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The Retirement and Pensions System of Germany
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Dr. Carsten Weerth BSc (University of Glasgow) LLM MA
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Final report of Stanford University's Class on Finance of Retirement and Pensions.
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First we will point out how the Dutch long term care has been organised for many years. In contrast with many other countries we have largely institutionalised our long term care. This means that we have a lot of places in nursing homes, homes fort he elderly, care for mentally handicapped and psychiatric patients. This care has been regulated for a long period through the General Law for extraordinary Heathcare expenditures ( Algemene Wet Bijzondere Ziektekosten, AWBZ), wich means that it has been part of our social insurance system. Though this system has provided care for many peolpe for many years the back side was that the costs were rising continiously. With the ageing of the population still going on till about 2040 the government felt some needed to be done. The new cabinet has now come to a number of policy changes. First of all people with the lowest levels of care ( the levels 1,2,3 from a scale ranging to 7) are no longer entiteld to care deliverd through the new Law for Longlasting Care (wet langdurige zorg, WLZ), wich replaced the former AWBZ. The can ask for care tot he community but first of all the communities have far less money to spend and secondly there are introduced copayments depending both on income and wealth, wich in some cases are quite high. For the psychiatric care the changes are even more complex because part of the psychiatric care has moved tot he health care insurance act ( Zorgverzekeringswet). What these changes mean fort the health care infrastructure remains our key qustion. We will analyze the changes so far and make scenario’s for the future. We shall discuss the changes separately for care fort he elderly, care for mentally handicapped and psychiatric care. One of the conclusions so far is that in the care for the elderly and als the care for mentally handicapped institutions that followed models of care that were advocated by the government ( e.g small scale, largely decontentrated) now have serious financial problems. Furthermore we will see that care for the elderly will continue to exist on a large scale but with many solutions outside the public system. This also means that a lot of elderly persons are in charge of the kind of care they want to have, because they also pay for it themselves.
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