How Can the Legal Nursing Care Insurance Be Reformed with the Help of Personal Budgets?
Against the background of increasing cost pressures and a deficit of the legal long term care insurance of 400 Mio. Euro in 2002, the Rürup-Commission considers personal nursing care budgets as one possible avenue amongst others to reform the legal long term care insurance. Unlike non-cash benefits, personal budgets enable long term care patients to realize an individually tailored home care arrangement by buying the desired care services. By implementing personal budgets, the Commission expects an increasing cost effectiveness of the long term care insurance due to higher quality nursing care at a given cost level. The aim of this article is to review the existing approaches concerning the implementation of personal budgets in the national and international context. After a theoretical discussion of the budget for nursing care, the article focuses on the requisites for a successful testing of a personal budget in the German context. Based on these insights, this article develops a research agenda for a comprehensive evaluation of personal budgets in Germany and recommends a social experiment with a randomized control group as the preferable evaluation design. Moreover, conducting such experiments in different communities allows for an identification of indirect effects in the complete system of the long term care provision.