Health reform decided by the Federal Cabinet

Health reform decided

The health reform was decided today by the Federal Cabinet.

(22.09.2010) The health reform of the CDU / CSU and FDP has been approved today by the Federal Cabinet, but the changes continue to be sharply criticized. So the economist and acknowledged expert Prof. Dr. Jürgen Wasem and warns against sharply rising additional contributions in the coming years.

Criticism of the reform from all sides
Not only the opposition, trade unions, public health insurances, medical associations and patient representatives express in the current decision energetic criticism of the measures designed by the Federal Minister of Health Philipp Rösler (FDP) measures of health care reform. The renowned expert Professor Dr. med. Jürgen Wasem from the Chair of Medical Management at the University of Duisburg / Essen reminds of the negative consequences of the decision. He expects a rise in additional contributions to just under € 80 per member of the fund until 2020.

The health care reform is heavily criticized by the social organizations. For them, the victims are the "workers, retirees and low-wage earners, who in the future alone have to bear the burden of rising health costs." The lump-sum additional contributions that health insurances can raise indefinitely in the future are the entry into a system change away from the solidary financed statutory In the process, low-income earners are clearly disadvantaged compared to high earners, which turns the principle of solidarity upside down. "

Head rate through the back door: additional contributions of 80 euros from 2020
So come „the capitation (...) practically through the back door“, explained Dr. Wasem opposite the "Saarbrücker Zeitung". Although the non-income-related additional contributions will not be particularly significant in 2011, since the general contribution rate has been increased by the Federal Government and the statutory health insurance companies are receiving so much more revenue. „But whenever health spending increases more than wages and salaries and the general contribution remains unchanged by law, then the additional contribution will increase significantly“, stressed the expert. Thus, the additional contribution to the statutory health insurance is calculated according to the calculations of Dr. med. Wasem and his colleagues from the University of Duisburg / Essen „By 2020, on average, just under 80 euros per member of the fund“.

The social security burden limit is likely to be raised
With regard to the proposed social compensation for low earners, Dr. Wasem critical, because at this point was „the exciting question (...), whether in the future sufficient tax funds are available“. The social compensation should ensure that the additional contributions do not exceed the limit of two percent of the insured's income. Since the compensation is made of tax revenue and this considerable additional burden on the federal budget are connected, but the expert expects „in just a few years (with a) discussion on raising the load limit to three or four percent.“

Also the social association VDK criticizes the alleged social compensation. As VdK President Ulrike Mascher said: "The planned social compensation does not deserve its name, it is completely inadequate, as it only takes effect when the additional contribution exceeds 2 percent of income, for example, a pensioner with 800 euros income in addition to his general health insurance contribution of 8.2 percent, which is equivalent to 65.60 euros, a monthly additional contribution of up to 16 euros pay yourself - without a Euro social compensation. "

Insured pay the bill
The Federal Cabinet has today decided on the black and yellow reform proposals. It was urgent, because without the increase in the general contribution rate from 14.9 to 15.5 percent threatened the statutory health insurance for the coming year, a deficit of about ten billion euros. Any further deficits that may occur in the coming years are, according to the current decisions from 2012 from the coffers to absorb additional contributions. In other words, the insured now pay a higher contribution rate and in future higher additional contributions. According to the experts, the increase in the contribution rate alone will burden contributors with around six billion euros. Since the employer contribution is fixed at 7.3 percent, while the additional contributions to cover future cost increases can increase at will, in the end the entire financial burden on the legally insured depends. „The insured pays the bill“ emphasizes also the SPD health politician Carola Reimann, because cash register members would be charged twice - to the contribution increase would come the additional contributions.

Social equalization does not work
Only the so-called social compensation could absorb some of this burden, but the expected compensation payments are marginal in relation to the additional expenditure. And if the load limit the fears of Dr. Ing. Wasem may even be raised to four percent, most insured persons in the future have no opportunity to benefit from social security. In addition, the SDP health expert, Karl Lauterbach, emphasized that the current payment of „a few euros“ No help for the victims anyway. And Renate Künast, leader of the Greens, doubts whether the social compensation comes at all: „I would like to see that, given a record debt and a debt brake.“

Upper limit for additional contributions is eliminated
So far, 16 health insurances are already demanding an additional contribution from their insured persons, since the allocations from the health fund are not sufficient to bear their financial burdens. As a rule, it is eight euros, but some funds also raise the previous maximum rate of one percent of the monthly income. However, this upper limit of the additional contributions will disappear in the future and, instead, social compensation will take effect if the burden exceeds two percent of the gross income. In the future, it will be calculated once a year how much additional contributions the funds would have to raise on average in order to cover their costs. In October, this average will then be announced for the following year, and patients who would spend more than two percent of their gross income on additional contributions are entitled to social security.

Health insurance companies should record income
However, since this is based on the average value of the additional contributions, there is the possibility that some insureds have to pay considerably more than two percent of their income. Conversely, some people insured under the law may also benefit because they are entitled to social security, even though they spend less than two percent of their income on supplementary contributions. To determine when the limit of the individual insured is reached, the funds should determine what different income types and pension rights their members have. Cashiers who do not pay the additional fee for more than six months must pay a penalty of at least € 30 to the respective health insurance company.

Federal Government holds despite criticism of their plans
By mid-November, CDU / CSU and FDP also want their controversial health care reform brought by the Bundestag. According to today's decision, the criticism expressed on all sides will not change that much. The black-yellow federal government cites the considerable funding gap in the statutory health insurance funds and the necessary decoupling of rising health costs from labor costs as additional measures. In concrete terms, this means that the contribution rates for employees and employers will be raised by 0.3 percentage points each on 1 January for the purpose of refurbishing the treasury, thus raising the general rate from 14.9 to 15.5 percent. Employees pay 8.2% and employers 7.3%. Employees and employers will contribute around € 6.3 billion to cover the funding gap. With the expansion of the additional contributions, all further financing needs are to be absorbed in the future.

Additional contributions from 2012 Gears and Gains
The Federal Government expects from 2012 with the comprehensive introduction of additional contributions to the statutory health insurance, which should be initially at an average of five euros and by 2014 rise to about 16 €. According to the Federal Minister of Health, Philipp Rösler, the social compensation should prevent a disproportionate burden on individual insured persons. A further contribution to the rehabilitation of the health system, according to the current Cabinet decisions by savings in medicines (7.5 billion euros by 2012), the doctors (850 million euros) the family doctors (500 million euros), the dentists (60 million euros) and hospitals (1.7 billion euros). (fp, sb, pm)

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Picture credits: Chris Beck