DGB abolition of private health insurance

Trade Union Confederation for the abolition of private health insurance: The DGB proposes the introduction of a civil insurance and abolition of private health insurance.

12/15/2010

The German Trade Union Confederation (DGB) has presented its model for the future regulation of the German health insurance system. Similar to the Greens, the DGB demands the introduction of a citizens' insurance in which all Germans are insured.

Next Friday, the Federal Council will decide on the health care reform of the black-yellow federal government and the two determining laws are expected to enter into force on January 1, 2011 as planned. In view of the approaching voting date, the DGB has now underpinned its already widely expressed criticism with an alternative model that is intended to remedy the financial ills of the statutory health insurance. Instead of the proposed contribution increase of 0.6 percent, contributions of up to 2.5 percent would be possible.

DGB for citizens insurance
Already in April the DGB had the commission „For a solidary health system of the future“ used to discuss the possibilities of reorganizing the health insurance system. As a result of its work on Monday in Berlin, the Reform Commission has presented a 34-page concept that aims to demonstrate the goal of a sustainable and solidary development of statutory health insurance (SHI). The current plans of the black-yellow federal government rejects the commission of representatives of individual unions, social organizations and science as unjust and instead suggests the entry into the so-called „citizens insurance“ in front.

PKV would be abolished according to the plans of the DGB
DGB board member Annelie Buntenbach stressed at the presentation of the report that only with the civil insurance, the chronic income weakness of the statutory health insurance „cure in a sustainable and socially equitable way“ could. In her model, there would be for all citizens only one form of health insurance, with the cash contributions are levied on all types of income, said Buntenbach in the name of the DGB. All today still privately insured persons, such as a lot of civil servants and self-employed, are to be integrated after the ideas of the reform commission of the DGB piece by piece in the legal health insurance (GKV). Thus, from a date yet to be determined no new entrants to the private health insurance will be more possible and the existing customers of the PKV return to the GKV. The PKV would therefore be abolished in its present form and housed in the future citizens insurance. According to the Commission's proposals, the accrued provisions should also be transferred to statutory health insurance and private health insurers should also contribute to the GKV financial equalization. Based on these restructuring measures alone, contributions could be reduced by 1.1 percent, according to the Reform Commission.

Income limit should rise to 5,500 euros
Just like the Greens in their model presented two months ago, the DGB also demands that the income limit, from which the insured pay a flat-rate (maximum) premium, be raised from 3,750 to 5,500 euros. In contrast, the federal government plans to reduce this income limit to 3,712.50 euros in its current health care reform. According to the reform commission of the DGB, raising the income limit would reduce contributions to the statutory health insurance by another 0.5 percent. However, the good to very good earning members of the board would have to pay significantly more, as well as the opinion of the health economist Heinz Rothgang, who advises both the Greens and the DGB. According to Rothgang, in the worst case, the earner would have to raise several hundred euros a month. After all, income types alongside wages, such as interest and rental income, are to be included in the calculation of the underlying income for the cash contributions. Furthermore, the Commission proposes to levy one fifth of incomes above the income threshold as a solidarity contribution to the financing of the SHI. Through this solidarity contribution in conjunction with the crediting of non-wage earnings, the contribution rate in the future civil insurance could be reduced by a further 1.4 percentage points, according to the calculations of the reform commission of the DGB.

Parity of contributions should be restored
In addition, the parity of employee and employer contributions, which was abolished under the former Federal Minister of Health Ulla Schmidt (SPD), is to be restored so that both sides benefit equally from health insurance costs. In addition, according to the plans of the DGB reform commission also the practice fee introduced by Schmidt and other co-payments of the insured ones would be deleted, whereby the statements of the experts according to further 7.5 billion euro could be saved. Taking account of co-payments and practice fees, employees currently have to pay about 15 billion euros more a year into the statutory health insurance system than employers, according to the Reform Commission.

Contribution rate could fall by 2.5 percent
According to the DGB concept, the contribution rates in statutory health insurance could be reduced by up to 2.5 percent with the introduction of a civil insurance and the other planned changes. The additional contributions could be completely eliminated and the contribution rate would be reduced to around 13 percent in the long term instead of the 15.5 percent, which are to apply from 1 January 2011. While, for example, the Social Association of Germany (SoVD) the reform concept as a „fair alternative to the black and yellow health policy“ praised and the Association President Adolf Bauer said it must finally „Stop the one-sided burden on the patients and the insured“, came from circles of the government promptly the answer. „The more concrete the plans for a citizens' insurance, the clearer it is that this is a rip off of the middle class“, said the CDU health expert Jens Spahn and rejected the DGB proposals for a civil insurance. A similar view was taken by Johannes Singhammer on behalf of the CSU. In addition, the contribution reduction promised by the DGB would correspond to 2.2 points, a financial volume of 22 billion euros, the sum would have to be applied by other means than by contributions and no one has yet to explain how this should work, so the charge of the coalition parties in the direction of the DGB. The FDP health politician Ulrike Flach called the numbers of the reform commission therefore „fantasy figures“, which lie far removed from any health political reality.

Positive view from the opposition
On the other hand, the SPD, the Greens and the Left reacted extremely open-minded to the concept of the DGB, or they themselves advocated similar models. For example, the health expert of the Left Party in the Bundestag, Harald Weinberg, said: „If you do not want two-class medicine, but first class for all“, private health insurance must be abolished as in the present DGB concept. Overall, the reform concept of the DGB is also considered as an entry into the 2013 election campaign, as the harshly criticized health care reform can no longer be stopped by the opposition parties and unions. As Annelie Buntenbach also emphasized: „The moment of truth beats in election year 2013 (...), because „then (already) millions of insured must pay the capitation“ and the rejection of the current health care reform will have become so acute that this will be reflected in the election results. Although the concept of the SPD has not yet been fully elaborated, the North Rhine-Westphalian Prime Minister Hannelore Kraft (SPD) stressed: „If in 2013 millions of insured persons have to pay additional contributions, we will move into the Bundestag election campaign with the Greens for citizens' insurance.“

The proposed by the Reform Commission abolition of private health insurance, but not only in the governing coalition is highly controversial. Because so far it is not clear whether the private law contracts between the insured and the insurance companies by such a state intervention may be regulated at all. Therefore, the DGB goes from one „long transition period“ until the PKV had finally been absorbed into the civil insurance. In the short term, therefore, savings in contribution rates are likely to be much lower than the aforementioned 2.5%. (Fp)

Also read:
Civil insurance instead of capitation
PKV wants to save costs for doctors' fees
Replacement funds warn insured persons before PKV change

Picture: Dr. Klaus-Uwe Gerhardt