GKV and PKV negotiate about citizen insurance?

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The private and statutory health insurance companies are apparently preparing for an upcoming citizens' insurance and entering into secret negotiations.

Since the health reform of the black and yellow coalition at the beginning of the year, it has become easier for people with statutory health insurance to enter private health insurance (PKV). If you have at least a gross monthly income of 4,125 euros, you can get private insurance regardless of your income. But how long will there be two different health insurance systems? While GKV and PKV board members are fighting hard in public, according to Wirtschaftswoche (WiWo), initial negotiations for future cooperation are already taking place behind closed doors.

Instead of two systems on the way to citizen insurance? Trade unions, social organizations, the Greens, the Left Party and the SPD have long been calling for uniform solidarity insurance. Everyone emphasizes on a broad front that if the current black-and-yellow federal government is voted out of office in 2013, private insurance will be turned off. All newly insured and therefore also the self-employed and civil servants would then have to enter statutory health insurance (GKV) depending on income. According to the SPD's plans, only old customers are likely to remain in private health insurance. However, since no new, healthy and young customers can be won, the private health insurance tariffs would become extremely expensive over the years. That would mean the death of the private health insurance in just a few years. This is also the view of the chairman of private health insurers in Germany, Reinhold Schulte. In a statement, he warned: "Our well-functioning system would be willfully destroyed." The provisions for old age would then hardly be sufficient for existing customers.

PKV tariffs become more expensive But is the private system really working properly? For years now, older and chronically ill people in the private health insurance system have been complaining about strongly rising tariffs. According to recent surveys, only every third private patient is actually still satisfied. Because while the new tariffs are extremely cheap in places, the former entry tariffs become more expensive with increasing age. The private providers have been moaning for a long time about the steadily increasing fee requests from doctors and clinics. These soaring prices are hardly sustainable anymore, especially when you consider that the demographic change is making insured people older and older and medical progress is a tribute.

Two-pillar care almost unique in the world Hardly any western industrialized country is treating itself to a two-pillar health care system. The board members of statutory and private health insurance companies also know this. Even if there is no political change after the general election, significant changes would have to be created. It is questionable whether the private sector can remain at the expense of the legal system for a long time. Today's citizens don't even have a train station built in Stuttgart without protests. The protests could become massive.

Legal and private advice on future models For some time now, the board members have been behind closed doors to discuss a common future. So far, however, none of these discussions have been made public. In February the leaders met at a future workshop in Bergisch Gladbach and in autumn at a symposium at the Cologne University of Applied Sciences.

Trade unions criticize head allowance In addition to the parties, the trade unions are also mobilizing. Above all, the burden of additional contributions is the focus of criticism. Annelie Buntenbach said on Thursday in Berlin: "The widespread social criticism of the so-called social compensation once again proves that the promise of the federal government to protect the 70 million insured persons from statutory health insurance against financial demands is pure waste. The social compensation is not worth its name because the insured person's actual burdens are not compensated for by the head allowance. It is already foreseeable that the promised compensation will result in bureaucratic costs in the billions, but many millions of insured will have none of it and will remain completely on the rising burdens. ”According to the DGB, the problem is not just the fact that additional contributions are levied, but that these now also have to be paid as a lump sum per head without employer subsidy. It is therefore “irresponsible to give up the solidarity compensation system in the statutory health insurance system and instead to introduce a highly complicated calculation procedure that is not up to the high flexibility on the labor market and does not compensate for the anti-social burdens on the head allowance. The GKV's financial problems can only be solved sustainably if all citizens are involved in the solidarity-based financing of health insurance. ”

Drastic premium increases in the coming years If reforms are not implemented quickly, insured persons in both camps will soon have to pay drastically increasing insurance premiums. Eberhard Sautter from the board of the PKV Hanse-Merkur warned: “Fewer and fewer contributors are getting more and more elderly patients who cause disproportionately higher costs. In the medium term, we have to make do with less money per case of illness. The costs have to go down, the efficiency has to increase. ”

The SPD, the Greens and the Left therefore stick to the model of citizens' insurance, which would mean income-dependent health insurance for everyone. Black and yellow, meanwhile, wants to continue to adhere to the model of the health premium (head allowance), which provides for a uniform contribution to minimal basic care. Anyone who wants or needs more health must also take out private insurance. The model is then anti-social despite the bureaucratic model of social equalization, but could, in the opinion of the FDP and Union politicians, save the private health insurance. The citizens must then vote on these two variants in the upcoming Bundestag election. (sb)

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