide information on pension insurance products (bank savings plans and similar products are not taken into account). The association shows around 20 million pension insurance contracts concluded for 2013 (GDV 2014: 14–15). In other words, in addition to around 11 million pension insurances funded through the Riester pension, there are a further 9 million (1.7 of which as basic pensions). For the Riester pension, the number of people with a contract can be related to the (estimated) number of those entitled to allowances (Fasshauer / Toutaoui 2009). This results in a distribution of around 40% - with in Surveys often a lower percentage indicates ownership of a Riester product (e.g. Blank 2011: 112; Wilke 2016: 232–234). In this respect, the values ​​for pension insurance shown in Table 1 seem to agree well with the findings from other studies. All in all, the educates Survey the spread of pension products in the population decreased relatively well.

Table 1

The spread of private services of general interest

AllNew federal statesWomenIncome below € 1,750Low level of education
Pension insurance42,89 %38,22 %40,03 %35,93 %38,55 %
Additional health insurance30,82 %25,49%28,40 %23,70 %24,41 %
care insurance8,26%5,57%7,76 %6,52 %7,33 %
Two insurance companies16,90%13,54%16,30%16,99%13,27%
Three insurances4,24 %2,03 %3,14%4,53 %3,83 %

The precautionary behavior in several security worlds cannot be reconstructed from other data sources. Table 1 provides initial information on this. It shows how often it happens that a person owns a product in at least two of the areas of age, care or illness. Of those surveyed with insurance in one area, almost 30% have products in exactly one other area. In addition, 7% even own products in all three areas.