Does citizen insurance make sense?

Pros and Cons Citizens 'Insurance: Citizens' Insurance Concept Continues Controversy

09/17/2013

On Sunday, the time has come: In the Bundestag election, the citizens decide with their cross on the political direction of the coming years. A central theme is the concept of what is known as the mainstream of the SPD, the Greens and the Left „citizens insurance“, which is still controversial and clearly rejected by CDU / CSU and FDP. Pros or Cons citizens insurance? Here are Prof. Karl Lauterbach, health policy spokesman of the SPD Group and Federal Health Minister Daniel Bahr (FDP) fundamentally different opinion.

SPD, Greens and Left for the introduction of a unified system
The topic „citizens insurance“ has been causing controversial discussions for many years: While the SPD, the Greens and the Left in particular are in favor of this idea and thus of abolishing the dual system of statutory and private health insurance in the long term, the CDU / CSU and FDP are clearly positioning themselves on the other side. The politicians Prof. Karl Lauterbach (SPD) and Federal Minister of Health Daniel Bahr (FDP) each pursue clear points of view:

SPD calls for civil insurance as the only option for new insured
As Prof. Karl Lauterbach, health policy spokesman of the SPD faction opposite „procontra-online.de“ explained, the social security concept of the Social Democrats provides that there is only the option of citizens' insurance for each new insured, „this can be offered by both private and public funds“. For existing contracts with private health insurances, however, exist „grandfathered“, In addition, however, every privately insured person generally has the opportunity to change to civil insurance.

Advantage especially for older insured persons
According to Prof. Karl Lauterbach, older insured people would benefit from this, as they would „not infrequently are financially overwhelmed with the rising insurance costs.“ The citizens' insurance will finance the idea of ​​the SPD „in addition to the again genuine equal contributions of employees and employers through tax funds“, so Karl Lauterbach opposite procontra-online.de. Overall, a citizens' insurance to Lauterbach would mean a reduction in the burden of tax for the average income - because as the Bertelsmann Foundation and the Federation of Consumer Organizations had found, would „Low paid and pensioners relieved, but the employer is not burdened.“

Dual system „Inefficient and problematic for the self-employed and low paid“
So had the „Study on integrated health insurance“ According to the Bertelsmann Stiftung and the Federation of Consumer Organizations, "the splitting up of health insurance is inefficient and problematic for the self-employed and low-paid“ is, as stated by Aart De Geus, CEO of the Bertelsmann Stiftung. Germany is the last country on earth to use this model, so the time is right for integrated health insurance: „An integrated health insurance is in the interest of all, even the privately insured "because" privately insured currently have to reckon with higher contributions“, said Gerd Billen, chairman of the Verbraucherzentrale Bundesverband.

Concept of the SPD can be implemented by a uniform fee system
The dismantling of the two-class medicine in the sense of the SPD would be implemented by a uniform fee system for the private and the legal health insurance - for it would be according to Prof. Karl Lauterbach for doctors no longer reason privately insured prefer to treat, instead would „the severity of the disease alone [.] Speed ​​and scope of treatment“ determine.

Health Minister Bahr clearly against a civil insurance
A completely different opinion, however, represents Federal Minister of Health Daniel Bahr (FDP). In his view, the citizens insurance endangered „the financing of health care, especially in an aging society. Because the concept leads into a unitary cash register without choices“, said the minister opposite „procontra-online.de“. Since the abolition of the dual system would no longer result in competition among the coffers „lost important incentives for the health insurance companies to offer insured persons the best possible value for money“, Bahr continues. As a result, this would mean not only higher administrative costs and lower quality of service, but also less motivation for the health insurance companies to conclude insured-friendly contracts. That would, according to Bahr „the insured and patients [.] to petitioners of a unitary fund. And above all, medical progress will suffer as a result“, writes „procontra-online.de“ continue.

citizens insurance „not practicable“?
In addition, according to Bahrs citizens insurance „not practicable“, since the calculation is to include all income including rental income and capital income - but so far no one knows how to do this without extraordinary administrative burdens and considerable extra work for the citizens. According to Bahr „Citizens' insurance is nothing other than the disguised transition to a state-financed and subsequently state-organized health care system“. However, the introduction of a civil insurance system would no longer allow private health insurance companies to have more space - because the dual system was the only one „Prepared for demographic change through the creation of aging provisions“. Citizens' insurance on the other hand is for our aging society „no reasonable answer“. (No)

Picture: Gerd Altmann / Gerold Meiners