AOK wants to spend reserves for structural reforms

AOK: Instead of paying out the surpluses to the insured, invest in structural reforms

09/09/2012

The association of the general local health insurance AOK defends itself against demands of the policy, which use approximately 22 billion euro financial reserves of the legal health insurance (GKV) for premiums. Instead, it should invest in structural reforms to make the health insurance crisis-proof.

Use financial reserves for structural reforms
Once again, the AOK stands up against a premium repayment. The chairman of the board of the AOK Federal Association, Jürgen Graalmann, appeals in the direction of politics, the accumulated financial cushion of about 22 billion euros for „to use structural reforms of the statutory health insurance“. In the sign of the European Fiscal Pact and the associated debt brake of the public budgets, the black-yellow federal government will not be able to manage the structural gap in the GKV with the previous models, so the chief of sales. For this reason urgently needed structural reforms should be addressed. „For this purpose, the financial cushion in the SHI must be used instead of burning the reserve by short-tempered actionism. "The AOK wants to make quality the benchmark for medical care, as the Executive Board of the AOK, Uwe Deh explained.

According to information from the AOK Federal Association exist today in the statutory health insurance a structural gap between income and expenditure in the amount of „over four billion euros.“ After all, spending has increased by 3.6 percent per year since 2004. In contrast, according to Graalmann, the cash contributions only increased by 1.5 percent annually.

Politics increasingly relied on fire department policy
Politicians have always used short-term measures to close the gap. These short-term effects include, for example, the increase in health insurance contributions, cost brakes, higher federal subsidies and cuts in health care benefits. The real causes were „but never properly addressed“. So that remained „Architecture of the house GKV always unchanged“, criticizes the AOK Federal Association Chairman. Due to the unique and historic opportunity of the billions in surplus, the SHI could be renewed through sustainable structural reforms. Especially on the expenditure side, many reforms could take effect.

These include, in the opinion of the AOK boss „Rationality instead of rationing a consistent benefit assessment of health care benefits, such as those provided by the AMNOG for drugs, as well as a strict orientation to the quality of care.“

"We have to turn the financial plus into a plus in quality, with around three billion more euros available each year," says Graalmann. At the same time, the chairman of the board of directors called for one „unified insurance market in the health system“ to install. For all providers equal competition incentives, courses of action and rules of the game should apply. "Then you'll see who's ahead of the competition for the best patient care."

The AOK board member Uwe Deh suggests, among other things, a so-called incentive system that increases the quality of medical care. "We have a lot of good doctors and a lot of good nurses, but with all their commitment, they can not change the fact that sometimes the quality of medical care fluctuates greatly." Therefore, patients in Germany are often at the mercy of chance.

As an example of major regional differences in medical care, Deh presented initial findings from the AOK Scientific Institute (WIdO) on the ongoing development of cardiac catheter-grade quality indicators. Thereafter, in regions with the highest mortality rate, catheter examinations are 10 times more frequent than in the lowest rate region. "This is supply by post code", criticized Deh. (Sb)

Also read:
AOK Plus: Homeopathy benefits instead of premium
Health insurance: Soon a federal AOK?
AOK stands up against a premium refund
AOK study: premium increases of 2700 euros