This means that services which could potentially fall within the remit of both insurance schemes tend to be shifted to the LTC insurance because this is much cheaper. Secondly, although the revenues and costs of all the German health funds are equalized to take account of their respective member structures (age, gender) (Strukturausgleich), this is not the case for the revenues and costs of the LTC funds. This leads to a high disincentive for the LTC funds to minimize their costs. Thirdly, the health insurance funds are in competition with each other as far as their contribution rates are concerned,.
