Dispute over billions in surplus in the health fund

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In spite of the statutory health insurance reserves, additional contributions will again threaten in the future

The final word has not yet been spoken in the dispute over the billions surplus in the health fund. While the health policy spokesman of the CDU, Jens Spahn, demands the repayment of the amounts to the insured, the statutory health insurers vehemently refuse to comply with this request. A new study by the consultancy company "McKinsey" gives the health insurers the backing, while the Kiel Institute for the World Economy (IFW) comes to a completely different conclusion.

Schäuble wants to cut federal subsidy for non-insurance benefits by one billion What happens to the 8.8 billion in the health fund? While Jens Spahn (CDU) demands repayment to the insured, Florian Lanz, spokesman for the umbrella organization of statutory health insurance companies (GKV), warns of impending additional contributions. The reserves are not sufficient to make payments to the health insured.

In addition to the billions in surplus in the health fund, the fact is that the statutory health insurance funds also have a generous financial cushion, the exact amount of which is not known in detail. For Spahn, the situation is clear: "Health insurance companies are not savings banks!" Finance Minister Wolfgang Schäuble (CDU) also demands part of the reserves. The federal government paid two billion euros into the health fund in 2011. This money is now to be repaid. In addition, Schäuble plans to cut the federal subsidy for non-insurance benefits by one billion euros in the future.

The McKinsey study provides support for the health insurance funds According to research by the magazine "Der Spiegel", a study by the consultancy firm McKinsey is to prove that in 2014 there will already be a large deficit of more than nine billion euros in the health fund. "McKinsey's sober tips are a cold shower for everyone who dreams of looting the reserves of statutory health insurance," commented the results of Jürgen Graalmann, CEO of the AOK Federal Association and also rejected repayments.

How can the financial hole be filled? Clear answer from McKinsey: With additional contributions! "The system of the health fund is such that there will again be additional contributions in the future," Florian Lanz, spokesman for the GKV umbrella association, told Bildzeitung.

In principle, the contribution for insured persons is fixed. It corresponds to 15.5 percent of gross income. These contributions are added to the health fund, from which the statutory health insurance funds are fed. The needs of the individual health insurers are determined beforehand by the official group of politicians, the supervisory authority and health insurers. Doctor's fees, hospital stays and medication will also increase by around 3.9 percent in the future.

The GKV association points out that the costs will increase faster than the income in the future. This creates a financial hole in the billions. According to the consulting company "McKinsey", expenses for medical fees, medication and other legal services will increase by an average of 3.9 percent per year. In comparison, the revenues would only increase by 1.4 percent, the experts calculate. Since the health insurance funds can only increase their income through additional contributions, this will likely be an average of EUR 15.50 per month. It is uncertain whether all health insurance companies actually use an additional fee. The economic balance sheets of the individual cash register providers are too uneven.

IFW study confirms rising surplus in the health fund Another study was recently published that came to a completely different conclusion. According to the Kiel Institute for the World Economy (IFW), the billions in surplus statutory health insurance will increase even further. For 2012, the IMF calculated 5.7 billion euros and for 2013 1.8 billion euros in additional revenue. Together with the reserves from 2011, the surplus amounts to more than 20 billion euros, according to the IFW. It is therefore no wonder that demands for reduced contributions are now getting louder.

But will the statutory health insurance companies really reduce their contributions? "Now is not the time to cut contributions," Florian Lanz told Bild. In his opinion, the reserves are too small because the expenditure of all statutory health insurance companies amounted to around 3.5 billion euros per week. This corresponds approximately to the surplus available in the health fund.

The cash surplus after the third quarter of 2011 corresponded to around EUR 10.6 billion. The health care fund of 8.8 billion is divided into 3.2 billion euros for the legally required liquidity reserve and two billion euros for securing social compensation. This would leave the government with 3.6 billion euros. However, it remains to be seen whether this money will be used to cut contributions, reduce government debt or remain in the health fund.

Are there alternatives to the additional contribution? Michael Sommer, head of the German Trade Union Confederation (DGB), answered with a clear "yes" at the end of last year. He insisted that there are other ways to relieve the cash register system. Among other things, solidary citizens' insurance would be possible, which would also involve other groups of insured persons. Christoph Straub from the Barmer GEK also believes that improved financial autonomy for the health insurance funds is necessary in order to be able to forego additional contributions in the long term. The health insurance companies should be able to decide for themselves which services they offer and for which contribution. (ag)

Read on:
Billion surplus in the health fund
Health insurance: additional contributions will come again
No additional contributions from health insurance companies in 2012
Health insurance companies abolish additional contributions

Image: Gerd Altmann / pixelio.de

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