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Autoritarismus : Einführung
(2012)
The present paper investigates potential fiscal and distributional effects which emerge due to four reform scenarios on the German income tax rate. The analysis is based on a static simulation model for the German tax system using income tax micro-data. The data shows that changing the present progressive tax system to a flat-tax, which was proposed by the FDP in 2010, could reduce the tax revenue by 15 billion Euro. Such a tax regime would increase the unequal distribution and polarisation of net incomes. The IW Koln suggested an alternative tax rate in 2008. This regime would increase unequal distribution and polarisation of disposable incomes to a greater extent than the FDP-tax rate. An implementation of this income tax scale would go along with losses in tax revenue of 18.8 billion Euro. Likewise, the implementation of a 2009 SPD tax rate proposal would reduce tax revenue by 14.8 billion Euro. Although this regime would reduce unequal distribution, the effect on the polarization of disposable incomes is not definitely predictable. In contrast to all the other scenarios, the realisation of the recent SPD tax rate proposal from 2011 could enlarge tax revenue by 4.7 billion Euro. This tax regime would reduce unequal distribution and polarisation of disposable incomes even more than the present tax system.
Currently used costing methods such as cost centre accounting do not sufficiently reflect the process-based resource utilization in medicine. The goal of this study was to establish a process-oriented cost assessment of percutaneous radiofrequency (RF) ablation of liver and lung metastases.
In each of 15 patients a detailed task analysis of the primary process of hepatic and pulmonary RF ablation was performed. Based on these data a dedicated cost calculation model was developed for each primary process. The costs of each process were computed and compared with the revenue for in-patients according to the German diagnosis-related groups (DRG) system 2010.
The RF ablation of liver metastases in patients without relevant comorbidities and a low patient complexity level results in a loss of EUR 588.44, whereas the treatment of patients with a higher complexity level yields an acceptable profit. The treatment of pulmonary metastases is profitable even in cases of additional expenses due to complications.
Process-oriented costing provides relevant information that is needed for understanding the economic impact of treatment decisions. It is well suited as a starting point for economically driven process optimization and reengineering. Under the terms of the German DRG 2010 system percutaneous RF ablation of lung metastases is economically reasonable, while RF ablation of liver metastases in cases of low patient complexity levels does not cover the costs.
Grußwort
(2012)