The cat is finally out of the bag, but she's not happy.
The hangover about the long-delayed financial reform in the statutory health insurance (GKV) is great.
The system is heading for a record deficit of 17 billion euros in 2023.
The increase in additional contributions announced by Health Minister Karl Lauterbach (SPD) as a partial compensation has been rejected by both employers and social organizations.
The doctors also feel cheated: Lauterbach assures that neither fees nor services will be reduced, but is now overturning the higher billing of new patients, who should be able to get an appointment more quickly.
The cash registers criticize that their reserves would be used up, and they were also left with the expenses for Hartz IV recipients.
Lauterbach himself is not happy either.
He would have liked a higher federal subsidy, but Finance Minister Christian Lindner (FDP) only made an additional 2 billion euros available and for the first time a loan of 1 billion euros.
But he is not as stingy as Lindner seems.
In total, the tax subsidy will amount to an impressive 16.5 billion euros.
It is intended to pay for non-insurance benefits, including for welfare recipients.
These sums may not be enough.
But the accusation by the National Association of Statutory Health Insurance Funds that the health insurers would subsidize the federal budget “year after year with around ten billion euros” turns the situation completely upside down.
Questionable special levy
Also inappropriate is the lamentation of the cash registers about wringing out their billion-dollar reserves.
They come from posts and of course have to be used up first before the rates can be increased further.
It is unlikely that the coffers will dry up, because there is a statutory minimum reserve and now also the credit line.
The premium increase, on the other hand, is a real nuisance.
On the one hand, companies and households are being supported by the state during the pandemic and the energy crisis, on the other hand, they are being asked to pay ever higher contributions.
Germany already ranks well ahead in terms of the tax ratio, which reduces the attractiveness of the location and restricts the scope for consumers and investors.
The "social guarantee" agreed upon under the past government is passé, and no one cares about it.
Lindner urges Lauterbach to raise 3 billion euros within the system.
The Social Democrat collects a third of this from the research-based drug manufacturers.
This is not really a saving, but a dubious special levy for a flourishing and therefore highly innovative industry.
The abolition of double billing in hospital care is long overdue, but otherwise there is little to be seen of "efficiency improvements".
This is because Lauterbach is not willing to cut benefits.
But that's a big mistake in such a bloated health care system.
It is also inconsistent, since Lauterbach also accuses his predecessor Jens Spahn (CDU) of having unnecessarily expanded the supply.
If so, then now would be the time to correct the excesses.
The pure citizen insurance is the wrong way
Lauterbach makes no secret of the fact that he is actually a friend of the citizens' insurance.
Everyone would have to pay into one, and other income could also be subject to contributions beyond wages.
Private insurance (PKV) would be trimmed.
The Greens also want such a system change, fortunately the FDP prevents it.
One does not want to insinuate that Lauterbach deliberately drove the cart into the wall.
But the less sustainable today's healthcare system becomes, the louder the calls for new forms.
However, as studies have shown and as the efficiency comparison of statutory health insurance and private health insurance already shows, pure citizen insurance is the wrong way to go.
Rather, it is necessary to sweep out the system, especially in the clinics, where there are far too many expensive but inadequate capacities to the detriment of patients, contributors, doctors and nursing staff.
Private insurance should not be weakened, but opened up for individual additional risk prevention for those with statutory insurance.
It is conceivable, for example, that higher earners in the GKV only acquire partial claims, but have to secure the rest privately.
There are some good ideas on the table that should be discussed.
Instead, politics exhausts itself in crisis management.
Lauterbach's patchwork will only last for the coming year.