Major reforms, but significantly less money: Health Minister Lauterbach has defended his plans in the Bundestag against criticism. However, health insurance companies and social organizations warn against increasing additional contributions, since federal subsidies are no longer available.
Federal Minister of Health Karl Lauterbach has defended the planned hospital reform and his health budget against criticism. “We have had a reform backlog for more than ten years,” said the SPD politician at the budget deliberations in the Bundestag. Unfortunately, the German health system is “chronically ill”. Despite comparatively high expenditure, the quality of results is not good and life expectancy is developing poorly.
Previous changes have been “trivial reforms” without much effect. With the planned hospital reform, the traffic light coalition wants to bring medicine back to the fore instead of a “thoroughly economized system,” said Lauterbach. He emphasized: “We give the small hospitals an existence perspective.”
In addition, there will be an overdue digital reform with new regulations for electronic prescriptions, e-patient files and data research. In the fall, Lauterbach also wants to launch a planned “Institute for Public Health” for better preventive medicine and prevention.
Significantly shortened Health budget
However, Lauterbach has less money available for this overall: Finance Minister Christian Lindner’s draft budget for 2024 earmarks 16.22 billion euros. In the previous year it was still 24.48 billion euros. However, the SPD politician defended the significantly reduced health budget. The cuts are due to the lack of costs for the corona pandemic.
Compared to the time before the pandemic, the health budget is growing, according to the health economist. “So we don’t have a budget that is shrinking overall, but a budget that is stabilizing,” emphasized the SPD politician.
The opposition sees it differently. She criticized the insufficient funds from her point of view. The government says “first the debt brake, then health,” said Left Group Vice President Gesine Lötzsch. That is the wrong way. Union parliamentary group leader Sepp Müller complained that the budget for prevention work was being reduced. “You are the announcement minister,” he told Lauterbach. Wolfgang Wiehle (AfD), on the other hand, emphasized that the hospital reform would end many clinics in the country.
BKK: “Declaration of bankruptcy the government”
The statutory health insurance funds were also concerned. They warn of a deficit in the billions for the coming year as a result of federal policy. So far, the cash registers are assuming a gap of between 3.5 and seven billion euros in 2024. The head of the umbrella organization of company health insurance companies (BKK), Anne Klemm, is assuming a deficit at the upper end of the estimates. “I’m afraid that we’ll end up with more than seven billion euros,” Klemm told the “Handelsblatt”.
In addition to additional burdens due to the reforms planned by Lauterbach in emergency care and clinics, the BKK boss warned that there were also “great risks for the income from the economy and rising unemployment”. Finance Minister Lindner had pushed through during the budget deliberations that additional federal subsidies paid to health insurance companies in recent years are now no longer available.
Without political measures, the average additional contribution in 2024 would therefore have to increase by 0.4 percentage points according to the “Handelsblatt”. For insured persons and their employers, this would mean an additional burden of more than three billion euros each. Klemm called the rising contributions a “declaration of bankruptcy by the federal government”.
No subsidy for care insurance
According to the draft budget, the subsidy for long-term care insurance should also be completely eliminated in the coming year. The social association SoVD sharply criticized this: “There must be no automatism that compensates for rising costs exclusively through increases in the contribution rate in health and long-term care insurance,” explained SoVD chairwoman Michaela Engelmeier.
In this way, small and medium-sized incomes would be additionally burdened, which would lead to “more social injustice”. As an alternative, Engelmeier proposed an increase in the top tax rate or inheritance tax in view of the scarce resources.
Diakonie: Additional costs are passed on to the insured
The Protestant social association Diakonie also criticized the cancellation of the grants for long-term care insurance. “Instead of finally putting the long-term care insurance on a financially solid footing, the additional costs are passed on to the insured,” said Diakonie social director Maria Loheide. This has “fatal consequences”.
The nursing employers’ association (AGVP) made a similar statement: “The traffic light government refuses to take responsibility for long-term, solid financing of nursing care insurance,” said association president Thomas Greiner. Instead of more burdens for those in need of care and those paying contributions, he called for a “big hit” for the expansion of care for the elderly, including a legal right to a place in a nursing home.
The FDP health politician Christine Aschenberg-Dugnus defended the budget cuts. “The Finance Minister’s strict budget course is the only right way,” she emphasized. However, instead of increasing contributions, health spending should be examined. “High spending in the health system alone does not automatically lead to better care,” argued the FDP politician.