Bundestag decides health reform

The Bundestag decides health reform against the votes of the opposition. Statutory health insurance must adjust to rising costs.

(12.11.2010) The German Bundestag has today adopted the health reform of the Federal Minister of Health Philipp Rösler (FDP). The most important point: the contributions from the statutory health insurance will increase from the first of January 2011 to a percentage of 15.5. Employers' contributions are frozen from that date, which means that the future increases will be borne by the insured alone.

The Bundestag has today adopted the planned health care reform of Federal Health Minister Philipp Rösler (FDP). Against the voices of the opposition of the SPD, the Greens and the Left, the black-yellow federal government decided to make far-reaching changes in the health system. With this decision, it is now quite official: The contributions of the statutory health insurance companies increase. In the coming year, health insurance customers will pay about six billion euros more for health insurance patients. Also on rising additional contributions, the insured must adjust. Because the entire financing system in the health system is being changed.

Already yesterday, the Minister of Health Rösler had brought the newly designed drug savings package through parliament. According to the coalition, the costs for medicines, doctors and clinics for the year 2011 should be reduced by about three billion euros. In order to make up for the billion-euro deficit in the health care system, the general health insurance contribution rate will be raised from 14.9 to 15.5 percentage points. For both employers and employees, this equates to an increase of 0.3 percent or three billion for each one.

High deficit in health fund
The Federal Minister of Health Rösler acknowledged in his speech in the Bundestag that, despite all efforts for meaningful cost recovery in the statutory health system, a deficit of about nine billion euros in 2011 is expected. This deficit must be provided in the future by the "service providers, taxpayers and contributors". According to the FDP minister, stay „patient“ spared from this. So Rösler said: „The only group we do not burden are the actual patients“.

Rising costs are compensated by an additional contribution
Despite all criticism from the opposition, trade unions and social organizations, the minister defended the planned changes to the statutory health insurance. In his opinion it was one „progress“, that the rising expenditure in the health system will be compensated in future with additional contributions from the health insurance companies. This means that, in the future, the health insurances will make an additional contribution either way, even if some health insurances now assume that the cost recovery reforms will be sufficient. Since employers are excluded from this, the cost of jobs will not „automatically boosted. That is our contribution to growth and employment“, Rösler said during the debate. For example, in order not to burden the chronically ill, a so-called social compensation will be introduced, the costs of which the federal government will finance from tax credits. I hereby „solidarity on a broader basis“, said the minister. From a solidary citizens' insurance demanded by the opposition, which the „Two-tier health care“ Rösler did not want to hear anything. In his opinion, is the uniform citizens health insurance „the opposite of justice“.

Instead of "two-tier medicine" now "three-tier medicine" expected
The opposition did not just want to leave those words behind and criticized the health care reform sharply. In the final debate SPD, Greens and Left criticized the plans as a way into the „"The three-class medicine." The reforms were a way in the privatization of health costs.The state would escape from its responsibility more and more.During a corresponding election victory of red-green in the coming election to the Bundestag promised the SPD „to completely undo this botch“, as the SPD vice fraction leader Elke Ferner announced. However, the next general election is only in 2013, until then critical voices could be silenced due to the poor financial situation.

The criticism of the Greens was also clear. Health expert Birgit Bender said: „This is a reform that does not deserve the name.“ The Minister of Health is planning a privatization of the statutory health insurance. Rösler would have his responsibility as a minister for a „Solidar system missed“, as the Green politician said.

The left threw the federal government even one „unconstitutional“ in front. Left-wing leader Gregor Gysi said Rösler wanted to promote a model of reimbursement. The patients would soon be divided into two different categories. On the one hand in private insured, on the other in cash patients with prepayment rate and finally in the disadvantaged group of „normal cash patients“. The last group could not afford the advance payment model. Unequal treatment in hospitals and general practitioners is to be expected. Similar to now with cash and private patients.

According to the Minister, the prepayment model should be voluntary. This means that in the future, cash-register members can choose whether, similar to the private health insurance, they first pay the running costs for doctor visits and treatments out of their own pockets and settle them only at the end of the year. In the opinion of the left-wing politician Gysi, these new regulations against the„Basic Law of the Federal Republic of Germany“ violated. The black-yellow coalition would have with the reforms „End of solidarity initiated.“

Heavy criticism from social organizations and trade unions
Trade unions and social organizations criticize the health care reform as the introduction of a so-called "head rate through the back door". As the chairman of the welfare association "People's Solidarity" Professor Winkler said: "By fixing the employer contributions and the development of additional contributions to a capitation, the already existing inequities in the financing of SHI are drastically tightened.“ The equality system of health care would be overridden by legislative changes. The German Trade Union Confederation DGB expressed itself similarly drastically: DGB Executive Board member Annelie Buntenbach said in Berlin on Friday: „With the passing of the health reform of minister Rösler the coalition makes policy against the population. It is the height of injustice that the 70 million insured in the future should pay all cost increases alone with the capitation.“ The only sustainable aspect of the reform is that 90 percent of the German population will be burdened more in future, according to the trade unionist.

Advantage for the private health insurance
In addition to the introduction of the drug savings packages and the savings at the clinics, the change from statutory health insurance to private health insurance should be facilitated in the future for employees who have a correspondingly high income. With the beginning of the new year, employees can switch more quickly to the private sector. The Minister of Health said that probably "thousands" will change. This project is also criticized by the health insurance companies. Because those will change who maintain the solidarity principle of health insurance by their high contributions.

Social compensation should protect the disadvantaged
Since the Federal Ministry of Health also expects a rapid increase in the additional contribution, from 1 January 2011 a so-called social compensation will apply. This means that grants are paid by the Confederation as soon as they have to raise two percent of their income for the additional contribution of the fund. The federal government expects that the additional costs will be around two billion euros per year. Even if many health insurance companies promise that there will be no additional contributions in the coming year, these additional lump sums will most likely soon be set up nationwide. How this compensation is to be paid, the Minister left open. However, Rösler promised to become the regulations for the planned social compensation „be unbureaucratic.“ (Sb)

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