Health insurance reform of the reform

Renewed health insurance reform by the Federal Cabinet decided

03/26/2014

Every federal government in recent decades has at least once tried to reform the health system and so can not surprise the now approved in the Federal Cabinet bill to finance the health insurance. However, the statutory health insurance (SHI) seemed on track after the last reform. Most recently, they were able to show millions of surpluses and, in some cases, paid considerable premiums to their insured persons. Nevertheless, the federal government has opted for another reform.

A major change in the adopted draft law on the development of the financial structure and quality in statutory health insurance is the introduction of an income-related additional contribution, which the health insurances can raise as needed to cover future cost increases. The non-income, flat-rate additional contributions should no longer exist in the future. „The general contribution rate for statutory health insurance is set at 14.6 percent“, the Federal Government continues to report. The employer's share is set at 7.3 percent. Possible future deficits of the health insurance companies would therefore have to be borne exclusively by the insured persons via the additional contributions.

Doubts about a discharge of the insured
With the current bill will „the financing of the statutory health insurance on a permanently solid basis“ The Federal Government explained in a recent press release. However, the GKV-Spitzenverband is less confident here. The CEO of the GKV-Spitzenverband, Dr. med. Doris Pfeiffer, explained to the „Passauer New Press“, that the planned financial reform brings short-term savings for all insured persons, „However, as the expenses continue to increase, for example for doctors, clinics and medicines, the health insurance companies will not be able to get along with the reduced contribution rate and will have to make an additional contribution.“ Only in the fall, „when the health insurances set their budgets for 2015“, I will decide, „whether, on average, all health insurances actually relieve the insured.“

Impending bankruptcies in health insurance?
However, those with statutory health insurance have a special right of termination if their health insurance company raises or increases additional contributions. This can lead to a significantly increased competition among health insurance companies. Cash registers that make an additional contribution may under certain circumstances lose members of health insurances without an additional contribution. At the end of such a development is at worst the insolvency of individual health insurance, as was the case for City BK in 2011, for example. However, the Federal Government is apparently prepared for such a development, because the current bill stipulates that the GKV Spitzenverband organizes insolvency liability for the claims of insured persons and service providers. For this purpose, the „GKV-Spitzenverband will in the future borrow up to 750 million euros from the liquidity reserve of the health fund“, reports the federal government. The amount must be repaid at the latest after six months. To enable such a withdrawal, the minimum level of the health fund's liquidity reserve would be raised from 20 to 25 percent of an average monthly spending.

Health insurance companies are not allowed to pay any premiums in the future
The Federal Cabinet has spoken out in the current bill against the payment of premiums, as is currently done at some health insurance companies in the face of surpluses. Instead, the health insurance funds should relieve their members on lower contributions, according to the release of the Federal Government. However, it must be remembered that surpluses will hardly ever be realized in the future, as in the past year, as medical progress and demographic trends will lead to significantly higher expenditure.

Institute for Quality Assurance in Health Care planned
Another important point in the submitted bill is the establishment of a professionally independent scientific quality institute by the Federal Joint Committee of doctors, hospitals and health insurances. „This Institute for Quality Assurance and Transparency in Health Care has the legal form of a foundation“ and „The aim is to develop instruments that can better measure the quality of care and document it more transparently“, reports the federal government. The insured would also benefit because they can inform themselves here about the quality of treatments. The institute is expected to start work in 2016, according to the Federal Government's announcement. (Fp)

Image: Claudia Hautumm