CDU health experts want to abolish the PKV

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CDU health expert Jens Spahn wants to abolish private health insurance

If the Union and the FDP were always "guardians of private health insurance", the following is slowly crumbling here too. The CDU health expert Jens Spahn has spoken out in favor of abolishing private health insurance. In this context, the renowned health economist Jürgen Wasem referred to the Dutch health system. A functioning health insurance system has existed there for a long time without any distinction between private and statutory health insurers.

Rising expenditure side of the PKV
Private health insurance companies have been criticized for some time. Due to the demographic change and the associated rising health costs, insurers have to constantly adjust their premiums. At the turn of the year alone they had to accept tariff increases of up to 60 percent. While the industry keeps on sealing off and deliberately speaks of good results, the numbers speak a different language. A good 12 years ago (2000), insurance companies had to spend around 13.6 billion euros for medical and other services. In 2010, the cost almost doubled to $ 22 billion.

The membership structure of the private funds has grown older on average because people are living longer. But that also means that insurers have to spend more and more on innovative medical services. The propagated advantage of the private health insurers therefore turns out to be a real cost driver: With private health insurance, the insured can submit almost any invoice from the doctor or the clinic.

Savings tariffs lure new members into the cost trap
In order to stimulate new customer business, many private insurers have begun to lure the undecided with so-called low tariffs. With tariffs well below 100 euros, customers are suggested that health insurance can be obtained at a ridiculously low price. Awakening usually comes after the affected person. Every year, the lured customers experience price increases of between 10 and 30 percent. Recently, it was an average of 40 percent, as industry experts calculated. Who then wants to switch back to the statutory health insurance company was unlucky in most cases, because a new inclusion in the SHI system is only possible in a few exceptions. More and more people get into debt every year because they can no longer pay the non-income-related insurance contributions. To date, the number of debtors has risen to over 144,000. However, because health insurance has been compulsory in Germany since the health care reform, the private health insurers are not allowed to cancel the defaulting payers. Together with the Federal Ministry of Health, it is now being considered to introduce a so-called “non-paying tariff” that only covers emergency care for EUR 100 per month. All of these reasons call for prompt action. The opposition is already introducing models such as "citizens' insurance" into the discussion.

The separation of the PKV and GKV is required
The CDU health expert Jens Spahn had already asked for the abolition of four-bed rooms in hospitals last year. Now the politician is campaigning for an end to the separation of private and statutory health insurance companies. Because in the long run there is no way around reform, as he said. Spahn receives applause from the GKV. The head of the association of the umbrella association of statutory health insurance companies, Doris Pfeiffer, said that she was convinced that the model "PKV is not sustainable in the long term." "The expenditure increases are higher than in the statutory health insurance," said Pfeiffer in an interview. However, the PKV has no way of getting a grip on the expenditure side.

Ever higher provisions for old age
Because health costs are rising, private insurance companies have to build up higher and higher pension provisions. In 2000 it was 60 billion euros, today it is 170 billion euros. In contrast, the number of fully insured members increased only minimally.

Spahn argues for the abolition of the artificial separation between statutory health insurance and private health insurance, but the variety of health insurers should be preserved in order to strengthen competition. In addition, it was necessary to think about fundamentally revising the structures. The statements met with great rejection among party friends in the CSU and the partner FDP. Necessary reforms should not be prescribed, but left to the industry, as stated by several CDU / CSU and FDP politicians.

Cash register system of the Netherlands as a model for Germany
The health economist Prof. Dr. Jürgen Wasem from the University of Duisburg-Essen advocates a uniform system based on the Dutch model. In 2006 there was a major reform in Holland to reduce the differences between private and statutory providers. Every Dutchman has to take out health insurance and the health insurance companies are not allowed to deny basic health benefits to any citizen. The financing of the model comes from two different lines. The citizen pays almost half of the insurance costs himself. The amount is levied as a lump sum, regardless of average annual income, age, gender and health. The other half is paid by the employer depending on income. The self-employed, on the other hand, have to bear both costs themselves. If you have too little income, you get a state subsidy.

The umbrella organization of private health insurance (PKV) rejects the Dutch health insurance model. According to the lobby representatives, there are many more restrictions in the range of services and rising costs due to the market concentration on a few providers. Nevertheless, there is competition with the help of insurance premiums and the design of the service. In addition, insured persons have more options for supplementary insurance than was previously the case.

Implementation could cause problems
In Germany there could be problems with the implementation of the model. While German clinics and doctors charge higher costs for private patients, this has never been the case in Holland. In addition, the Dutch private providers had not accumulated a retirement provision, as is the case in Germany. In this context, the PKV criticizes the plans sharply and speaks of "expropriation" of the customers if the retirement provisions have to be abandoned if the systems merge. Critics reply that the money could be spent on the insured before a reform, or that the privately insured would simply take the retirement provisions with them.

But such models are still a long way off and are categorically rejected by the federal government. On the contrary, in order to keep the private health insurance viable, new legislative changes are constantly being introduced in order to constantly revitalize the new customer business. The coalition agreement also stipulated between the Union and the FDP that the separate system would continue to exist. For the economist Prof. Stefan Greß it is already clear: In ten years, the PKV as we know it today will no longer exist. (sb)

Read on:
PKV: For nonpayers only emergency care
Health insurance companies: Non-payers cause losses
Private patients flee to the health insurance companies
Health insurance: additional contributions will come again
Complaints about increases in private health insurance contributions
Health insurance: what will change in 2012

Matthias Preisinger /

Author and source information

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