Old patients do not automatically get more expensive

Overestimated additional costs of demographic change

08/31/2012

In general, much of the rising costs in the healthcare system are attributed to demographic change and population aging. However, the additional costs of old patients are systematically overestimated according to calculations by the health insurance company Barmer GEK. Only a fraction of the cost increases go back to the higher average age.

„Routinely justify doctors and clinics“, according to the CEO of Barmer GEK, „their demands for fee bonuses with the age-related increase in disease burdens.“ But „more elderly patients do not necessarily mean more need for treatment“, stressed the Barmer GEK boss Dr. Christoph Straub. The actual cost increases in the years 2007 to 2010 are according to calculations of the Barmer GEK only 18 percent through „pure age structure effects“ conditionally. The argument of demographic change „be pushed too much in the foreground“, so the message of the largest German health insurance.

Aging of the population requires only a fraction of the cost increase
In recent years, health care cost increases have often been explained by aging populations. However, according to Barmer GEK calculations, this is actually responsible for less than a fifth of the increase in expenditure. Of the annual increase in costs by an average of around 88 euros per capita in the years 2007 to 2010, only 16 euros (18 percent) were caused by the demographic change, reports the health insurance. Thus, elderly patients incur significantly less costs than commonly thought. Actual cost drivers are much more the medical-technical progress, the changed supply structures, price increases and the increasing marketing of medical services, explained the experts of Barmer GEK on Thursday in Berlin. The statement has a certain explosiveness, since Dr. Straub at the same time pointed out that demands for fee surcharges of the medical profession „routinely with the age-related increase in disease burden“ justified.

Negotiations between medical profession and health insurance
The Barmer GEK results were published in parallel with the crucial round of negotiations between the medical profession and the health insurance companies on the future remuneration. Here the suspicion of a certain calculus comes up, since the calculations tend to strengthen the argumentation of the health insurance companies. These had in the negotiations massively opposed the demand of the National Association of Statutory Health Insurance Physicians for additional 3.5 billion euros and instead brought a reduction in the orientation value for the compensation in the conversation. The arbitration award, which has now been made, provides for an increase in compensation of 0.9 percent or around EUR 300 million. A result with which the health insurance companies can be satisfied. The doctors, on the other hand, are considering ways of achieving their call for a significant increase in pay.

Age-related cost increases reach their peak in 2013
Although the figures presented by Barmer GEK show that the demographics-related cost increase in the health system is lower than previously assumed. But the calculations also make it clear that in recent years there has been a continuous increase in additional expenditure. As an argument against a significant salary increase of doctors, the numbers are therefore limited. According to the author of the current study, Uwe Repschläger, Head of Corporate Control at Barmer GEK, the cost increases due to the impact of demographic change will reach their peak in 2013. After that, only annual increases of between 11 and 13 euros per capita are expected by 2040. (Fp)

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