BDA AGENDA 09/2024 | TOPIC OF THE WEEK | May 8, 2024

This time it really is coming: the big jump in contribution rates in statutory health insurance (GKV). At the end of March, the CEO of DAK already predicted an increase of 0.5 contribution rate points, while the BKK umbrella organization warned in April of a massive increase of at least 0.75 percentage points in 2025.

The reserves of the health insurance funds are exhausted and there is not much left in the health fund. As in recent years, expenditure continues to rise much faster than SHI income. The federal subsidy is not being increased and the government is doing nothing to reduce expenditure. On the contrary. In the end, there is only one solution to the problem: the health insurance funds have to raise the additional contributions and employers and insured persons have to pay even more. The red line of 40% total social security contributions is increasingly becoming a pleasant reminder of the good old days.

The government's current legislative plans will only make things worse, not better. Many hopes were pinned on the major hospital reform. These have now been largely buried. This is because the planned hospital reform is one thing above all: very expensive for those paying contributions. This is due in particular to the unjustified participation in the costs of the transformation fund, the passing through of the complete refinancing of collectively agreed wage increases and the further restriction of the options for auditing hospitals' accounts. Against the background of the historically highest, dynamically rising health insurance contributions and the foreseeable further increase in pension and nursing care contributions, all efforts should now be directed towards significantly limiting costs in the hospital sector, which is by far the largest area of expenditure in statutory health insurance. However, the draft bill fails to make this effort.

In particular, half of the costs of the planned transformation fund must not be passed on to the contributors. The €2.5 billion per year over a period of 10 years from contributors' funds provided for in the draft are relevant to the contribution rate at the equivalent of 0.15 contribution rate points. It is audacious that the contributors should pay €25 billion to deal with the consequences of overuse in the hospital sector caused by politicians.

Instead, it would be more important to stop shirking the task of sustainably consolidating the hospital landscape. We cannot afford to continue paying for so many underutilized hospitals. To achieve this, it must be ensured that the quality and minimum criteria apply nationwide without exception and that the federal states may only award care contracts to hospitals that meet the criteria. In addition, the federal states must finally meet their investment obligations and not pass on the costs of infrastructure and services of general interest to those paying contributions.

All efforts should now be directed towards significantly limiting the costs of statutory health insurance, but politicians are continuing to fly blind.

BDA statement: Necessary structural reform largely fails to materialize - instead a massive burden on contributors