Now the health insurances are calling for the taxpayer
Statutory health insurance members are threatened with a contribution shock in the next few years. This is not just due to the corona crisis. Higher tax subsidies should help – forever. To an extent that has so far only been necessary for pension insurance.
Dhe statutory health insurance (GKV) is getting more and more into financial difficulties. A record deficit of 16 billion euros is expected for the coming year, in 2025 it should even be a good 27 billion euros that are missing like AOK, Barmer, TK & Co. The health insurance companies are therefore calling for a drastic expansion of tax financing. The model is the pension insurance, which receives around 100 billion euros a year from the federal government – by far the largest item in the budget.
In order to still be able to pay all expenses in the future, the regular federal subsidy must increase permanently from 14.5 billion euros to 41.3 billion euros per year, states a study on the medium-term financial position of the statutory health insurance, which was commissioned by DAK-Gesundheit.
The growing financial gap is threatening the statutory health insurance’s ability to act, warns the CEO of DAK-Gesundheit, Andreas Storm. “If there is no action now, the insured will face the historically largest increase in contributions as early as 2023.” The average additional contribution could rise by 1.6 percentage points to three percent. Overall, the health insurance contribution currently averages 15.9 percent.
The study finds that the growing financial gap is by no means solely due to the corona crisis. The “costly legislation” under Federal Health Minister Jens Spahn (CDU) also increases expenditure. Whereby “the enormous cost increases” would only become clearly visible from 2022 onwards.
Added to this are the structural driving forces that have been foreseeable for a long time: In addition to medical and technical progress, the aging of the population is also driving up spending. This is because statutory health insurance, like care and pensions, is organized as a pay-as-you-go system in which the young support the old.
And the pensioners’ lower average contributions cover only a small part of their health care expenses. In contrast to private health insurance, statutory health insurance does not build up any financial reserves to absorb the steeply rising costs in old age.
The health insurance companies justify the call for significantly higher tax subsidies with the so-called non-insurance benefits, which include, for example, the contribution-free co-insurance of children, spouses, pensioners, but also childcare and maternity benefits. According to the IGES study, non-insurance benefits of around 41 billion euros are offset by a regular federal grant of 14.5 billion euros.
The study itself admits, however, that the definition of non-insurance benefits is controversial. Should the health insurance companies enforce their demand for the federal subsidy to be tripled, taxpayers would bear around 16 percent of the health insurance expenses. When it comes to pensions, it is already a good 30 percent.
The economy reacts alarmed to the calculations of the IGES institute. Employer President Rainer Dulger spoke of an alarm signal. The looming record increase in health insurance contributions must be prevented.
“We need comprehensive reforms in all branches of social security immediately after the federal election, because pension, long-term care and unemployment insurance is also threatened with higher contributions in 2023,” warns the President of the Confederation of German Employers’ Associations (BDA). The 40 percent limit for social security contributions set by the grand coalition last year must be maintained.
However, employers are skeptical of the cash demand for a drastically higher federal subsidy. Dulger emphasizes that simply giving more and more tax revenue to health insurance is not a sustainable solution to keep health insurance affordable.
What is needed above all is measures to reduce the cost pressure, which has been increased again by the spending-friendly laws of recent years. Employers advocate strengthening competition and consistent care management, in which health insurers are increasingly allowed to conclude selective contracts with service providers.
Health Minister Spahn had initiated numerous costly laws in recent years. For example, appointment service points have been set up for statutory health insurance patients who need a quick specialist appointment. The improvements in the care sector, for example with personnel keys and pay, also cost a lot of money.
The next federal government will have to decide quickly after the election whether it will bring reforms to contain costs or spend a growing share of the federal budget on plugging the financial holes in the social coffers.