Health insurance companies for a flat fee



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Health insurance companies demand autonomy for contributions to statutory health insurance

In the opinion of the umbrella association of statutory health insurers, the uniform contribution to the statutory health insurance is one of the reasons for the massive financial difficulties of some health insurance companies as well as for the insolvency of City BKK and the BKK for health professions.

The bankruptcy of the City BKK and the BKK for healthcare professions should also give politicians reason to revise the system of unit contributions and additional contributions to the statutory health insurance funds, explained the CEO of the umbrella association of statutory health insurance companies, Doris Pfeiffer. On behalf of the health insurance companies, Pfeiffer called on the federal government to abolish the single contributions and to reintroduce more autonomy in setting the contributions.

A small additional fee already causes considerable membership losses
In the opinion of the CEOs of the Central Association of Statutory Health Insurance Funds, the standard and additional contributions for the City BKK and the BKK for health care professions introduced with the health fund acted like a vicious circle that increased the financial difficulties of the health insurance funds to such an extent that in the end only the way remained in bankruptcy. Doris Pfeiffer therefore asked the federal government to move away from the system of unitary and additional contributions. Politicians should definitely grant health insurers more autonomy when setting premiums. Pfeiffer told the "Handelsblatt" that the statutory health insurance companies urgently "need more premium autonomy, that is, the possibility to set the price of the benefits and the contribution rate themselves". The leading association of statutory health insurance companies "warned already when the fund was introduced that the insurance companies would be exempt from the contribution autonomy", emphasized Pfeiffer and added: "We are now seeing that even a small additional contribution leads to much higher membership losses than previously much larger contribution rate differences."

System of unit and additional contribution for health insurance companies a vicious cycle
In the opinion of the CEOs of the Central Association of Statutory Health Insurance, the standard contribution and the additional contributions pose a significant threat to numerous health insurance companies, as these quickly lead to a kind of vicious circle, at the end of which - as with the City BKK and the BKK for health care professions - the bankruptcy of the affected Health insurance companies. Pfeiffer describes the process that covers health insurance companies as follows. Health insurance companies that do not make do with the allocations from the health fund must raise an additional contribution to avoid possible deficits. However, the additional contribution resulted in real waves of change, with young, healthy members primarily changing insurance. According to Pfeiffer, a disproportionately large number of older, sick insured persons remain behind, which cost more than their contribution payments generate income. Because of the deterioration in the membership structure, the affected health insurance company is again faced with financial difficulties and has to increase the additional contribution. This in turn triggers additional insurance changes, whereby with the loss of members, the administrative apparatus of the health insurance companies no longer corresponds to the required level and causes disproportionately high costs. The situation worsens and "in the end the cash register can no longer save itself from its own resources," explained Pfeiffer. Another side effect of the system of health funds and additional contributions, according to the expert, is that health insurance companies no longer compete for the best "price-performance ratio", but only for the cheapest care.

Fewer and fewer health insurance companies
Industry experts warned immediately after the introduction of the health fund that this would result in the takeover or closure of numerous statutory health insurance funds. At the end of the process, the number of statutory health insurance funds was forecast to shrink from just under 200 to only around 50. A look at the insurance landscape shows that numerous factors of the predicted development have already become facts. In the past two years there have been more cash register mergers than ever before and this year the first closings followed with the City BKK and the BKK for health care professionals. If politicians want to stop the development, the suggestion of the umbrella organization of the statutory health insurance companies for the reintroduction of the contribution autonomy seems to be the only way, whereby it is not clear whether further bank failures can actually be completely avoided in the future. (fp)

Image: Gerd Altmann, Pixelio

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