Health insurance companies warn of new additional costs

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Health insurance companies raise the alarm: health insurance patients have to face rising costs

The statutory health insurance companies expect the insured's contributions to increase. When the health care reform was implemented, the black-and-yellow coalition had promised to compensate for additional burdens with additional contributions through social compensation. Doris Pfeiffer, chair of the Federal Association of Statutory Health Insurance Funds (GKV), said in an interview with the newspaper "Die Welt" (Sunday edition), but the insured will soon have to pay the social compensation themselves. At that time, the then Federal Minister of Health Philipp Rösler (FDP) promised that the social compensation would be financed from the federal budget with tax money. Now, however, a new law is being put in place to counteract the rural shortage of doctors. According to the health insurance funds, the new law causes “billions of new editions”.

Tax financing of social equalization levered out
The Federal Minister of Health Daniel Bahr (FDP) wants to present the new legislative proposal to the cabinet. Federal Finance Minister Wolfgang Schäuble (CDU) had previously enforced that the tax subsidy for social compensation should be reduced or limited. Schäuble fears that the special programs to promote doctors will consume enormous sums of money. The funding programs are already more expensive than initially calculated. Like the health insurance companies, the finance minister is skeptical about whether the health minister correctly estimates the follow-up costs. Schäuble therefore wants to ensure that the expenditure side is cushioned under the new supply law. "With this protective clause for the federal government, the tax financing of social compensation is undermined - at least for the part that results from higher expenses for doctors," the health insurance representative told the world. The Ministry of Health has so far not commented on the question of where the money should come from. The head of the board of the Association of Replacement Funds, Thomas Ballast, came to a similar assessment. "In the end, the insured at least partially pay the social compensation themselves." Ballast let his displeasure run wild. For him, the implementation plans of the black and yellow federal government have even failed. This had envisaged making the cash contributions independent of income through the additional contributions.

Care Act Against Medical Deficiency
The real goal of the Minister of Health is to use the new health care law to remedy the shortage of doctors that exists in many places. In fact, the density of doctors in rural areas is much lower in relation to the population. However, there is usually medical oversupply in the cities. Especially in areas with high income structures, many doctors are disproportionately located side by side. In order to address this problem, the health insurers are proposing to limit the number of urban admissions. This is to ensure that doctors tend to settle in the country. Instead, Federal Minister of Health Bahr wants to award a surcharge to doctors who work in the country and have to care for many people. In addition, medical fees are to be negotiated by region and no longer centrally, so that rural doctors and dentists in rural areas receive more funds. The incentives for doctors are said to be around 200 million euros per year. According to calculations by the Ministry of Health, the additional expenses are offset by fewer hospital admissions. However, the ministry has not published any concrete calculations. The bill says succinctly that one assumes a "considerable non-quantifiable scope". In other words, one does not know how high the relief will be. The additional expenses, especially for dentists, are also said to be another 120 million euros a year costs.

After reading the bill, the finance minister decided that implementation would need to be reviewed in two years. In 2014, it should be checked again whether an actual effect could be achieved and whether the expenses correspond to the planned savings in the area of ​​hospital admissions. The Federal Minister of Finance has also included a rule in the bill. It says that the federal budget will not pay a higher social compensation if the plans of Bahr cause additional expenses and for this reason the health insurance companies have to demand higher additional contributions from the insured. According to the fear of the health insurance companies, the insured must be asked for additional incentives for doctors with higher flat-rate contributions in the form of additional contributions to the fund.

Social compensation should not be adjusted However, in the course of the health care reform, it was agreed that with increasing additional contributions, social compensation would also increase so that lower income groups were relieved. If additional contributions now have to be set up due to the pension law, the social compensation should not increase according to the template text. The Federal Ministry of Health, however, does not understand all the fuss. Reference is made to the exact legal text. It says that a cut in social compensation will only take effect a year later than in 2015. As early as 2014, negotiations are already underway to negotiate the level of social compensation. By this time, the two billion budgeted in funds should be sufficient. And if the new law produced higher costs, the effects would be less than what the health insurers had propagated. According to the official statement of the ministry: "The federal government does not plan any cuts in social compensation," as a spokesman announced. And: "The social compensation will continue to be paid from tax money."

Health insurance companies criticize high expenditure for doctors law The health insurance companies can not believe the words. Because in their view, the supply law will not only cost a few million euros, but expenditure in the billions. And because the black-yellow coalition wants to keep the non-wage costs as low as possible, these additional costs will be recouped through newly introduced additional contributions. Because these are independent of income and must be paid out of your own pocket by the insured persons without employer contributions. Because expenditure in the health sector is increasing due to medical progress, the ever increasing medical fees, the higher pharmaceutical expenditure and the demographic change. Instead of doing something about the high density of doctors in the cities, the doctors are only given financial incentives, while elsewhere there is a real oversupply, the criticism. Therefore, the health insurance companies do not speak of a lack of doctors, but of a regional unequal distribution. Because on the whole there are not too few doctors, just too many side by side in the cities. (sb)

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