Hospital reform and debates on financing the German nursing care insurance

(de-news.net) – Health Minister Lauterbach (SPD) has announced that the proposed hospital reform is set to pass in the Bundestag by the end of the week. After extensive negotiations, coalition party representatives finalized the details and technical changes. For instance, small rural clinics will now be allowed to provide outpatient specialist treatments if no local specialist is available. Lauterbach proclaimed this to be the most significant hospital reform in two decades. Despite state-level criticism. He said he is confident that the reform will not be referred to the mediation committee.

Regarding Germany’s statutory nursing care insurance, Lauterbach refuted media reports suggesting imminent insolvency. He asserted that the insurance is not, nor will it become, insolvent. The government guarantees that nursing care insurance will continue funding care and services, he added, however acknowledging current financial strains. The Ministry of Health denied any immediate threat of insolvency. Lauterbach plans to introduce a “financial concept” soon to bolster the insurance, promising both short-term and long-term impacts. The “Redaktionsnetzwerk Deutschland” had previously reported the insurance might face insolvency by February. Consequently, there is consideration to increase the contribution rate to up to 0.3 percentage points instead of the planned 0.2 points. The financial issues stem partly from recent nursing care reforms, which have eased burdens on those in need and raised caregivers’ wages. Additionally, there are more people requiring care than initially anticipated.

Saxony’s Prime Minister Kretschmer (CDU) advocated for a reform of nursing care insurance and urged the federal budget to cover non-insurance benefits. He cautioned that in eastern Germany, personal contributions are increasingly overwhelming those in need of care as well as their families. Amid the tense situation, the head of the CDU workers’ wing, Radtke, sharply criticized Health Minister Lauterbach and suggested he step down. Radtke further noted that low and middle-income earners suffer the most when social insurance contributions rise significantly.

The FDP had proposed a reform for increased capital coverage in nursing care insurance to Lauterbach, as well as equal treatment of company nursing care and pensions and enhancements in private care. They also stressed the necessity for better management of available funds. The Greens, on their part, had proposed allocating more tax revenue to support the insurance, as outlined in the coalition agreement. They argue that this is essential to ease the burden on the insurance and that contribution hikes are inevitable but should be equitable.

Anne-Kathrin Klemm from BKK suggested that the government should provide a tax subsidy and exempt the insurance from non-insurance expenses such as pandemic-related costs and training expenses for care workers. This would help stabilize the contribution rate. The head of the Health Insurance Association, Pfeiffer, stated that without reform, contribution rates would need to increase by at least 0.25 percentage points in January. She also urged the state to cover pension contributions for caregiving relatives.

Renowned economist Werding said that although politicians have made significant improvements in services in recent years, they have not adequately addressed how to fund these improvements given the aging population. He does not see any short-term solutions. Instead, he believes that contributions to nursing care insurance would need to rise even more if all current claims, particularly for home care support, were fully utilized. However, the severe shortage of skilled workers in this sector makes this unfeasible at present.

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