SPD wants to reverse the health reform

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The SPD wants to reverse the health reform of the black-yellow coalition.

(23.09.2010) The cabinet decision on the black and yellow health reform is barely a day old, as the SPD has announced, in the spirit of all critics, that if it wins an election it will completely reverse the reform. However, no one from the ranks of the SPD mentions that the cornerstones of the current reform were laid during the time of Ulla Schmidt as Federal Minister of Health (SPD).

Something has to change in the health system, as demographic change means that more and more elderly people with a relatively large number of ailments and high treatment costs are faced with an ever decreasing number of fully paid contributors. All critics of the current reform also see the need for action - costs must be reduced and the finances of the health insurance funds sustainably restructured. The way to the goal, however, is controversial and the current approaches of the black and yellow federal government seem to share very few. Because criticism comes from all directions, not just from the opposition.

Carola Reiman (SPD), chairwoman of the Bundestag health committee, describes the reform as “the worst and most unsocial of all time” and the SPD general secretary Andrea Nahles speaks of “brazen clientele policy” in favor of the private sector. The SPD health expert Karl Lauterbach even stated that if his party wins an election, this “form of one-sided burden on workers will be completely reversed.” But what does the opposition actually base its criticism on? Primarily on the following cornerstones of the reform: the increase in the contribution rate from 14.9 to 15.5 percent, the introduction of additional contributions and the associated social compensation, the freezing of the employer's share of the contribution costs to 7.3 percent, the expansion of drug discounts on private health insurance, making it easier to switch between statutory and private health insurance as well as savings for doctors (850 million euros), general practitioners (500 million euros), dentists (60 million euros) and hospitals (1.7 billion euros) ). The opposition is not alone with its criticism on most of the points, because the social associations, trade unions, medical associations and statutory health insurance funds also refer mainly to the factors mentioned in their negative assessment of the reform.

However, the fact that many elements of the current reform were already introduced under Ulla Schmidt (SPD) as Federal Health Minister of the grand coalition does not ring the bell for the SPD either. Instead, it announces the complete withdrawal of the reform in the event of an election victory, which is likely to be somewhat more difficult in detail. As already mentioned, a reform is urgently needed, especially for cost reasons, and even a future SPD government cannot easily do without additional income that will be opened up by the current resolutions. It is more likely that, if there is a change of government, improvements will be made in those areas where the current reform is clearly too anti-social or where the insured are unilaterally burdened (e.g. freezing of the employer's share).

In connection with the reform, the image of the Federal Minister of Health and his party in particular was seriously damaged by the allegation of clientele politics, with the concessions in the direction of private health insurances and the pharmaceutical lobby being massively criticized by the statutory health insurance companies. As a result, far greater savings could have been made for reducing costs in pharmaceuticals. In addition, the politically built-up competitive pressure from the direction of private health insurance is putting a strain on the general situation of statutory health insurance companies. The fact that the current pharmaceutical savings package means that the health insurers will have to spend around two billion euros less on pharmaceuticals in the coming year is not enough for them as a concession by the pharmaceutical industry. Gerd Billen, head of the Federal Association of Consumer Organizations, also sees this as a starting point for criticism, because part of the cost increases for patients could have been avoided "if the government had dared to take more of what they were looking for from the pharmaceutical industry and pharmacists our health system ”.

Meanwhile, there is growing concern among the population and among statutory health insurances that additional contributions will explode. The renowned expert Professor Dr. Jürgen Wasem from the Chair of Medical Management at the University of Duisburg / Essen recently warned against an increase in additional contributions to just under 80 euros per health insurance member by 2020. In this way, "the flat rate per capita (...) comes practically through the back door," emphasized Prof. Dr. Wasem in conversation with the "Saarbrücker Zeitung". And Karl Lauterbach assumes that there will be much tougher collective bargaining battles in the future because the unions are demanding compensation for taking on the health costs. With the model now adopted, "the consequences of aging society and technical progress in medicine (...) will in future be paid for solely from the net income of employees," which Lauterbach believes the unions will not simply accept. (fp)

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