GKV and PKV negotiate about citizens insurance?

The private and statutory health insurance seems to be preparing for an upcoming civil insurance and enter into secret negotiations.

28.04.2011

Since the health reform of the black-yellow coalition at the beginning of the year, it has become easier for people insured to enter the private health insurance (PKV). Anyone who has at least a monthly gross income of 4,125 euros, can insure income independent of the private. But how much longer will there be two different health insurance systems? While GKV and PKV executive committees deliver in the public hard battles, according to information of the Wirtschaftswoche (WiWo) already under closed doors first negotiations for a future co-operation.

Instead of two systems on the way to citizens insurance?
Trade unions, social organizations, the Greens, the Left Party and the SPD have long been calling for a united solidarity citizens' insurance. Thus, all emphasize on a broad front, that in a deselection of the current incumbent black and yellow federal government in 2013, the private insurance of Hahn is turned off. All newly insured and therefore also self-employed and civil servants would then have to enter the statutory health insurance (GKV) income-related. Only old customers should remain according to the plans of the SPD in the private health insurance. But since no new, healthy and young customers can be gained, the private health insurance rates would become extremely expensive over the years. That would mean the death of private health insurance in just a few years. This is also the view of the chairman of the private health insurer in Germany, Reinhold Schulte. In a statement he warned: „Our well-functioning system would wantonly be destroyed.“ The retirement provisions would then hardly be enough for the existing customers.

PKV tariffs become more expensive
But is the private system really working well? For years, older and chronically ill patients in the private health insurance system have been complaining about sharply rising tariffs. According to recent surveys, only one in three private patients is actually still satisfied. Because while in some places the new rates are extremely cheap, the former Eineperigertarife increase with age. The private providers moan for a long time about the ever increasing fee wishes of doctors and clinics. These steeply rising prices are barely sustainable, especially considering that demographic change is making older people older and that medical progress is a challenge.

Two-pillar supply in the world almost unique
Hardly a western industrialized country indulges in a two-pillar health care system. The board members of the statutory and private health insurance companies know that too. Even if there is no political change after the general election, significant changes would have to be created. It is questionable whether private individuals can keep up with the legal requirements for a longer period of time. The citizens of today can not even build a train station in Stuttgart without protests. The protests could become massive.

Legal and private advise on future models
For some time now, the boards have come together behind closed doors to debate about a common future. However, so far nothing has come to the public of these talks. In February, the tips came together at a future workshop in Bergisch Gladbach and in autumn at a symposium organized by the Cologne University of Applied Sciences.

Trade unions criticize capitation
In addition to the parties, the unions also mobilize. Above all, the burden of additional contributions is the focus of criticism. Annelie Buntenbach said in Berlin on Thursday „The broad social criticism of the so-called social compensation proves once again that the promise of the Federal Government to protect the 70 million insured of the statutory health insurance from financial overstretching, is pure waste. The social compensation is not worth its name, because the actual burdens of the insured are not compensated by the capitation. It is already foreseeable that the promised compensation will cause billions of euros in bureaucratic costs, but that millions of insured people will not benefit from them and will remain completely absorbed in the rising burden.“ The problem is in the opinion of the DGB not only the fact that additional contributions are levied, but that they must now also be quasi paid as head lump sum without employer's allowance. Therefore it is „irresponsible to terminate the functioning of solidarity compensation in the SHI and instead to introduce a highly complicated calculation method that is not equal to the high flexibility in the labor market and does not compensate for the anti-social burden of capitation. The financial problems of the SHI can only be solved sustainably if all citizens are involved in the solidarity-based financing of health insurance.“

Drastic contribution increases in the coming years
If reforms are not implemented quickly, insured persons in both camps will soon have to pay drastically rising insurance premiums. Thus warned Eberhard Sautter of the board of the PKV Hanse-Merkur: „Increasingly fewer contributors are getting more and more elderly patients, which cause disproportionately higher costs. In the case of illness, we have to make do with less money in the medium term. The costs must go down, the efficiency must rise.“

The SPD, the Greens and the Left therefore stick to the Citizens' Insurance model, which would mean income-based health insurance for all. Black and yellow, however, will continue to adhere to the model of the health premium (capitation), which provides a single contribution to a minimal primary care. Those who want or need more health must also secure themselves privately. The model is then antisocial despite bureaucratic model of social compensation, but could save the PKV in the view of the FDP and Union politicians. The citizens then have to vote on these two options in the coming Bundestag election. (Sb)