With the rollator in the nursing home: Residents have to continue to pay high personal contributions to the costs.
Photo: dpa/Sebastian Willnow
The warning of increasing contributions for those with statutory health and long-term care insurance next year is getting louder: the Association of Substitute Health Insurance Funds (vdek) also announced its concerns in Berlin last week. Around 28 million people are currently insured with this group of health insurance companies, which includes TK and Barmer. The association thus covers 38 percent of the market. Five of the six insurance companies are keeping their contribution rates stable this year. But that does not mean that this will remain the case in 2023.
Uwe Klemens, honorary vdek chairman, does not only speak of increased spending due to the “black box pandemic”. Due to laws from previous years, the providers of remedies, such as physiotherapists and occupational therapists, are also paid higher. It is roughly expected that spending will grow by 3.4 percentage points, an equivalent for the statutory funds of around ten billion euros. From the point of view of the vdek, there are now several ways of compensating for this growth with higher income. One variant would be to increase the additional contribution of the insured to 2.34 percent. At the moment it is between 1.1 and 1.6 percent for the substitute funds.
Alternatively, the statutory health insurance schemes (GKV) as a whole could be stabilized with a permanent, constantly adjusted tax subsidy. This is actually intended according to the coalition agreement, but the traffic light has not yet decided on the amount of the subsidy. The statutory funds would also be relieved if the state co-payment for the contributions of ALG II recipients were adjusted to the actual costs of caring for this group. Here, too, an increase is anchored in the coalition agreement, but not precisely quantified. In order to curb price increases for new drugs, the prices negotiated with the National Association of Statutory Health Insurance Funds should apply retrospectively from the first day of approval, not just from the seventh month, as the federal government wants. Klemens sees other possibilities: “If the value-added tax for all statutory health insurance services is reduced to seven percent, annual expenditure would fall by six to seven billion euros.”
Social long-term care insurance is waiting as the next financial construction site. On average, home residents currently pay 2179 euros per month. Since the beginning of the year, at least a partial reduction in personal contributions has come into effect: people in need of care in facilities pay between five and 70 percent less, depending on the length of their stay there. This requires three billion euros more per year from the long-term care insurance funds. Expenditure in care will increase if wages are raised there or if more staff are hired, both of which are urgent tasks from the point of view of the vdek. It is also critical that ten percent of those in need of care, especially those in inpatient care, are dependent on “help for care” from the social welfare offices – their pensions cannot cover the necessary amounts.
The vdek demands that the training costs be covered by the state, as it is a task for society as a whole. A further relief for the long-term care insurance funds should result from the fact that the investment costs for inpatient care may no longer be collected from the residents of the homes. Currently, that is an average of 466 euros per month per person in need of care. The federal states should take over this post. In addition, the vdek hopes that the 60 billion euros in reserves that have been accumulated by private long-term care insurance companies will be used to stabilize the long-term care insurance funds.
The vdek also presented the results of a survey on satisfaction with care. Most of them liked the fact that general practitioners and specialists took enough time for their patients. However, the waiting times are also worthy of criticism, especially for specialist appointments. 38 percent of those surveyed had to wait a month or longer for an appointment, one in six even more than three months. Vdek CEO Ulrike Elsner criticized in this context that these waiting times exist, although appointment service points exist. In addition, the statutory health insurance companies paid 800 million extra fees for reducing waiting times. The practices could offer more here, including the option of booking appointments online. That happens far too little, especially in rural areas.