Sustainable financial reform instead of further compensation commitments at the expense of contributors!
23.01.2024 12:24
The Administrative Board of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) strongly urges the Federal Minister of Health to prioritize the sustainable financial stabilization of the statutory health insurance system. A reform must address both the revenue and expenditure sides. The Administrative Board will assess the Minister's future plans against this. Reforms of emergency care and the hospital sector must finally move forward. Instead of uncontrolled financing of inefficient structures, hospital care must be designed in a needs-based, quality-oriented, and future-oriented manner. Furthermore, measures that would further exacerbate the already strained financial situation and lead to further increases in contribution rates, such as the de-budgeting of medical services, must be ruled out.
At the turn of the year, the additional contribution rates of health insurance funds increased noticeably. The reason for this sharp increase compared to previous years is the continued rise in expenditures in statutory health insurance (SHI). Contributors now have to pay an average of 1.7% of their income subject to contributions for the additional contribution. In 2020, the average additional contribution rate was 1.0%. This cannot continue! The legislature must urgently initiate measures for truly sustainable financial reform and counteract the unchecked increase in additional contributions. The federal government must fulfill its financing responsibility and not pass this on to contributors. The increases at the turn of the year will close a financing gap of €3.2 billion.
Breaking the contribution spiral
The central goal must be to break the spiral of contributions. The implementation of the cost-covering contributions for citizens' allowance recipients agreed in the coalition agreement and the dynamic adjustment of the federal subsidy remain essential to ensure responsible financing of government tasks. The subsidization of the federal budget by contributors must finally come to an end! Contributors are being denied a total of well over €10 billion per year! Functional instruments for managing cost-effective, high-quality patient care are also an important prerequisite for stable statutory health insurance finances.
The "Recommendations for Stable, Reliable, and Solidarity-Based Financing of Statutory Health Insurance" recently presented by the Federal Ministry of Health do contain starting points in this regard, but they do not adequately address the now urgent need for action. It is highly doubtful that the expenditure-related measures mentioned will actually achieve the hoped-for efficiency improvements. Furthermore, various plans proposed by the ministry would even undermine financial stabilization! Against this backdrop, the Administrative Board of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) urgently warns against legislative measures that lead to further expenditure increases without significantly improving care. Manifest deficits in care provision will not be resolved by pouring ever more money into structures in need of reform.
Developing supply structures in line with needs
Concern about the availability of effective emergency care is a concern for many people. Reforming emergency care is therefore particularly urgent! This also applies to hospital care. The Board of Directors is strongly committed to placing the care needs of patients at the center of the ongoing reform process. Instead of uncontrolled financing of inefficient hospital structures, hospital care must be designed in a needs-based, quality-oriented, and future-oriented manner. The current discussion about additional funding that is to be distributed indiscriminately is therefore fundamentally misguided.
The same applies to the currently presented plans for outpatient medical care. The financial situation of the practicing physicians remains very good. Deconstructing primary care services would not benefit primary care practices in rural areas, but primarily practices in already over-served areas. This would not result in any advantages in care for patients. Deconstructing medical services, on the other hand, would lead to billions in additional expenditures for contributors in the short and medium term and would perpetuate over- and under-provision, especially in metropolitan areas. Demands for deconstructing specialist care are completely out of the question. We unequivocally criticize the healthcare boycott by the practicing physicians – it is taking place at the expense of patients!
Consider the revenue and expenditure side
The Administrative Board of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) strongly urges the Federal Minister of Health to prioritize the sustainable financial stabilization of the statutory health insurance system. A reform must address both the revenue and expenditure sides. In particular, measures that further exacerbate the already strained financial situation must be ruled out. The Administrative Board will assess the Minister's future plans against this.