The ethics of behaviour-based insurance models
Solidarity-based concerns in Germany's statutory health insurance
Bibliographic Data
| ID | 21468026 |
|---|---|
| Authors | Carl Justus Bredthauer (0000-0002-5490-8431, Technical University of Munich, corresponding author), Eva Kuhn (0000-0002-8337-9639, Charité - Universitätsmedizin Berlin), Alena Buyx (0000-0002-5726-7633, Technical University of Munich) |
| Year | 2025 |
| Volume | 156 |
| Pages | 105318 |
| Publication date | 2025-06-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy (JOURNAL) |
| Journal identifiers | ISSN: 0168-8510 • E-ISSN: 1872-6054 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.healthpol.2025.105318 |
| PMID | 40250334 |
| OpenAlex | W4409261154 |
| Language | EN |
| References cited | 53 |
Sickness funds have begun to harness digital behavioural data to incentivise physical activity in their members. This ethical and societal effects of this phenomenon remain largely unclear, especially in solidarity-based insurance systems. Therefore, this study analysed the risks and benefits of such programmes with respect to solidarity against the background of recent efforts by German statutory health insurance funds to integrate digital tracking data into their bonus programmes. Key, potential benefits include new forms of solidarity that may emerge based on sharing personal health data. The incentives introduced by these reward programmes could lead to efficiency gains used to benefit society. However, three conceptual pitfalls have been identified: First, the data gathering method may penalise certain vulnerable groups. Such discrimination could, however, be avoided by minimising barriers to participation. Second, digitally mediated bonus programmes may create deadweight effects, i.e. beneficiaries are likely to already be healthy and active. Consequently, behavioural targets should be designed to consider individual prerequisites. Lastly, linking premiums to behaviour might diminish solidarity with poor risks within statutory health insurances and between statutory and private health insurance. Hence, this study aimed to stimulate debate on the ethical and societal implications of the systemic integration of eHealth innovations into healthcare systems
Actuarial science · Business · Casualty insurance · General insurance · Health care · Health insurance · Insurance law · Insurance policy · Political science · Solidarity · Statutory law · Health and Medical Studies · Healthcare cost, quality, practices · Healthcare Policy and Management · Law
Adaptive Self-Regulation of Unattainable Goals
eHealth Literacy
Predictors of eHealth Usage
Social Media Use in the United States
Factors predicting the use of technology
Digital health and the biopolitics of the Quantified Self
Long-term health benefits of physical activity – a systematic review of longitudinal studies
Origins and functions of positive and negative affect
Utilitarianism as a Public Philosophy
Run for Your Life
The Ethics of Medical Data Donation
Solidarity in biomedicine and beyond
Quantifying the body
Is personalized medicine different? (Reinscription
Insurance and Prevention
Digital Natives, Digital Immigrants Part 1
Enacting Actuarial Fairness in Insurance
Self-Tracking for Health and the Quantified Self
Algorithmic Personalization as a Mode of Individuation
Personalizing solidarity? The role of self-tracking in health insurance pricing
| Highly cited | No |
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