Additional contributions save health insurance companies

BMG statistics: additional contributions bring health insurance approximately 500 million euros more revenue. The collection of additional contributions will continue to play an important role in the future if the evaluation of the Federal Ministry of Health is correctly interpreted.

08/12/2010

Some statutory health insurance companies have been collecting additional contributions from their insured persons since the beginning of the year. Earlier this week, the Federal Ministry of Health (BMG) announced a statistic on the financial development of the statutory health insurance (SHI). According to the surveys, the health insurances were able to take about 500 million euros in addition to the regular contributions through the additional contributions collected. If the financially troubled health insurance funds had collected no additional contributions, the economic situation of the funds would be much worse than it already is. The deficit would be according to the BMG at around nine billion euros.

The statistics of the Federal Ministry of Health clearly shows in which situation the statutory health insurance funds are. In its analysis, the ministry also refers to future issues and thus gives a filtered outlook on the future. At the same time, the report warns that the adopted health care reform was indispensable for supporting the system of statutory health insurance funds. In the first three quarters, all health insurances jointly had revenues from the health fund of around € 131.2 billion. Also included is the additional income of the funds through the additional contributions of the insured persons.

By contrast, the health insurance funds reported that they spent around € 130.9 million on health care, staff costs and administration. So just a surplus of about 277 million euros left. Three years ago measured in the same period, the health insurance funds have still generated a surplus of about 1.4 billion euros. Since experience shows that expenditure is rising again at the end of the year, the Federal Ministry of Health expects a shortfall in financial development. This means that the BMG expects a significant underfunding of the statutory health insurance.

Additional contributions with increasing importance
The additional contributions will play an increasingly important role in the financial development of the health insurance system in the future. Without the additional contribution levied by individual health insurances, it would have been possible to close individual health insurances. The Federal Ministry of Health itself points out that the additional contributions are indispensable and that this also applies to the future. These contributions alone have yielded around 463 euros in additional revenue, which prevented even greater underfunding. If these lump sums had not been collected, a deficit would have arisen in the first three quarters of around € 186 million. Statutory insured must be prepared in the future, soon to have to pay additional contributions nationwide. At present, individual health insurance funds, including the third largest health insurance fund in Germany, levy an additional contribution of a flat rate of eight euros per contributor member.

Rising medical care costs
Due to demographic change and the rediscovery of medical therapies, the cost of treatment is also increasing. This is also shown by the current BMG statistics. In particular, the cost of health care and care will increase. Expenditure on outpatient therapies and treatments rose by 3.7 percent year-on-year. If one compares the increase in expenditure with the year 2009, then the increase in the expenditure side in this area has quasi halved. The cost of treatment in clinics increased by 4.5% with an increase in expenditure (compared to 6.6% in the previous year). Spending on pharmaceuticals increased by 4.2 percent. In the course of the drug market reorganization law the expenditure side for medicaments is to be lowered clearly. Spending on administration increased 3.9 percent. For the coming year 2011, the law stipulates that the administrative share of the funds must remain at the 2010 level.

Outlook for the years to come
Without the regular contribution rate of the statutory health insurance from the turn of the year 2011 to 15.5 percent, a deficit would be unavoidable despite the good economic situation. If the contribution rate were not raised, a deficit in the health fund of about 9 billion euros, as it is called in the forecast of the Ministry of Health. For this reason it is absolutely necessary to raise the health insurance contribution rate to the level before the economic crisis. In addition, it has been shown that savings in the doctors, hospitals and health insurance companies are still necessary. Also, the reorganization of the drug market is of the utmost importance to halt the increase in expenditure. Unlike independent health economists, the BMG does not expect a deficit of the health insurances in the coming year. Also, the additional contributions will not increase according to official information. In contrast, five health insurance companies have already announced that they will require an additional contribution in 2011. Nevertheless, the federal budget must provide a subsidy of two billion euros to strengthen the health fund. This is used exclusively to fill the reserves of the health insurance funds and to finance the social compensation for the additional contribution.

Doubts from critics
However, many health economists doubt that the savings will be enough to keep the statutory health insurance system stable. For example, different experts have already calculated that in the near future insured individuals will receive far higher additional contributions than is occasionally the case. The fact is that the employee share of health insurance was frozen from the beginning of the year. This means that all higher costs inevitably have to be borne by the insured themselves. Also, the Federal Ministry of Health sees this apparently also and just because of the planned introduced the social compensation. (Sb)

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