The Bundestag should arrest Karl Lauterbach

Mutuals are conservative. Until the 1990s, their employees had a status comparable to that of civil servants. It is all the more astonishing to note how clearly your Central Association of Legal Health Insurance Funds comments on the “financial stabilization law”. At the center of the criticism is its author: Federal Minister of Health Karl Lauterbach (SPD). Representatives of the box office accuse the permanent guest of talk shows of not listening. His proposal “contains no improvements”. The bulk of 11 billion should support the contributors. Lauterbach wants to settle the rest through debt and the dissolution of reserves. One can lead to cash flow instability; the other is that even small economic fluctuations are enough to trigger further dues increases.

“Fiscal policy cynicism”

Lauterbach flees costs – health insurance deficit is even higher

The reasons for the underfunding of the coffers can be seen in the previous government. So with former Health Minister Jens Spahn and Chancellor Angela Merkel (both CDU). They “distributed the money lavishly and took control and control rights of the statutory health insurance (GKV)”. But Lauterbach now abstains from possible reforms. The federal government continues to pay ten billion euros less to health insurers than they have to spend on the care of Hartz IV beneficiaries. And unlike most EU countries, the federal government charges full VAT on medicines. Lauterbach did not tackle structural reforms. Therefore the Bundestag must stop it now: “After the cabinet decision, Parliament is now obliged to pull the trigger.”

According to the Federal Statistical Office, medical costs in Germany increased by 28% between 2015 and 2020. It was 431.8 billion euros in 2020. Or 5190 euros per inhabitant and per year. The share of the pandemic in the cost explosion cannot be deduced from the figures of the Federal Office. What is certain is that the increasing aging of society will lead to a continuous increase in costs. Women already cost more per capita than men. But according to the office, this is due to their higher life expectancy. Two-thirds of people over 85 were women. In addition, costs related to pregnancy and childbirth are included in “medical costs”. However, the age factor is decisive: for people over 85, the per capita costs of 25,350 euros are almost five times higher than the general average.

Among the diseases, those of the circulatory system generate the highest individual costs with 56.7 billion euros. But mental and behavioral disorders have caught up with the first year of the pandemic. They now follow in second place in the cost table with 56.4 billion euros. While the psyche and the circulatory system are now neck and neck as the cause of costs, 20 years ago they were still separated by 4.4 percentage points in terms of total costs. That is around 15 billion euros. Diseases of the digestive system follow in third place with 47.1 billion euros – but this also includes dental care. In this comparison, cancer ranks fourth with 43.8 billion euros. These four diseases therefore together accounted for more than half of the total cost.

A reform of cash register finances must take into account that the costs of illness will increase structurally – due to the aging of society. The pandemic has also led to an increase in the number of cases among psychotherapists, as announced by their professional associations. A review of expenditures will be required. This includes above all the requirement of the health insurance funds to no longer have to take on tasks which are external to them, such as the cross-financing of Hartz IV.


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