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Health insurance funds have insureds collect arrears with the help of the main customs offices
The number of debtors in chalk with the health insurance company is growing. Last year alone, the customs authorities had to deploy thousands of times to collect open contributions from around 1.6 million legally insured. The health insurance companies complain of arrears of over 1.5 billion euros.
Customs collects health insurance arrears from non-payers
Statutory health insurers are losing more and more money because delinquent contributors do not pay outstanding claims. Customs officers collect outstanding contributions on behalf of the cash registers. Despite several payment requests, over 1.6 million insured persons did not pay their premium debts last year.
The Association of Statutory Health Insurance Companies complains of an increasing number of insured who cannot pay their open premiums. One and a half billion euros were not paid in 2011. In order to collect at least partial amounts, the health insurers have taken drastic measures: they have the amounts collected with the help of the state customs authorities. As a result, delinquent health insurance patients are getting more and more visits from enforcement officers. According to the Federal Ministry of Finance, the health insurance funds have commissioned the main customs offices to collect them in around 1.6 million cases. First, the customs officials announce a warning period. If payment is still not made, accounts are seized and goods are confiscated. In 2010 there were still 1.3 million cases, so the number of people affected has increased by at least 300,000.
As a federal debt collection agency, customs is responsible for visiting and reminding debtors of the federal government and other public law institutions. As a spokesman for the ministry said, the numbers "tend to suggest that the federal health insurance funds are increasingly paying arrears for enforcement to the main customs offices." The customs authorities report to the Ministry of Finance.
Most of those affected cannot pay their contributions for financial reasons. Because employers transfer the contributions directly to the health insurance companies, it can be assumed that the total number of freelancers and self-employed affected is quite high. Consumer advocates and unions therefore assume that the proportion of negligent insured persons is quite low. Accordingly, it is "a social problem".
Consumer advocates are demanding affordable health insurance coverage
Affected people can turn to the consumer advice centers in case of financial difficulties. Debt advisor Dörte Elß from the Berlin Consumer Advice Center told dpa that "Debts of a few thousand euros are common". If cash contributions are not paid, personal bankruptcy is often already present. Against this background, Elß called for "affordable health insurance protection". "A real problem" exists, for example, with small business owners.
Due to irregular income from self-employment, many cannot pay their insurance premiums continuously. If the expected contribution collides with the actual income, there will be no repayment at the end of the year. Only if the income is higher than the assumed contribution rate, the health insurers require an additional payment and a higher contribution rate for the next year.
The German Trade Union Confederation (DGB) also sees this problem and therefore calls for legislative reform for traders or freelancers with low incomes. “Self-employed people, like employees, should pay contributions based on their actual income,” says DGB board member Annelie Buntenbach. At the moment, only flat-rate minimum contributions apply to voluntarily insured entrepreneurs.
According to the Federal Association of Statutory Health Insurance (GKV), the arrears of all health insurance funds are currently a good 1.53 billion euros. The association assumes that hundreds of thousands have not paid their contributions. A spokesman said that the problem had worsened in the final months of 2011. In February 2011, the GKV was still 1.04 billion euros behind.
The number of debtors has risen rapidly after the introduction of compulsory insurance. In the course of the health reforms, the obligation was initially introduced for health insurance patients in 2007 and for privately insured persons in 2009. Anyone who had not taken out insurance at that time and only decided to take out health insurance years later had to reimburse the previous premium months. As a result, many started health insurance with debt. The then federal government introduced compulsory insurance because more and more people had no health insurance.
Non-payer also with the PKV
The problem of nonpayers is not limited to the SHI. The Association of Private Health Insurance (PKV) estimates the amount of the outstanding amounts at around 550 million euros. Due to the planned debt relief for Hartz IV recipients, the amount of the contribution debt could be put into perspective. "Because the job centers only took over a good half, formerly self-employed people were often in debt," said expert Wolfgang Alexander Müller. In the case of open tariff amounts, the private health insurers have not been allowed to simply cancel the insured since the introduction of compulsory insurance. At least medical emergency care must be guaranteed. However, tariffs have also risen because of the contributors.
Opposition calls for health system reform
According to the health policy spokeswoman for Alliance 90 / The Greens, Birgitt Bender, there is a system error in German health insurance. The strict rules would apply in favor of private insurance. “Minimum contributions and access restrictions for the self-employed in the SHI are the price for dividing our health insurance system in two,” says Bender. The politician spoke out in principle for including entrepreneurs in the statutory funds. If there were no restrictions, many self-employed people with low income and high risks of illness would opt for health insurance companies.
Prevent attachment in case of debt
Before the customs authorities seize them, the insured can take action themselves. The debt advice centers point out the possibility of paying in installments. Almost every cash register gets involved. "It is important to stay in contact with the health insurers and to signal a willingness to pay in principle". The current contribution payments can also be reduced if the health insurance company is credibly informed that the income will be significantly lower than in the same period last year. Help is also provided by the free advice centers. (sb)
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