Health Insurance Reform 2015: The four most important facts

Monday, 07.07.14 , written by editor The final implementation of the health insurance reform in 2015 is not much in the way. Next Friday, the Federal Council will also wave the reform project through. In principle, this could mean for the insured in the long term that they have to spend more money on their insurance cover. But that’s not all that changes. > 

The 2015 health insurance reform is intended to strengthen competition among health insurances and relieve some 20 million insured persons next year for the time being . This is the optimistic assessment of Federal Health Minister Hermann Gröhe (CDU). But that’s not all: the opposition, for example , sharply criticized the reform plan and voted against the GKV’s Financial Structure and Quality Development Act. However, this can not be prevented by the implementation of the health insurance reform, as it was approved by the Federal Government on 5 June. Even the outstanding debate in the Bundesrat will not be expected to bring any big surprises. Unexpectedly, however, some insured could reach post announcing the new additional contributions.

Update 11 July 2014: As expected, the Federal Council approved the new regulation.

What brings the health insurance reform in 2015 – 1. Special contribution is omitted

At first glance, the plans of the Grand Coalition in the context of health insurance reform in 2015 look insured: The health insurance contributions are reduced from the current 15.5 to 14.6 percent. Because the special contribution of 0.9 percent, which is carried by the employees alone, is eliminated. Employees and employers each receive half of the remaining 14.6 percent. If health insurances did not have the possibility to levy an income-dependent additional contribution from 2015 onwards, this would mean a real relief for the insured.

2. New additional contribution with the health insurance reform 2015

As of 1 January 2015, insured persons face an additional contribution, which is calculated as a percentage of income. According to the latest estimates of the chairman of the Association of statutory health insurance funds, Doris Pfeiffer, it is very unlikely that the health insurance can waive this – especially in view of the shrinking reserves of health insurance companies. Instead of the special contribution, around 50 million insured persons will have to pay an additional income-related contribution in 2015 as a result of the health insurance reform.

Initial benefits from the additional contribution 2015

Nevertheless, the additional contribution can initially represent a – albeit minor – relief for the insured. The insured persons could initially pay a lower health insurance contribution than previously, since probably not all health insurance companies will demand the additional contribution of 0.9 percentage points or more. However, the Federal Insurance Office estimates the additional contribution to 2017 at 1.6 to 1.7 percent. How much the additional contribution will be at the respective fund depends very much on their financial cushion and efficient management.

3. Will the benefits of the health insurance reform 2015 fall by the wayside?

Basically, the health insurance reform in 2015 should contribute to a higher quality of care. This is accompanied by economic action. Thus, the health economist Professor Eberhard Wille explains in an interview with the Stuttgarter Nachrichten on the one hand, that there is still rationalization potential in the service areas of the German health care system.

On the other hand, the Ministry of Health wants to persuade the health insurances to offer good services while using their own reserves. However, a competition of health insurance companies in terms of cost-effectiveness could be at the expense of comprehensive and good health care. Because the individual health insurance companies will first try to keep the contribution increase as low as possible in order to avoid a loss of members. As a result, austerity measures of the health insurance companies could eventually be reflected in benefit cuts for the legally insured.

4. Quality, midwives and UPD are encouraged

The health insurance reform 2015 also aims to ensure the quality of health care. For this reason a quality institute should check services and quality in the health service. This is intended to specifically improve treatments and identify deficiencies. Contributing to this is, for example, the Independent Patient Counseling of Germany (UPD), which has currently carried out the evaluation of patient inquiries and drawn conclusions about health care and existing problems. This institution will also be funded with another nine million euros in the future.

Last but not least, the health insurance companies have been supporting midwives since June 2014, who can no longer afford the greatly increased contributions to the professional liability insurance. Otherwise, many people are at risk of becoming unemployed.

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