Health insurance companies warn of new additional costs

Health insurance companies sound the alarm: Cash patients have to be prepared for rising costs

01/08/2011

The statutory health insurance companies expect increasing contributions from the insured. When the health care reform was implemented, the black-and-yellow coalition had promised to compensate for additional burdens by making additional contributions through social security. Doris Pfeiffer, chairman of the Federal Association of Statutory Health Insurance Funds (GKV), said in an interview with the newspaper „The world“ (Sunday edition), the insured must pay but soon the social compensation itself. At that time, the former Federal Minister of Health Philipp Rösler (FDP) had promised that the social compensation from the federal budget would be financed by means of taxpayers' money. But now a new law will be launched, which is intended to work against the rural medical shortage. The new law causes, according to the cash registers „New issues in the billions“.

Tax financing of the social compensation leveraged
The Federal Minister of Health Daniel Bahr (FDP) wants to submit the new bill to the Cabinet. Federal Finance Minister Wolfgang Schäuble (CDU) had prevailed in advance that the tax subsidy for the social compensation should be reduced or limited. Schäuble fears that the special programs for doctor support devour enormous sums of money. The subsidy programs are already more expensive than initially calculated. Like the health insurance funds, the finance minister is also skeptical about whether the health minister correctly assesses the follow-up costs. Therefore, Schäuble wants to ensure that the output side of the new supply law be cushioned. „With this safeguard clause for the federal government, the tax financing of the social compensation will be undermined - at least for the part that results from higher expenses for doctors“, said the health insurance company representative to the world. For the Ministry of Health has not commented on the question of where the money should come from. A similar assessment was also made by the chairman of the board of directors of the Ersatzkassen, Thomas Ballast. „In the end, the insured pay the social compensation at least partially themselves.“ Ballast let his displeasure run wild. For him, even the implementation plans of the black and yellow federal government have failed. This had intended to make the cash contributions on the additional contributions income independent.

Supply law against lack of doctors
The real goal of the Minister of Health is to eliminate the existing shortage of doctors with the new supply law. In fact, the density of doctors in rural areas is much lower in relation to the number of inhabitants. However, there is usually a medical oversupply in the cities. Especially in areas with high income structures many doctors are located disproportionately next to each other. To counter this problem, the cash registers suggest a limitation of the municipal cassettes. This is to ensure that doctors settle in rural areas. Instead, Federal Health Minister Bahr wants to grant a supplement to doctors who work in the countryside and have to care for many people. In addition, the doctors' fees are to be negotiated by region and no longer centrally, so that land physicians and dentists in the countryside receive higher funding. The cost of medical incentives should be around 200 million euros per year. According to the Ministry of Health, the overspending is offset by a lower number of hospital admissions. However, the ministry has not published concrete calculations. The bill succinctly states that one goes from one „In other words, one does not know how high the discharge will be.The additional expenditure especially for dentists should also cost more than 120 million euros per year.

After the Minister of Finance had read the bill, he decided that the implementation would have to be reviewed in two years. In 2014, it should be re-evaluated whether an actual effect could be achieved and whether the expenditures coincide with the planned savings in the area of ​​hospital admissions. In addition, the Federal Finance Minister has included a rule in the bill. It states that the federal budget will not pay a higher social compensation if the plans of Bahr cause excess expenditure and for this reason the health insurance companies have to demand higher additional contributions from the insured. According to the fear of the health insurance companies, the insured must be asked for the additional incentives of doctors with higher flat-rate contributions in the form of additional contributions to the cash.

Social equalization should not be adjusted
In the course of the health care reform, however, it had been agreed that with increasing additional contributions, the social compensation also increases, so that lower income groups are relieved. If additional contributions have to be set up on the basis of the pension law, according to the text of the text, the social compensation should not rise. The Federal Ministry of Health, however, does not understand all the excitement. Reference is made to the exact text of the law. There stands that a cut in the social compensation only a year later, as 2015 grab. As early as 2014, the amount of social compensation is supposed to be renegotiated anyway. By this time, the two billion budgeted funds are sufficient. And if the new law produces higher costs, the impact would be lower than that propagated by the health insurance companies. According to the official statement of the Ministry: „The federal government plans no cuts in the social compensation“, as a speaker announced. And: „The social compensation will continue to be paid out of taxpayers' money.“

Health insurance companies criticize high expenditure for doctors law
The health insurance companies can not believe the words. Because in their opinion, the supply law will not only cost a few million euros, but billions in expenditure. And because the black-yellow coalition wants to keep the ancillary wage costs as low as possible, these additional costs will be overtaken by newly introduced additional contributions. Because these are independent of income and must be paid by the insured person without employer's contribution out of pocket. Healthcare spending is becoming increasingly important as a result of medical advances, ever-increasing physician fees, higher drug spending and demographic change. Instead of taking action against the high density of doctors in the cities, the doctors are only given financial incentives, while elsewhere there is a veritable oversupply, so the criticism. Therefore, the health insurance companies do not speak of a lack of doctors but of a regional unequal distribution. Because on the whole there are not too few doctors, but only too many side by side in the cities. (Sb)

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