analysis
The financial situation of statutory health insurance companies is strained, and they expect further increases in contributions in 2025. This could particularly burden people in low-paying jobs.
Doris Pfeiffer knows all about bad numbers. It is not the first time that the chairwoman of the GKV umbrella association has had to announce that the funds are expecting a deficit of billions: “This year it is particularly unpleasant because we do not have a particularly good outlook.”
A development that worries Germany’s top health insurance chief. “We now have a situation where I can only wonder why there are no political answers to it,” Pfeiffer told ARD Capital Studio.
Depending on income
Things could get more expensive again next year for those who pay contributions to statutory health insurance. Around 90 percent of people in Germany are covered by statutory health insurance. The contribution rate is set by law and is 14.6 percent. The employer covers half of the costs.
There is also an additional contribution, which can vary depending on the insurer. This could rise significantly in the coming year, warn the health insurance companies. They expect an increase of up to 0.6 percentage points.
What this would mean specifically for those insured depends on their income and health insurance provider, among other things. Anyone earning 2,000 euros gross would have to pay six euros more per month. Anyone earning 4,000 euros gross would have to pay twelve euros more per month. In addition, there is the employer’s share.
One of the most expensive Health systems
“That may not sound like much at first glance,” says Pfeiffer. “But there are people who earn very little for whom that is a lot: cashiers in supermarkets, truck drivers.” It is also crucial that this is not a one-off burden.
The problem is not new; the expenditure of statutory health insurance companies has been rising for years. The German health system is one of the most expensive in the world. The GKV umbrella association estimates that it will cost around 314 billion euros this year to care for the insured. The money goes mainly towards hospital stays, medication and medical treatment.
In the Coalition agreement says something else
Health Minister Karl Lauterbach has so far presented few concrete ideas on how he intends to ease the burden on health insurers in the future. Instead, the system will probably face further expenditure. Lauterbach’s hospital reform could drive up costs. He also wants to pay family doctors better in order to combat the shortage of doctors.
The costs of these reforms have not yet been factored into the health insurance companies’ calculations. Pfeiffer from the National Association of Statutory Health Insurance Funds therefore assumes that insured persons and employers could be burdened even more. “We now finally need an approach to put this health care system on a new footing,” Pfeiffer told the ARD Capital Studio.
The traffic light government had agreed on something else in the coalition agreement, namely to support the coffers with more tax revenue. This has not happened yet. Lauterbach’s ideas paper on this is more like a description of the problem. It states, almost a little resignedly, that this should be implemented “as soon as the budgetary framework allows it in light of economic developments”.
“Redistribution from bottom to top”
In view of the difficult budget negotiations, it does not seem as if the traffic light coalition will implement this plan. This is causing criticism within the coalition. Green budget politician Paula Piechotta believes that the government has repeatedly relieved the federal budget in recent years at the expense of statutory health insurance.
“This means that redistribution is taking place from the bottom to the top and non-wage labor costs are constantly rising. This must stop,” demands Piechotta. Not everyone pays into the statutory health insurance scheme. Many higher earners are privately insured. If the health system were financed with tax money, everyone would finance it together, for example through income tax or value added tax.
The Union also criticizes the fact that the traffic light coalition has not yet presented a concept. “That is not acceptable,” says CDU health politician Sepp Müller. In addition to rising health insurance contributions, Müller also sees a problem for the nursing care funds. “The tense situation in the social insurance system must no longer be ignored,” warns the deputy parliamentary group leader of the CDU and CSU.
No better under Spahn
When the Federal Minister of Health still came from the CDU and was called Jens Spahn, things didn’t go any better. He left his successor Lauterbach with financial holes worth billions. Even before the Corona pandemic, Spahn had introduced many expensive laws that had a negative impact on health insurance companies.
The CDU/CSU/SPD government at the time had also planned to provide more financial support to health insurance companies in addition to the additional Corona funds. However, Spahn was unable to implement this during his time in government.
Flowery financial planning
It is unlikely that things will be any different under his successor Lauterbach. The traffic light government is still struggling to get a budget in place. The FDP finance minister’s austerity targets are strict.
This is probably why the Federal Minister of Health often sounds flowery when it comes to financial issues. It looks as though his reforms will continue to drive up additional contributions in the coming years.