Bundestag passes health care reform

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The Bundestag decides health care reform against the votes of the opposition. Statutory health insurers have to be prepared for rising costs.

(12.11.2010) The German Bundestag today passed the health reform of the Federal Minister of Health Philipp Rösler (FDP). The most important point: The contributions of the statutory health insurance will increase to a percentage of 15.5 from the first of January 2011. From this point on, employer contributions are frozen, which means that future increases will be borne by the insured alone.

The Bundestag today approved the planned health reform by Federal Health Minister Philipp Rösler (FDP). Against the votes of the opposition from the SPD, the Greens and the Left, the black and yellow federal government decided the far-reaching changes in the health system. With this decision it is now quite official: The contributions of the statutory health insurance companies are increasing. In the coming year, health insurance patients will pay around six billion euros more for health care. The insured must also adjust to increasing additional premiums. Because the entire financing system in the healthcare system is being converted.

The Minister of Health Rösler had already brought the newly designed drug saving package through parliament yesterday. According to the coalition, the costs for medicines, doctors and clinics for 2011 are to be reduced by around three billion euros. In order to compensate for the billion deficit in the healthcare system, the general contribution rate for health insurance has been raised from 14.9 to 15.5 percentage points. For employers and employees alike, this means an increase of 0.3 percent or three billion for each.

High deficit in the health fund
In his speech to the Bundestag, the Federal Minister of Health Rösler admitted that despite all efforts to cover costs in the statutory healthcare system, a deficit of around nine billion euros can be expected in 2011. In the future, this deficit must be met by the "service providers, taxpayers and contributors". According to the FDP Minister, "sick people" are spared this. So Rösler said: "The only group that we do not burden are the really sick".

Rising costs are offset by an additional contribution
Despite criticism from the opposition, trade unions and social organizations, the minister defended the planned changes to statutory health insurance. In his view, it was "progress" that the rising expenditure in the health system would be offset in the future by additional contributions from the health insurance companies. This means that the health insurers will in future make an additional contribution one way or another, even if some health insurers currently assume that the reforms will cover the costs. Since employers are excluded from this, the cost of jobs is not "automatically increased. This is our contribution to growth and jobs, ”said Rösler during the debate. In order not to burden the chronically ill, for example, a so-called social compensation scheme was introduced, the costs of which the federal government financed from tax funds. This would put "solidarity on a broader basis", said the minister. Rösler did not want to hear anything about the solidarity-based citizens' insurance demanded by the opposition, which abolishes the “two-class medicine”. In his opinion, the uniform public health insurance is "the opposite of justice".

Instead of "two-class medicine" now "three-class medicine" expected The opposition did not want to just leave these words and criticized the health care reform sharply. In the final debate, the SPD, the Greens and the Left criticized the plans as a way into "three-class medicine". The reforms were a way into the privatization of health costs. The state would continue to shirk its responsibility von Rot-Grün in the upcoming Bundestag election, the SPD promised “to completely undo these murks,” as the SPD vice-group leader Elke Ferner announced, but the next Bundestag election is only in 2013, until then critical voices could come again due to the poor financial situation fall silent.

The criticism of the Greens was also clear. Health expert Birgit Bender said: "This is a reform that does not deserve the name." The Minister of Health is planning to privatize statutory health insurance. Rösler would have missed his responsibility as minister for a "solidarity system", as the Green politician said.

The left even accused the federal government of a “breach of the constitution”. Left-wing chairman Gregor Gysi said Rösler wanted to advance a reimbursement model. The patients would soon be divided into two different categories by the doctor. On the one hand in privately insured persons, on the other hand in health insurance patients with prepayment tariffs and finally in the disadvantaged group of "completely normal health insurance patients". However, the last group cannot afford the prepayment model. Unequal treatment in hospitals and general practitioners is expected. Similar to the case now with health insurance and private patients.

According to the Minister, the prepayment model should be voluntary. This means that, in future, health insurance fund members can choose whether, like private health insurances, they should first pay the running costs for doctor's visits and treatments out of their own pockets and only settle them at the end of the year. In the opinion of the left-wing politician Gysi, these new regulations would violate the “Basic Law of the Federal Republic of Germany”. With the reforms, the black and yellow coalition would have “ended solidarity.”

Violent criticism from social organizations and unions
Trade unions and social organizations criticize the health care reform as the introduction of a so-called "head allowance through the back door". For example, the chairman of the "Solidarity of the Welfare Association" Professor Winkler said: "By fixing the employer contributions and developing the additional contributions to a lump sum, the injustices already existing in the financing of the SHI will be drastically aggravated once again." The German trade union confederation DGB also made a similarly drastic statement: DGB board member Annelie Buntenbach said on Friday in Berlin: "With the adoption of Minister Rösler's health care reform, the coalition is making policies against the population. It is the Incredible injustice that the 70 million insured who will pay all future increases in costs with the lump sum per head alone. ”The only sustainable thing about the reform is that 90 percent of the German population will be burdened more in the future, said the trade unionist.

Advantage for private health insurance In addition to the introduction of drug savings packages and savings at the clinics, the switch from statutory health insurance to private health insurance will also be made easier for employees who have a correspondingly high income. With the beginning of the new year, employees can switch to private companies more quickly. The health minister said that "thousands" will change. This project is also criticized above all by the health insurance companies. Because those will change who maintain the solidarity principle of health insurance through their high contributions.

Social compensation is designed to protect the disadvantaged
Since the Federal Ministry of Health also expects a rapid increase in the additional contribution, a so-called social compensation should apply from January 1, 2011. This means that grants are paid by the federal government as soon as those affected have to raise two percent of their income for the additional contribution from the fund. The Federal Government expects the additional costs to be around two billion euros a year. Even if many health insurance companies promise that no additional contributions will be raised in the coming year, these additional flat rates will very likely soon be set up nationwide. The minister still left open how this compensation should be paid. However, Rösler promised that the regulations for the planned social compensation will be "unbureaucratic." (Sb)

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