The federal government ends the GKV solidarity principle

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The federal government ends the solidarity principle of the SHI: Social associations and opposition criticize passed health care reform

The government coalition of CDU / CSU and FDP has enacted the new financing law for statutory health insurers (GKV). Federal Health Minister Philipp Rösler (FDP) wants to save eleven billion euros with the reform of the Medicinal Products Act and the law on the financing of statutory health insurance: social associations and the opposition criticized the reform package sharply: the basic principle of parity and income-dependent financing of statutory health insurance (GKV), which has been tried and tested since Bismarck abandoned with it.

Employees bear all cost increases
As an entry into the exit from the statutory health insurance funded in solidarity and jointly, the social associations assessed in particular the new law on the financing of the SHI. Since future increases in contributions are only to be made by the employees, whereas the employer's share has been fixed, the insured bear all of the cost increases in the healthcare system alone. The opposition and social organizations criticize that this not only undermines the principle of solidarity in the SHI, but that statutory health insureds have little to do without the financial pressure of individual service providers without the support of the employer.

Employer no longer on board The president of the social association VdK Germany, Ulrike Mascher, criticized the freezing of the future employer contribution to 7.3 percent as a serious mistake. “Many illnesses are proven to be caused by considerable stress in the workplace, especially by stress and increasing work densification. That is why employers should not be left out in the future when it comes to financing rising healthcare costs, ”explained the expert. The deputy parliamentary group leader of the SPD parliamentary group, Elke Ferner, formulated her criticism a little more strikingly: "From today on, employers are no longer on board".

Additional contributions jeopardize the social balance of statutory health insurance The additional contributions are also hotly criticized by social organizations and the opposition. This is because the additional contributions are also to be borne exclusively by the insured, and while up to now they were only allowed to amount to a maximum of one percent of gross income, there will be no upper limit in the future. However, insured persons who spend more than two percent of their salary on additional contributions are to be reimbursed by the state for all contributions above the two percent through social compensation. This indirect "introduction of the unfair head allowance in unlimited amount without adequate social compensation (leads) to a dangerous slide especially for low-income earners and pensioners," explained the deputy SPD parliamentary group leader, Elke Ferner. This criticizes the opposition, criticizing the social equilibrium in statutory health insurance that has so far been achieved automatically through percentage contributions.

Three-class medicine through advance payment from the doctor The principle of advance payment from the doctor enforced by the Federal Minister of Health is also viewed critically by the social organizations and the opposition. Ulrike Mascher emphasized that this is not a suitable means of making health care costs transparent. The opposition of the SPD goes one step further in its criticism. For example, Elke Ferner fears that a three-class medicine will be established through prepayment at the doctor - "First Class for privately insured, business for patients with prepayment and wood class for the standard SHI insured." By adopting the benefit in kind principle in the direction Prepayment, low-wage earners and pensioners would again be particularly badly affected. In view of current reports, the opposition's criticism at this point does not appear to be entirely unjustified, although insured persons with basic private health insurance (PKV) tariffs would have to be included as a fourth category. According to media reports, their insurance cover means that they are even worse off than those insured by law.

Fresh cell treatment for private health insurance Another criticism of the health reform that has been decided is for social organizations and the opposition to strengthen private health insurance at the expense of statutory health insurance. "The private health insurance company receives a makeover that the SHI insured ultimately pay for," said Elke Ferner. The simplified switch for high earners from statutory health insurance to private health insurance, the ban on supplementary insurance with statutory health insurance and the expansion of discount contracts for medicinal products to private health insurance have considerably strengthened the competitive position of private health insurance - at the expense of those insured by law. The experts of the National Association of Statutory Health Insurance Funds estimate that the simplified change alone means that 400 million euros in premiums from top earners are lost each year. Conversely, private insurance companies would benefit from the discount contracts negotiated in the SHI with the pharmaceutical manufacturers and save around 200 million euros annually.

Allegation: Privatization and clientele policy These are just a few examples of the comprehensive criticism which the Federal Minister of Health Philipp Rösler (FDP) is currently facing from the ranks of social organizations and the opposition. Elke Furthermore emphasized that the black and yellow federal government continues its privatization and clientele policy uninhibitedly and that people with low income are not only materially burdened, but are discriminated against in case of illness. The opponents of the reform thus also referred to the Medicinal Product Reorganization Act (AMNOG), which they believe gave pharmaceutical manufacturers a disproportionate advantage. Because in the original bill some changes were made in favor of the pharmaceutical industry.

Criticism of the new drug law, for example, AMNOG pills for rare diseases up to a turnover of 50 million euros have been exempted from a benefit assessment and approved drugs can no longer be excluded from reimbursement by the statutory health insurance companies. Even if it should be determined that the preparations do not work well or badly. Only if the Institute for Quality and Efficiency in Health Care (IQWiG) can clearly prove that a preparation is ineffective or even has a negative effect, can an exclusion from the reimbursement be possible. However, since the IQWiG bases its findings mainly on the results of manufacturer studies and negative studies of the industry are only rarely published, an exclusion from the reimbursement of costs is very difficult to enforce. This means that the SHI are tied to the pharmaceutical industry at this point. The fact that the pharmaceutical manufacturers themselves set the price in the first year when a drug is introduced and that new price negotiations will only take place in the coming years on the basis of this entry price is not only criticized by the social associations and opposition, because this is likely to make the entry price as high as possible for the manufacturers start. (fp, 11/12/2010)

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