The situation of the statutory health insurance companies is deteriorating again.

After the deficit in the first quarter was even lower than feared - some insurance companies had even reported surpluses - expenditure is now clearly exceeding income again.

The general local health insurance companies report a deficit of 1.6 billion euros for the first half of the year.

In the first six months of 2020, the AOK network had generated a surplus of 320 million euros.

Christian Geinitz

Business correspondent in Berlin

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The increase in expenditure in the second quarter of 2021 is striking, it was just under 10 percent.

The AOK Federal Association explains this with the fact that at the beginning of the corona pandemic last year, fewer services were used in many areas.

For example, the insured went less to the doctor, therapist or rehabilitation clinic for fear of infection.

The hospitals also reduced their admission of "normal" patients to make room for Covid-19 cases.

Further increase in costs

"After the decline in treatments and operations in the first quarter still had a positive effect on the financial results, this trend is now reversing", says Jens Martin Hoyer, the association's deputy chairman. Compared to the same quarter of the previous year, the so-called performance activity normalized, which drove up the expenditure of the health insurance funds.


"The current results confirm our fears for the year 2022: In the second half of 2021, there is no relief from the expected structural deficit of the statutory health insurance (GKV) in the coming year," says Hoyer.

Since there are signs of a further increase in costs in the second half of the year, the AOK community expects a deficit of well over four billion euros by the end of the year. Other effects are also having a negative impact, such as the renewed increase in VAT on pharmaceuticals. In addition, "the representatives of the medical profession and the hospitals are waving in the currently ongoing remuneration negotiations with additional claims amounting to billions," criticized Hoyer.

Even without such additional burdens, the difference between income and expenditure will grow so much due to expensive laws that the federal grant, which has already increased by 7 to 21.5 billion euros, will not be sufficient in 2022. The government must bring another additional subsidy on the way before the election, demands Hoyer. "Otherwise there is a risk of contribution rate increases across the board at the end of the year at the latest."

The other associations also report worse numbers. The guild health insurance funds (IKK) had achieved a surplus of 46 million euros in the first half of 2020, this time a negative result of 25.4 million. "Accordingly, the fears have been confirmed after the positive first quarter with a plus of 49.2 million euros," writes the IKK Association. Since politicians have ruled out a further lockdown, which in the past led to falling cash costs, the increase in expenditure will continue.

The development looks better for the small miners' union, which a year ago was the only type of cash register to show a deficit. It now shows a deficit of 18 million instead of 50 million euros. "Overall, the financial situation is currently developing slightly more favorably than forecast at the beginning of the year," says association manager Bettina am Orde.