Billions of health insurance deficits expected

Despite additional contributions and massive savings efforts, a billion deficit in the statutory health insurance funds is expected.

(16.09.2010) Despite health funds, additional contributions and massive savings efforts, the deficit in statutory health insurance is expected to increase to over 3 billion euros this year. According to the Federal Ministry of Health, the main culprit is the rising expenditure on medical fees, hospital treatment and medication.

While the statutory health insurers still had a relatively large financial reserve of around 1.2 million as of September 1, 2010, the published financial reserves of 112 million will, according to the Federal Ministry of Health, not be enough to cover the costs for the rest of 2010 of insurance. In the first half of the year, expenses are generally lower than in the second, and the average most expensive months of November and December are still ahead of the health insurers. As a result, their financial reserves are shrinking rapidly and puzzles are already being posed about how to deal with the enormous deficit of around 3.1 billion to be expected.

At 87.37 billion euros, the statutory health insurance funds in the first half of 2010 made around 2.2 percent more than the previous year, which already included a tax subsidy of 3.9 billion euros. In the same period, their expenses rose by 4.2 percent to EUR 87.25 billion, so that they still managed to make ends meet in the first half of the year, but the deficit is already emerging. The additional contributions played only a subordinate role in the previous financial statements of the health insurers with only 272 million euros.

While the surplus of 1.2 billion last year offered health minister Ulla Schmidt praise for the health fund, all responsible politicians and the representatives of the statutory health insurance funds are currently relatively helpless. It is clear that a significant deficit will end of the year and that this is mainly due to the increased costs in service expenditure. These increased by an average of 4.2 percent, with medical fees (+ 5.4 percent per insured person), medication (+ 4.8 percent) and hospitals (+ 4.2 percent) being the biggest cost factors. The still enormous growth rates are based on already relatively high expenditure in 2009, so that an increase of almost 5 percent is particularly critical of the BMG. The BMG has also recorded a massive increase in costs (+ 10 percent) in the area of ​​sick pay, which the Ministry attributes to a growing number of people entitled to sick pay as the retirement age increases and a sharp increase in protracted mental illnesses.

The Federal Ministry of Health explains why the costs of medical treatment, hospitals and medication are exploding in this way, too, with the increased fee requirements for doctors, the higher collective agreements for hospitals and the lack of competition in the pharmaceutical market. The black and yellow federal government believes that, in particular, the still very high drug prices in Germany require political intervention, because "the high increase in expenditure on medication has continued almost unabated in recent years," said a spokesman for the Ministry of Health "The result of a lack of price competition for patent-protected drugs with often only minor additional therapeutic benefits," the ministry said. According to the Federal Ministry of Health, Philipp Rösler, the BMG believes that the current publication of the financial results fits well with the upcoming decisions on the law on the reorganization of the pharmaceutical market (AMNOG), which is intended to create a "balance between innovation and affordability" A stronger price regulation but also the allocation of additional benefits to justify high prices will be clearly clarified. According to plans by the BMG, the law should come into force this year and save the health insurers around one billion euros annually.

And the health insurance companies should also make their contribution in view of the impending deficit. The Federal Minister of Health has asked them to further reduce the costs of their administration, because these too rose by around 4.5 percent last year. If one takes into account the reimbursement of administrative costs by other institutions, the net administrative costs have increased by almost eight percent. "Against this background, the limitation of the administrative costs of the health insurers in 2011 and 2012 to the level of 2010 appears to be an indispensable contribution of the health insurers to the necessary expenditure limitation in the SHI," said the Federal Ministry of Health. The statutory health insurance companies, however, have to cover most of the deficit from their own reserves anyway, since a special subsidy from the federal government, as in 2009, is not to be expected. (fp)

Also read:
Rösler disagrees: No additional contributions in 2011
Federal Government: Billions package for the PKV
Health insurance additional contributions also in 2011

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