Additional contributions save health insurance companies

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BMG statistics: Additional contributions bring health insurers around 500 million euros in additional revenue. The collection of additional contributions will continue to play an important role in the future if the evaluation of the Federal Ministry of Health is interpreted correctly.

Some statutory health insurance companies have been collecting additional contributions from their insured since the beginning of the year. Earlier this week the Federal Ministry of Health (BMG) released statistics on the financial development of statutory health insurance (GKV). According to the surveys, the health insurance companies were able to earn around 500 million euros in addition to the regular contributions through the additional contributions collected. If the financially stricken health insurance companies had not made any additional contributions, the economic situation of the health insurance companies would be significantly worse than it already is. According to the BMG, the deficit would be around nine billion euros.

The statistics of the Federal Ministry of Health clearly show the situation of the statutory health insurance companies. In its evaluation, the ministry also refers to future expenditure and thus gives a filtered outlook into the future. At the same time, the report warns that the health reform that was decided was essential to support the statutory health insurance system. In the first three quarters, all health insurance companies had revenues from the health fund of around 131.2 billion euros. Also included are the additional income of the health insurers through the additional contributions made by the insured.

In contrast, according to the information, the health insurance companies spent around 130.9 million euros on health services, personnel costs and administration. This leaves just a surplus of around 277 million euros. Measured three years ago in the same period, the health insurance companies still generated a surplus of around 1.4 billion euros. Since experience has shown that expenditure will increase again at the end of the year, the Federal Ministry of Health expects the financial development to be underfunded. This means that the BMG expects the public health insurance to be significantly underfunded.

Additional contributions with increasing importance In future, the additional contributions will play an increasingly important role in the financial development of the health insurance system. Without the additional contribution levied by individual health insurance companies, closings of individual insurance companies would have been inevitable. The Federal Ministry of Health itself points out that the additional contributions are indispensable and that this will also apply in the future. These contributions alone generated around EUR 463 in additional revenue, which prevented even greater underfunding. If these lump sums had not been collected, a deficit of around EUR 186 million would have arisen in the first three quarters. In the future, insured persons with statutory health insurance will have to be prepared to pay additional contributions soon. At the moment, individual health insurers, including the third largest health insurer in Germany, charge a flat fee of eight euros per member who is liable for contributions.

Rising treatment costs in the healthcare system
Due to the demographic change and the rediscovery of medical therapies, treatment costs are also increasing. This is also shown by the current BMG statistics. In particular, the costs of health care and nursing care will increase. Expenditures for outpatient therapies and treatments rose by 3.7 percent compared to the previous year. If you compare the increase in expenditure with 2009, the increase in the expenditure side in this area has almost halved. The cost of treatment in clinics rose by 4.5 percent with an increase in expenditure (see previous year: 6.6 percent). Spending on pharmaceuticals increased by 4.2 percent. In the course of the drug market reorganization law, the expenditure side for medicines should be reduced significantly. Administrative expenses rose 3.9 percent. For the coming year 2011 it was stipulated by law that the administrative share of the cash registers must remain at the level of 2010.

Outlook for years to come
Without raising the regular contribution rate of statutory health insurance to 15.5 percent from the turn of the year 2011, a deficit would be inevitable despite the good economic situation. If the contribution rate were not raised, there would be a deficit in the health fund of around 9 billion euros, according to the forecast by the Ministry of Health. For this reason, it is imperative to raise the health insurance contribution rate to the level before the economic crisis. In addition, it has been shown that savings for doctors, hospitals and health insurers are still necessary. The reorganization of the pharmaceutical market is also of the greatest importance in order to stop the increase in expenditure. In contrast to independent health economists, the BMG does not expect the health insurers to deficit in the coming year. According to official information, the additional contributions will not increase any further. In contrast, however, five health insurance companies have already announced that they will request an additional contribution in 2011. Nevertheless, the federal budget must make a grant of two billion euros to strengthen the health fund. This is used exclusively to replenish the reserves of the health insurance companies and to finance the social compensation for the additional contribution.

Doubt from critics
However, many health economists doubt that the savings will be enough to keep the statutory health insurance system stable. Various experts have already calculated that in the near future the insured will receive far higher additional contributions than is now the case. It is a fact that the employee share of health insurance was frozen from the beginning of the year. This means that inevitably all higher costs have to be borne by the insured themselves. The Federal Ministry of Health apparently sees this as well and that is precisely why the planned social equalization has been introduced. (sb)

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