Table 4.

Potential gateways to institutional corruption

Breakdown/motivation structure according to federal/state laws	potentially promotes	puts at risk
• Existence of a physician fee per se	prioritization of supplementary- insured patients, increasing/by-passing public waiting lists	equal treatment for equal needs in terms of volume, range, timing and access
• Restriction of hospital and physician fees to inpatient (day) care	inpatient care of outpatient (ambulatory) care	service provision at the ‘best point of service’ and relief of the inpatient sector
• Limiting the special-class bed capacity to 25% of the overall bed capacity	high capacity utilization	reasonable reduction in the overall bed capacity and capacity-reducing innovations
• Tariffication of physician fees	overprovision of medical services, prolongation of length of stay	equal and efficient service provision
• Possibility of dual practice	redirection of profitable patients to private practice/private hospital	service provision at the ‘best point of service,’ coordinated service provision, prevention and decrease of parallel structures and relief of the inpatient sector
	overprovision of medical services through self-referral
	focus on private practice at the expense of public health care provision
	misuse of public resources for privately offered medical services
	absenteeism
	outflow of public hospitals’ resources to private hospitals