The private health insurers (PKV) in Germany are among the endangered species. A private comprehensive health insurance only for higher-earning employees, civil servants and the self-employed, which stands alongside a statutory insurance system for the rest of the population – something like this is very rare worldwide.
It always leads to political pressure. The system reeks of two-tier medicine. Even if this rarely applies to the actual treatments: Many of the approximately 73 million patients with statutory health insurance are extremely annoyed if they have to wait three months for an appointment with a specialist, while the almost nine million fully insured people get their turn within a few days because the doctor has higher income with them achieved.
SPD, Greens and Left want the abolition of private health insurance as full insurance. All residents should become members of the citizens’ insurance, whoever wants to can buy additional coverage from the private sector. The PKV owes it to the FDP that there is a protection of status in the coalition agreement of the traffic light. Nevertheless – the pressure will not disappear, but rather stronger. SPD and large parts of the Greens are suspicious of capital cover in health and long-term care insurance.
The insurance chamber in Munich works with two health insurers, the Bavarian official health insurance fund and the nationwide Union health insurance company. Together they are number six in the market with a turnover of 2.7 billion euros.
It is quite possible that the climate goals cannot be achieved with state finances alone
Versicherungskammer board member Andreas Kolb believes he has found a way for the industry to make capital cover more palatable for the parties. The industry’s investments could be used decisively to promote climate protection and decarbonization, says Kolb in an interview with the SZ. Because it is very clear that state finances are not sufficient to achieve the ambitious climate goals.
In Kolb’s opinion, politicians shouldn’t always only see the contradiction to the social system in capital cover. “You can also do something for society with the money.” The considerations are still in the early stages. “It would be conceivable that a part of the capital investments in the full insurance and the additional insurance flows into a kind of climate fund,” explains Kolb. “With such an approach, you could achieve a double return for future generations: on the one hand, building up a provision for old age and, on the other hand, faster, more effective financing of climate protection.”
If part of the capital investments flows into a kind of climate fund, then you can “achieve a double return for future generations,” says Versicherungskammer board member Andreas Kolb.
(Photo: Mareen Fischinger/imago images)
However: The private health insurance does not want to bear the risk alone, state guarantees are necessary. According to Kolb, such a fund or investment stock must be secured to a certain extent. “We must not play with the aging provisions.” In private health insurance, part of the premiums are used to build up provisions for aging. They serve to cushion the otherwise necessary premium increases due to rising healthcare costs in old age. Industry-wide, aging provisions amounted to a whopping 302 billion euros at the end of 2021.
You could even do something with climate protection with a part. And then the industry could argue that the abolition of private health insurance would also damage climate protection.
Collateral for the investments by the KfW development bank would be conceivable for Kolb. “You could bring the topic up in talks with politicians and show PKV’s willingness to change and its willingness to get involved.”
He hopes that politicians will be willing to engage in dialogue, especially on the part of the SPD-led Federal Ministry of Health. Minister Karl Lauterbach is a declared opponent of private health insurance. But that doesn’t deter Kolb. “We have to look for solutions together, not act dogmatically, but make something better out of what we have.”
This applies not only to the PKV climate fund, but also to policy areas such as prevention: Kolb expressly welcomes the fact that the traffic light coalition has made the expansion of precautionary measures a priority. “We hope that this will take place with the involvement of the private health insurance.”
In the past, the problem faced by the private sector was that the supervisory authority BaFin, which reports to the SPD Ministry of Finance, was critical of the financing of preventive services by private health insurance. “BaFin interpreted the concept of medical expenses very narrowly,” explains Kolb. She saw investments in prevention as advertising measures by insurers.
Kolb says that private health insurance can and wants to get involved in the overall system when it comes to important health policy issues such as digitization and the improvement of care structures. “We have to work together to make the healthcare system more efficient.”
The manager sees private health insurance at the forefront when it comes to innovations. In relation to the statutory health insurance companies, he relies on cooperation instead of confrontation. “We have to join forces more, act as partners and reduce reservations.”