The deficit of the German statutory health insurance is estimated at up to seven billion euros for 2024. The expenditures will rise disproportionately strongly, on average by more than one percentage point per year above the contributory incomes of the insured. Future generations in particular will be heavily burdened, as they will have to pay higher contributions for the same benefit entitlements.
The solidarity principle of the statutory health insurance is thus coming under increasing pressure to justify itself.
Economic incentives are needed for cost-conscious demand for health care services. Neither health insurers nor the providers of medical services can distinguish themselves through cost-effective care management. Advances in medical technology are steadily increasing the equivalent of the insurance promise. In addition, demographic change is leading to increasing funding requirements in the pay-as-you-go scheme since health risks increase with age.
In order to maintain acceptance of the solidarity principle and to secure the financing of statutory health insurance in the long term, it would be appropriate, in addition to a solidary financed insurance base, to require statutory health insurees to cover the share of expenditures that is no longer financed by contributions through deferred annuity insurance.
In order to maintain the acceptance of the solidarity principle in SHI and to secure the financing of SHI in the long term, it would be appropriate, in addition to an insurance base financed on a solidarity basis, to oblige SHI insurees to cover the share of expenditure that is no longer financed by contributions through an insurance scheme that is covered on a prospective basis.
This interview identifies the causes of steadily rising expenditures and outlines a way to ensure a sustainably financed system for future generations.
The publication is only available in German.
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