Health Government relies on capitation

Is the Federal Government planning the capitation fee through the back door? The health economy should be promoted, the responsibility of the state, however, should be reduced.

Nine to eleven billion deficit threatened the statutory health insurance for the year 2011. This could be avoided essentially only by raising the contribution rates from 14.9 to 15.5 percent. The health system is running on the limit even if some measures in the short term to relieve the situation.

„Health economy instead of state medicine“ - the state abolishes itself
On Tuesday, within the framework of a symposium of the Economic Council of the CDU, health politicians of the party met with the FDP Minister of Health and leading representatives of the health insurance to discuss the future of the German health system. The direction of the discussion was in the title chosen for the event „Health economy instead of state medicine“ already clear in advance.

Head rate through the back door
The representatives of the governing parties are so far quite innovative when it comes to covering the deficit in the health system, only the best should neither doctors nor Pharmalobby be affected by the negative consequences of possible changes. So what to do? Oh, why not introduce the capitation fee through the back door and pass all financial burdens on the insured. After all, the additional contributions to be expected from 2012 will, in the opinion of the renowned expert Prof. Dr. med. Jürgen Wasem is likely to increase to around 80, - € per capita by 2020. This comes „the capitation (...) practically through the back door“, explained Dr. Wasem.

Reproach of clientele policy
In addition, the Federal Minister of Health reaffirmed its commitment to a balance between legal and private insurers, which in reality means that the position of private health insurance companies (PHI) is supported as well as possible against statutory health insurance (SHI). For example, by the Federal Government, the previously limited to the GKV discount agreements with the drug manufacturers, extended to the private health insurance, extended insurances in the SHI prohibited, so that they are in the future reserved exclusively private and the change in the direction of PKV simplified to more people Possibility to offer to insure in the PKV. All measures that infiltrate the statutory insurance system in favor of private health insurance and thus make the accusation of the clientele policy not completely unjustified.

Additional contributions can be levied independently of wage developments
Eberhard Wille, the economist and chairman of the Health Advisory Council, sees the major weakness in financing the health care system is that wage increases are lower than those of gross domestic product. Additional contributions offer here, similar to a capitation, the advantage that they can be raised or fixed flat rate. „The package is not so slow growth“, stressed will. It remains to be seen whether the insured will be disproportionately burdened. The social compensation provided to avoid excessive burdens, however, helps little to offset the additional costs. Especially since experts such as Norbert Klusen, CEO of the Techniker health insurance, doubt in any case whether the planned social compensation from tax funds will come at all.

Efficiency efforts through additional contributions? - the illusion of competition
The State Secretary Annette Widmann-Mauz sets regardless of the social compensation in any case on the expansion or further development of income-independent additional contributions, because so would the health insurance "significant efficiency efforts" triggered, which are in the interests of the insured. The fact that the efficiency efforts are more likely to be triggered by the financial bottlenecks to be expected from 2012 at the latest and are not a result of the additional contributions is probably also aware of the State Secretary. And that the additional contributions or the introduction of a head lump sum through the back door is not at all in the interest of the insured, is likely to have Annette Widmann-Mauz meanwhile noticed.

Criticism of the opposition
So does the criticism from ranks of the opposition does not tear off. Birgitt Bender, the health policy spokeswoman of the Bundestag faction Alliance 90 / The Greens, criticized the "pimping" of PKV massively and believes similar to the CEO of Techniker Krankenkasse not that taxes are levied to finance the future social compensation. Your party would in case of future government participation, the additional contributions or capitation and all related steps „of course reversed“ make, emphasized Bender. In the same way, leading politicians of the SPD have already expressed their opinion, so that the reform, which is now being implemented by black and yellow against all criticism, will probably not last very long. (fp, 07.10.2010)

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