The German healthcare system is better than its reputation. According to a study by the OECD, no country in EU Europe spends more on the health of its citizens than the Federal Republic, namely well over 5,000 euros per person per year. No country employs more medical staff, namely 4.5 doctors and twelve nurses per 1,000 inhabitants. But no other country has such a strong fully comprehensive mentality, according to which every small additional payment at the pharmacy is an imposition.
In an aging society in which fewer and fewer young, healthy contributors have to finance more and more older and more insured people in need of care, the best health system reaches its limits. The fact that additional contributions from statutory health insurance companies will soon rise sharply is just the most visible symptom of a systemic crisis for which politicians have not yet found a solution. Your remedy consists primarily in increasing premiums for health insurance companies, for care, for… Interest. From Daniel Bahr to Herrmann Gröhe and Jens Spahn to the incumbent Karl Lauterbach, no minister has really addressed the question of whether Germany can afford its all-inclusive approach to health policy for a long time to come.
The problems are obvious: More than 90 statutory health insurance companies also mean more than 90 expensive fund managers and fund administrations – Denmark, for example, gets by with a single fund. In Germany, an insured person sees a doctor ten times a year – on average in all industrialized countries there are just over six visits. And when calculated across all health insurance funds, both private and statutory, the average German pays around a tenth of their health costs themselves, from the prescription fee to the massage to the new inlay in their teeth – in Switzerland it is almost 20 percent.
The federal subsidy is too low
In Germany, around 500 billion euros flow into health care in the broadest sense every year, around two thirds of which goes to statutory health and nursing care insurance alone. Using this money more efficiently and proactively should actually be the first duty of politicians. However, the federal government, which is cutting benefits or introducing personal contributions staggered according to income, has yet to be elected – the parties are too worried about incurring lasting resentment from those insured. It would be all the more important to streamline the structures in the system and reduce the number of cash registers. Even a gentle pressure to impose more cost discipline along the lines of private health insurance companies would not shake the foundations of the system. On the contrary: Why, for example, should people with statutory health insurance not receive a premium refund if they have not used any services for a year or if they pay small medical bills themselves?
The state could also take some pressure off its cash finances by increasing the annual federal subsidy. The 14.5 billion euros only covers some of the non-insurance benefits that the community of all taxpayers should actually pay for and not the health insurance company – for example maternity benefit, the non-contributory co-insurance of children, but also the expansion of emergency care.
Our health is an expensive commodity, yes. Nobody should skimp on it. But that doesn’t mean that the health insurance company has to pay for everything.
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Rudi Wais Icon checkmark set in a circle Icon Plus in a circle
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