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Insurance cards: The funds must be helped with a lot of state money as early as 2023

Photo: Jens Kalaene / dpa

The finances for 2023 have only just been secured after a long dispute, and the statutory health insurance (GKV) is already threatened with the next billion-dollar deficit. Next year, it is to be expected that there will probably be a gap between 3.5 billion and seven billion euros, said the head of the GKV-Spitzenverband, Doris Pfeiffer, in Kremmen, Brandenburg.

Without countermeasures, this would result in a mathematical increase of 0.2 to 0.4 percentage points in the average additional contribution for contributors. Pfeiffer therefore called on the German government to achieve sustainable stabilisation. "The spiral of contribution increases must be broken," she warned.

In view of this, Federal Health Minister Karl Lauterbach announced a financing concept. This is what the government is talking about, said the SPD politician in Berlin. He ruled out cuts in benefits at the health insurance funds when asked.

Previously, IKK treasurer Ralf Hermes had proposed drastic cuts in benefits in the fight against increasing deficits in statutory health insurance. In the three areas of dental treatments, dentures and homeopathy should be deleted, he demanded.

In the GKV, a historic deficit of 17 billion euros was already threatened this year due to the consequences of the pandemic, among other things. In order to fill the gaps, the SPD and the Greens within the traffic light government are pushing for a greater burden on higher earners – but the FDP has so far rejected this. In long-term care insurance, too, at least 4.5 billion euros could be missing for short-term stabilization alone.

GKV boss rejects debate on benefit cuts currently

For this year, the Bundestag has decided on an extra financial injection for the health insurance companies because of the expected gap. Pfeiffer explained that ten billion euros of this alone had been raised from contribution money – from reserves in the area of the funds and an increase in the average additional contribution from 0.15 points to 1.51 percent. In addition, the federal government increased its usual subsidy by two billion euros, among other things, and the pharmaceutical industry and pharmacies will be used with higher discounts. Against this backdrop, a "break-even result" can be expected in 2023, Pfeiffer made clear.

Stable employment and higher collective bargaining agreements in view of high inflation have a positive impact on revenues, said the GKV boss. At the same time, it is to be expected that wage increases will also lead to cost increases in negotiations with service providers. For the time being, however, there is "no solid feeling" about how spending will develop in 2023. Overall, a slightly more favourable financial performance this year could help support 2024.

With regard to possibly conceivable benefit cuts for the insured, Pfeiffer said: "I don't think it makes sense to discuss the issue now." In general, one could certainly talk about whether all treatments are useful and necessary and also have a scientifically proven effect.

Health Minister Lauterbach, on the other hand, rejected the calls for benefit cuts: "Dental treatment remains a health insurance benefit," he wrote on Twitter. "We can save money by avoiding unnecessary surgeries or performing more necessary procedures on an outpatient basis. Health ministers need to confront lobby groups, not patients and citizens."

In 2022, the funds had posted a surplus of 4.7 billion euros. however, service expenditure also grew – by 3.8 percent to 274.1 billion euros, with hospital treatment being the largest single item at 87.5 billion euros. The exact amount of the additional contribution for the insured is determined by the funds themselves, they can deviate from the average. The entire contribution also includes the general rate of 14.6 percent of the gross salary.

apr/dpa