Do AOK insured persons threaten additional contributions?

AOK threaten additional contributions due to millions of losses?

07.03.2011

Numerous statutory health insurance companies (GKV) recorded millions in losses last year. Reports of the „Handelsblatt“ According to the General Local Health Insurance Funds (AOK), a deficit of around 500 million euros has accumulated. Industry experts now fear additional contributions from the AOK.

Several statutory health insurance companies suffered a significant loss last year as a result of corrections for disease-related financial equalization. With a deficit of more than half a billion euros, the AOKs are particularly affected, the report said „Handeslsblatt“ citing information from treasury circles. In view of the loss of millions, the first speculation about further additional contributions is now being made.

Billions of losses in the statutory health insurance
the „Handelsblatt“ several statutory health insurance companies suffered significant financial losses last year. Surprisingly, the AOKs were particularly affected. While the twelve general local health insurance funds in 2009 with a surplus of 771 million euros were still able to record the best result of all statutory health insurance, the AOKen now slipped with a deficit of about half a billion euros, the strongest in the minuses. Since the statutory health insurance companies can cover their deficits only by collecting additional contributions, it is already speculated about the introduction of corresponding additional contributions. However, the AOK had previously excluded additional contributions for the year 2011 in principle and confirmed their position even after the deficit became public knowledge. But how the AOKen want to get the deficit of 500 million euros in another way under control, is questionable.

Speculation about additional contributions at the AOK Bayern
At the AOK Bayern is the numbers of „Handelsblatt“ According to the financial situation particularly critical. The AOK Bayern would have to pay back contributions of 91 million euros to the health fund for 2009 and another 55 million, which would have granted the local health insurance according to its own account for 2010, had not been disbursed. This has piled up at the AOK Bayern a significant debt mountain, which makes the introduction of an additional contribution almost inevitable, according to experts. So reported the „Southwest Press” of the fact that an additional contribution of eight euros per month is already being discussed for the approximately three million contributing members of AOK Bayern. This could come to the media reports still in 2011. However, the AOK has always denied such reports and had wanted to know nothing of the introduction of an additional contribution. Several rumors have already occurred in the past, according to which some AOKen want to make additional contributions. So it was speculated about additional contributions in the spring of 2010 also at the AOK Saarland and the AOK Rhineland-Palatinate. However, all AOKen have waived the introduction of additional contributions and were able to gain additional members of health insurance, which already make additional contributions.

Corrections for disease-oriented financial equalization cause deficits
Cause of the significant deficit of several health insurance companies are loud „Handelsblatt“ above all, corrections to the disease-oriented financial compensation newly introduced two years ago. Here, the Federal Insurance Office, the payments set in compensation for the year 2009, subsequently significantly reduced. Thus, for example, the twelve AOKen, which would have achieved a total just without corrections a just-balanced result, have slipped into the red, reports the „Handelsblatt“. At DAK, the situation is comparable. Thus, the DAK with its over four million insured by an additional contribution of eight euros since the beginning of 2010 financially caught and reported an operating surplus of 62 million euros, which, however, the subsequent cuts in financial equalization in a financial deficit of 79 million Euro turned. Also had loud „Handelsblatt“ The Barmer GEK in 2010 to cope with a minus of 298 million.

AOK Bayern particularly affected by convergence rule
The AOK Bavaria is particularly affected by the repayments due to the convergence rule. The Convergence Rule was originally negotiated in 2008 by the then Bavarian Prime Minister in order to avoid disproportionate burdens for Bavaria through the Health Fund. The AOK Bayern also received considerable sums based on the convergence rule, but was subsequently asked to repay too much distributed funds. With a lawsuit against repayment, the AOK could not enforce before the competent Landessozialgericht North Rhine-Westphalia and therefore had to reimburse the corresponding sums. In the verdict the Landessozialgericht designated the reasoning of the AOK, „previously received monthly allocations § 272 SGB V are in no case repayable“, when „outlandish and incomprehensible“. The chairman of the board of AOK Bayern, Helmut Platzer, had already criticized the verdict of the Federal Social Court on several occasions and also pointed out in the light of the subsequent corrections to the disease-oriented financial equalization that „Nobody (...) is able to seriously plan a budget until the end of 2010, when they find out how much money they would have had in 2009.“ In addition, the convergence regulation is now so watered down that there are hardly any financial relief for Bavaria, Platzer continued his criticism.

Additional contributions long term unavoidable?
In contrast to the AOK, DAK and Barmer GEK, the Techniker Krankenkasse (TK) was able to present a very gratifying result last year. The TK has the „Handelsblatt“ According to the surplus of 558 million euros, a record result has been achieved which the other health insurance companies can only dream of. But this should not be taken as a general sign of the all-clear. The „Handelsblatt“-Report reveals that many public health insurance companies are under considerable financial pressure. Also, the measures of health care reform have so far apparently cause no relief. If even one of the largest German health insurance funds runs into a massive deficit and initial speculations about additional contributions become apparent, experts estimate that additional contributions in the long term are likely to become standard in the statutory health insurance system. For the health insurance companies, however, it is particularly unsatisfactory in the current situation that they have little planning certainty if retrospective reimbursement threatens. Additional contributions are of little help here, as the example of the DAK shows. Despite raised additional contributions, the DAK was in deficit due to the repayments of the disease-oriented financial equalization last year. (Fp)

Read on this topic:
AOK with 500 million euros in deficit
AOK Nordost starts without additional fees
AOK Bayern has to repay 91 million euros

Picture: Harry Hautumm