PKV new business is booming: at the expense of the GKV

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PKV new business is booming - at the expense of statutory health insurers

While some statutory health insurance companies are suffering massively from the burdens of the past health care reform, private health insurers (PKV) benefit from the new freedom of choice and were able to increase their new business by 20 percent in the first half of 2011, reports the "Handelsblatt".

Since the beginning of the year, the switch to high-earning insured persons towards private health insurance has been made significantly easier. If they had to prove a correspondingly high income for at least three years to date, this year it has been enough to exceed the income limit of 45,900 euros annual income once. Numerous insured persons apparently used this option in the first half of 2011 and switched to private health insurance. Many expect not only lower contribution costs but also significantly improved benefits. But even in private health insurance, all services are no longer taken over without further inquiries, reports the private health insurance ombudsman, Dr. Klaus Theo Schröder, opposite the "Ärzte Zeitung".

PKV new business grows by 20 percent The PKV association was also pleased with the significant growth in new contracts and emphasized the positive effect of the political decisions. But where the private health insurance benefits, the statutory insurance companies are facing growing difficulties. The increase in new business of private health insurance by around 20 percent in the first half of 2011 is clearly at the expense of statutory health insurers. Above all, high-earning employees are increasingly switching to private ones, which significantly weakens the membership structure in the statutory health insurance. The old, sick insured, whose contributions generate less income than their care costs, remain exaggerated in statutory health insurance (GKV), while the young, healthy, well-earning members switch to private health insurance. This more or less undermines the principle of solidarity that underlies the statutory health insurance system. According to the "Handelsblatt", while the private providers are pleased about the "noticeable revival of competition" and the addition of 54,000 fully insured persons in the first half of 2011, some statutory health insurance companies are struggling with considerable financial difficulties and the first have already had to cease operation (see City BKK and BKK for health professions).

Good business with supplementary insurance Today around 8.95 million Germans are fully insured in private health insurance. The overwhelming majority of around 70 million people, on the other hand, are members of statutory health insurance. However, the GKV loses members to the same extent as the PKV wins. In addition, the statutory health insurers were prohibited by the legislature from continuing to be involved in the business with supplementary insurance, so that this business area falls exclusively to the 40 or more private health insurers. The private health insurance companies were able to take out around 119,000 additional insurance policies in the first half of 2011, which was also significantly higher than the previous year (77,000), reports the "Handelsblatt". According to the latest reports, private insurers currently provide more than 22 million supplementary insurance policies. The business with private health insurers is doing pretty well. The industry expects premium income of EUR 34.9 billion for the full year, which corresponds to an increase of 4.9 percent. Health insurance accounted for the overwhelming majority of income at € 32.76 billion, but private insurers also recorded premium income of € 2.14 billion in the area of ​​long-term care insurance.

Rising expenditures for health care benefits also in private health insurance However, with private health insurances the increasing annual expenditures for insurance benefits are also having an increasing impact and were around 23.1 billion euros in the first half of 2011. This corresponds to an increase of 5.5 percent compared to the same period in the previous year, which means that "the cost increase will remain well above the general price increase in 2011", quotes the "Handelsblatt" from the PKV Association's 2010/2011 report. Critics suspect that this is also one of the reasons why the services taken over are looked at much more closely today than a few years ago. Dr. Dr. contradicts this assessment Klaus Theo Schröder, former State Secretary in the Federal Ministry of Health and PKV Ombudsman since January 2011, told the "Ärzte Zeitung" that the refusal to cover costs for special services could also reflect a higher level of attention by private health insurers for the quality of the services.

Increased quality requirements or cost pressure? Accordingly, a refusal to assume the costs would not necessarily be an expression of the rising cost pressure, but possibly a sign of increasing quality demands on the part of private insurers. Like Dr. Schröder explained, "There is increasing discussion in the private health insurance as to what good quality care is," and in principle it is "progress if quality aspects play a greater role." According to the private health insurance ombudsman, 18 percent of the disputes concern that to be clarified about him, the need for medical services. Before an expensive treatment can be planned, privately insured persons should urgently ask for a cost estimate and ask their insurance company what proportion of the costs will be borne. As an example of refusals to assume the costs Schröder different lifestyle products, the costs of which were often borne without further demand in the past, but which are now no longer covered by many private health insurance companies. (fp)

Read on:
PKV: 20 percent more full insurance
Lower PKV commissions planned
Switching to private health insurance is often not advisable
Warning of private health insurance tariffs
PKV: 150,000 insured in the debt trap
Numerous private health insurance companies are planning to increase premiums in 2011
Contributions from the private health insurance are increasing

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