From 2011 Higher health costs

Higher health costs: This is all changed by the health care reform for the insured

(14.11.2010) The German Bundestag has decided on the health reform and thus also a reform of the statutory health insurance funds. Cash patients must adjust to higher costs in the health system from the turn of the year. We show what changes everything. On Thursday, the Medicines Savings Act and on Friday the financing law of the health insurance (GKV-Financing Act) was decided. Against the votes of the opposition, the black-yellow federal government decided one of the biggest reforms in the health sector. For most insured persons, rising health care expenditures are now available.

Increase in the regular health insurance contribution
From January 1, 2011, health insurance contributions will increase from 14.9 to 15.5 percentage points. This means that the health insurances will receive about six billion euros more in membership fees from next year. That was also necessary because the expected deficit in the health fund was estimated at a whopping eleven billion euros. With the increased cash contributions, this deficit should be partially offset. In the case of cash contributions, employers and employees each pay half the contributions. From this increase, however, the contribution rate for the employer is frozen. This means that all future increases must be paid by the insured themselves. The employer's share is thus frozen at 7.3 percent. Any cost increase beyond the general wage trend will have to be borne by cash-desk patients from next year onwards.

Additional contributions soon nationwide?
Most health insurance companies promise that the increased regular contributions will be sufficient to avoid raising or raising additional contributions. However, currently nine statutory health insurance companies already require an additional contribution. The amount of the additional contribution is currently at the affected funds at eight euros a month. However, health economists assume that additional contributions from all health insured persons will soon be required nationwide. For the costs in the health system have been rising steadily for years. The main reason for this development is above all the demographic change of society. People are getting older, medical options are getting better and health care is getting more and more expensive. Doctors and clinics also demand ever higher fees in order to work cost-effectively. This means that insured persons must set up additional and higher additional contributions in the near future. According to a study by the German Trade Union Confederation, the additional monthly contribution in 2025 could already amount to about 100 euros per month (additional 1164 euros per year). And these are still conservative estimates.

So that the funds can determine the amount of the additional contribution itself, the legislature has decided on a far-reaching change. From the first of January, each individual fund will determine if and how much the flat-rate additional contribution will be calculated. The Federal Government, however, assumes that most people will be spared an additional contribution in 2011. If a statutory health insurance fund raises an additional contribution, insured persons can change their health insurance. For this reason, most health insurance companies are rather covered, because they fear a high willingness to change. The Federal Ministry of Health estimates that from 2012 onwards, on average, every health insurance fund will raise an additional contribution of four to five euros. This means that although not all SHI insurances will make an additional contribution, however, many financially troubled health insurance will raise at least from 2012 one. The planned social compensation, however, comes only for very few into consideration. Because this is not based on the individually raised amount of those affected, but on the average amount of all health insurance.

Who is exempt from an additional contribution?
In the future, some insured persons will in principle be exempted from an additional contribution. This includes:
- Recipient of Hartz IV benefits (without mini-job)
- Persons in training according to the Vocational Training Act,
- Disabled people are in recognized workshops or facilities
- Participants in services for participation in working life, on findings of professional aptitude or work testing are, as far as these measures are not provided in accordance with the provisions of the Federal Care Act ,
- To have or receive a claim for sickness or maternity benefits who receive parental or parental allowance or parental leave
- refer to injured money, pension sickness or transitional allowance during a medical rehabilitation,
- be given a leave of absence without pay during their pregnancy,
- Infringement according to SGB VII, sickness benefits according to the federal pension law or similar remuneration,
- Persons who do military service or civil service while receiving no salary,
- are employed for their vocational training, pay not exceeding EUR 325 per month, a one-time allowance being allowed,
- a voluntary social year or a voluntary ecological year i.S.d. Youth voluntary service legislation, but only so long as they do not receive any additional contributory income.
- For welfare recipients, their additional contribution has been and will be § 32 para. 4 SGB XII paid by the service provider.

Unemployment benefit One of the recipients and pensioners are not spared from the additional contributions of the health insurances. Also on so-called "mini jobbers" additional contributions could be possible. For them, only a social compensation in question.

Who gets a social compensation?
Health insured persons, who have to pay more than two percent of their average gross income per month for an additional contribution, receive a so-called social compensation from the federal government. However, the amount of the compensation is based on the amount of the additional contribution levied on the average of all funds. And only this difference is then paid to the person concerned. If the individual subsidy is higher then the insured person has to pay the difference out of his own pocket. If the additional contribution is below the average of all, then the affected person benefits and receives a higher compensation from the taxpayer. This means, conversely, that from next year all insured persons have to follow almost daily, how high the individual additional contributions of the funds are, in order to be able to change accordingly. Those who are pensioners, chronically ill or not flexible enough to change, is disadvantaged - the additional contribution and social security.

Defaulting payers should be asked to pay more
Already knowingly or unknowingly many refuse to pay an additional fee. Again, the federal government wants to tighten the thumb screws stronger. As of 2011: If the additional fee has not been paid six consecutive times, an additional delay will be charged i.H. the last 3 additional contributions, at least 20 euros. This is intended to drive defaulting payers to pay.

Conclusion: The health care reform makes health insurance more expensive
All in all, we health in the future more expensive. Disadvantaged are above all middle and low earners. Because the social compensation offers by no means a social balance. In the majority, almost all insured persons will have to pay heavily in the future. Only those who have a high income and come across the mandatory insurance limit of 49,500 euros a year, can now easily switch to private health insurance. This fact will lead to further losses in the legal provisions and to higher contributions for the remaining insured persons. (Sb)

Also read:
Health insurance: In the future 100 Euro additional contribution?
Prepayment plans: Many doctors' practices would have to close
Additional contributions also possible in 2011

Picture credits: Harry Hautumm