Health insurance reform rich people should pay

Reform of health insurance: rich people in the future pay more health insurance contributions?

05/25/2013

The model of private health insurance in Germany seems to have served its time. Currently, various alternatives are being considered. All considerations in common seems to be that high earners in the future have to pay more.

Germany as the last country with this obsolete system
A reform of German health insurance is long overdue. At the moment, there is still a dispute over various cost-saving designs for an alternative to the existing system. In addition to a transformation, as for example the model of civil insurance provides, is mainly of a „integrated health insurance“ the speech. Such is required by the Bertelsmann Stiftung and the Verbraucherzentrale Bundesverband (vzbv). Its draft envisages a merger of statutory (statutory health insurance) and private (PKV) health insurance. Aart De Geus, CEO of the Bertelsmann Foundation said in a report of the medical journal: „The splitting of health insurance is inefficient and problematic for the self-employed and low paid.“ In this old system, costs are still rising. De Geus criticized: „Germany is the last country on earth where this model exists.“ The point is that the new integrated health insurance should be based on the model of the statutory health insurance.

Amount of the contribution depends on the „financial capacity“
The Bertelsmann Stiftung and the vzbv have drawn up a ten-point plan for their draft reform of the health system. This provides, among other things, that the entitlement to benefits should be independent of the contribution and income of the insured person. Every insured should be free to choose any provider, whether privately or legally. The future contribution rate should be „not on the individual risk, but on the financial capacity“ of the individual. In addition to the equal contribution financing by employees and employers, the third pillar will be supplemented by a tax subsidy. In the process, high earners will have to pay more in the future. It is true that the higher the tax financing of the health insurance companies, the greater the burden on middle incomes. In a study by the Berlin-based research institute IGES for Infrastructure and Health, it is said that the burden on high earners rises by up to five percentage points to the threshold of 40 percent.

End of private health insurance at change of government?
Gerd Billen, director of the Verbraucherzentrale Bundesverband, pointed out the expected political change: „Health policy must take a directional decision in the coming legislature for the integration of statutory health insurance and private health insurance so that all stakeholders know where the journey is going.“ („“ The different parties have very different positions on the topic. For example, the concept of the SPD on civil insurance does not provide that the health system should be financed by a third of new taxes. Instead, they want to use the capital gains tax for financing in order, among other things, to relieve medium incomes. For the coffers the additional contribution should be omitted and the possibility created to determine their contribution rate. For Alliance 90 / The Greens, the current system is unfair, as is private insurance „only their own, usually below-average risk of illness“ assure.

The green election program states: „So they do not contribute to the solidarity settlement.“ In the future, all income, including rental income, stock profits or interest, should be relevant to contributions, because: „This creates more equity in healthcare by involving well-earning fairers, making future-proofing funding and creating room for contribution rate cuts.“ DIE LINKE also demands more justice. Thus, co-payments, additional and special contributions are to be abolished and their election program states: „Abolish income threshold: The contribution is thus based on the financial capacity: who has little, pays little, who has more, pays more.“ As expected, the Union and the FDP support the preservation of the existing system. Likewise, the German Medical Association is in favor of the continued existence of private health insurance. Thus many medical practices are endangered in their existence, since without private patients an economical practice guidance would hardly be possible any more. It is likely, however, that in the event of a possible change of government after the federal election on 22 September, private health insurance could have become obsolete. (Sb)

Image: Benjamin Klack