Citizens' insurance could lower cash contributions

Study: A citizens' insurance could lower the cash contributions for low and middle income

20/08/2011

According to a scientific study, a solidary citizens' insurance could reduce the regular contribution rate of the statutory health insurance to 10.5 percent. A prerequisite would be that the private health insurance is eliminated and all people regardless of their income status in a public health insurance are insured.

The insured persons of the statutory health insurances will receive higher contributions in the future. Since the last increase of the contribution rate to 15.5 percent, the employer's share has been frozen. This means that all perspective increases in contributions are at the expense of the employee. The black-yellow coalition had laid in the course of health care reform, the design and collection of additional contributions in the hands of the funds. In practice this means that collection and increase of additional lump sum contributions will be determined by the funds themselves if they are no longer able to manage the allocations from the health fund. It is undisputed that the contributions will increase steadily in a few years due to the demographic change in society. Private patients have been paying continuously increasing contributions for years.

Study on civil health insurance
The left now has an interesting study titled „Civil health insurance and long-term care insurance“ published, which proposes to introduce a uniform health insurance. The introduction could reduce the regular contribution rate by one-third to 10.5 percent. For this, all citizens would have to be insured regardless of income and status in a health insurance. Thus, as the number of contributors increases massively, the contribution rate could be lowered. In addition, all additional contributions, co-payments of medicines, health services and practice fees would be abolished. According to the results of the study, the rate would remain stable at least until 2020, even though hospital and doctor fees are increasing in relative terms and that the process of aging as a whole is continuing. With such an implementation, long-term care insurance could fall from 1.95 to 1.6 percent, despite rising expenditure and benefit requirements in the care sector. In the context of the citizens' insurance, according to calculations of the experts this could be maintained in the longer term to less than 2.0 percent. Even with this model all citizens would have to pay into the health insurance funds depending on their income.

Largest abolition of private health insurance
The main point of the study is the largest possible abolition of private health insurance. A good 10 percent of Germans are currently privately insured. Among the 10 percent of private insured are above all better earners with above-average salaries. The private health insurance would be limited according to the model only on supplementary insurance. Instead of a normal income test, all insured persons should also include income from capital gains and rental income in full in the calculation. So far, the contribution assessment is limited, since the calculation rate in the statutory health insurance of currently 15.5 percent only up to the contribution ceiling of 3712.50 euros applies. Accordingly, all incomes would also count for the calculation. With such a low contribution rate, non-wage labor costs would automatically decrease, because even the insurance contribution financed in equal proportions decreases.

Second model for the transitional period
In a second calculation model, this computational power was not completely eliminated, but in a first step only increased to 5500 euros. After all, the contribution rate could fall to 11.7 percent and the contribution to long-term care insurance to 1.8 percent by the year 2020 in this calculation variant.

Relief of low and middle income at the expense of high earners
In the bottom line, the model mainly relieves low and medium-income incomes, because the funding of health insurance is redistributed from top to bottom. For example, those who earn 1500 euros a month experience a financial relief of up to 1251 euros a year. With this method of calculation, the average additional payments (practice fees, drug allowances) and the elimination of the additional contributions were also included. If you earn more, you save more. With a salary of 2500 euros per month, the health insurance saves up to 2085 euros per year. Only from a monthly income of 5800 euros higher contributions would have to be paid according to study estimates, as would be the case today.

Low labor costs and more purchasing power
As well as the ancillary labor costs reduce, people have more money for consumer goods and purchases, the purchasing power would increase significantly according to the study. As a result, at least 500,000 new jobs would be created permanently. A lower unemployment rate would also reduce spending on social benefits in the future.

Constitutional concerns
The concept of citizens insurance has existed for some time and is criticized above all by business circles. Because the transformation of the entire health system is considered by critics as „not realizable soon“. From a purely legal point of view, private individuals could not be required by law to waive their accumulated retirement provisions. At least constitutionally questionable is that the abolition of the income threshold the „Ratio of performance and consideration“ would be unreasonably high. Top earners such as the German bank boss Josef Ackermann earn well and gladly even once 10 million euro in the year. In the course of a citizen's insurance, the bank manager would then have to pay about one million euros for health insurance. According to legal experts, an action before the Federal Constitutional Court would potentially be successful due to the disproportionate performance and consideration.

Left defends model proposal
Despite the criticism, the group leader of the Left, Gregor Gysi, defended the concept in the Frankfurter Rundschau (FR). In his opinion, finally must „Stop the privilege of the rich at the expense of the poor“. It is time, „to turn back the wheel and create more solidarity“. All citizens with an income would have to pay in the same health insurance. Only a fair model is in conformity with the Basic Law, because „protect the health of people on an equal footing“ would, so Gysi. Because private insured persons have a right to their old-age provisions, a transitional model can be created. The new business would have to be stopped and the previous private insured could be offered a vote. The only problem: the long transitional periods. (Sb)

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Picture: Pino Madeo