The accommodation of relatives in need of care in a care facility is often not only an emotional challenge, but also an economic one. Because although solutions have been struggled for years, the financial burden on those affected continues to increase. Why is that and how politicians want to solve the problem.
What is the financial burden on those in need of care and their families?
In Germany, about one fifth of all people who are dependent on care live in a care facility. The rest, i.e. the vast majority, are cared for at home by relatives. Both variants often have enormous economic consequences for the whole family, for example when relatives can work less or not at all because of the care. If people in need of care are accommodated in the home, they have to pay part of the costs themselves. The state provides subsidies for this so-called own contribution. Nevertheless, the financial burden for those affected has recently increased massively, as a new evaluation by the Association of Substitute Health Insurance Funds shows. In the first year in the home, the nationwide average was 2548 euros per month. That was 348 euros more than in the previous year. The amount includes payments for pure care as well as costs for room and board. The personal contribution for care increased by 281 euros within twelve months to an average of 1245 euros per month. It can be assumed that this amount will continue to rise until the end of the year, according to the substitute health insurance association.
The amount of state subsidies for the personal contribution increases with the length of stay. Nevertheless, the increase in the financial burden for people who had been living in the home for a long time was similar to that for new residents: those in need of care who were being cared for in the second year had to pay an average of 2299 euros, which was 292 euros more than a year ago previously, for residents in their third year, an increase from 236 euros to now 2050 euros was registered. People who live in a home for 36 months or longer pay 1738 euros today, which is 165 euros more than a year ago.
Why is it getting more expensive?
Experts cite increased personnel expenses as the main reason. Since September 2022, all facilities have had to pay their nursing staff at least according to the collective agreement in order to be able to settle accounts with the nursing care insurance companies. This salary adjustment for the nursing staff – which is scarce anyway – had been widely demanded politically. Nevertheless, there is now criticism that these costs are passed on to those in need of care: “If more and more people can no longer pay for their stay in the nursing home, something goes terribly wrong,” says Jörg Meyers-Middendorf, spokesman for the Board of Directors of the substitute health insurance association.
When will politicians react?
Strictly speaking, she already has. The federal government recently passed a long-term care reform that is to take place in several steps. At the beginning of July, the contributions to long-term care insurance were increased for most contributors in order to bring more money into the system. On January 1, 2024, services will then be expanded – including grants for the personal contribution of those in need of care who are cared for in the home. In 2025, the rates are to be increased again.
How much relief does that mean in concrete terms?
The following rates will apply from 2024: In the first year of residence, the state will in future pay 15 percent of the personal contribution (instead of the previous five percent). In the second year, 30 percent are taken over (previously 25 percent), in the third year 50 percent (previously 45 percent) and from the fourth year 75 percent (previously 70 percent). On Wednesday, the Federal Ministry of Health calculated on request that for people who have been living in a care facility for three years, this means an average reduction in their own contribution of 560 euros per month. From the fourth year onwards, instead of the previous national average of around 1246 euros, only 374 euros would be due – i.e. 872 euros less. However, this relief only applies to payments that relate purely to the care service. The costs for board and lodging are additional, they vary depending on the facility and federal state.
Are there any other relief measures?
There are always calls for the end of all co-payments for pure care – instead, full insurance should be introduced, says Anja Piel from the trade union federation. This is at least a topic of discussion in the federal government: by the end of May 2024, the house of Federal Minister of Health Karl Lauterbach (SPD), together with the Ministry of Labour, Economics and Finance, wants to present proposals for permanently stable financing of care. The coalition agreement states that they want to “examine” “voluntary, equally financed full insurance” as a supplement to the existing long-term care insurance.