Care: Next contribution increase soon?

Traffic light group without result:Care: Next contribution increase soon?

by K. Hofmann and B. Spiekermann

There is too little money in nursing care insurance. Everyone knows that, but nothing will change any time soon. A coalition working group ends today. Result: none.

Two residents of a nursing home sit next to their walkers.

The statutory health insurance companies are calling for a fundamental restructuring of nursing care insurance. Or a financial injection.

Source: dpa

May ends on Friday, and with it the hope that the traffic light coalition will reform nursing care insurance. On Friday, a group of experts from various ministries will present their report. However, there is no joint proposal for a solution and no timetable. The group has not even met yet.

This concerns one of the biggest problems in social policy: the ever-growing financial problems in nursing care insurance. And the question of whether these can only be solved with constantly increasing contributions for those insured.

Ministry of Finance blocks coalition agreement

Health Minister Karl Lauterbach (SPD) admitted this week that a fundamental reform would probably no longer be achievable in this legislative period. “The views of the various ministries and coalition partners are too different for that,” the minister told the editorial network Germany. “But there is a very good analysis of the problem,” said Lauterbach, referring to the inter-ministerial working group.

This also means that a financial injection that had been agreed upon in the coalition agreement is off the table. In it, all three parties agreed that “non-insurance benefits such as pension contributions for caregivers and the additional costs caused by the pandemic will be financed from tax revenue.” This would have made it possible to pump up to ten billion euros into nursing care insurance in the short term in order to avoid rising contributions.

Number of people in need of care increases sharply

According to the Ministry of Health, the number of people in need of care has risen sharply. This is also fuelling the discussion about care reform.27.05.2024 | 1:45 min

But the Federal Ministry of Finance does not want to hear anything about this agreement at the moment. The measures would not solve the difficulties of the nursing care funds in the long term. The problem is much more that fewer and fewer contributors have to support more and more people in need of care, according to ministry sources. Much more important is generation-appropriate financing and a strengthening of capital-funded instruments. Similar to the pension reform that has just been passed.

So many people in Germany are in need of care

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Nursing care funds: financial injection until reform

The nursing care funds see things a little differently. In the short term, the funds can certainly be helped. On the one hand, there is around 5.5 billion euros that they believe they are still entitled to from the federal government: This is because these are additional costs due to the corona pandemic that were never compensated. “The state has not kept its promises,” says Florian Lanz, spokesman for the general association of statutory health and nursing care funds.

“I don’t see it as being as dramatic as it is being made out to be,” said social scientist Prof. Stefan Sell about the increase in nursing cases. However, “more money in the system” is needed.27.05.2024 | 6:13 min

In addition, there are the pension contributions for the caring relatives, which according to Lanz are not the responsibility of the nursing care insurance, but a responsibility of society as a whole. The finances must be “distributed fairly”. The state must fulfill its obligation, says Lanz:

The problem is that everyone is right in saying that something has to happen. We need fundamental reform. With the money, we could build a financial bridge to this reform.

Florian Lanz, spokesman for the GKV umbrella association

Has the increase in numbers been known for a long time?

What remains at the end of the traffic light reform efforts is Lauterbach’s “very good problem analysis”. Although, according to the Federal Ministry of Health, the working group had “already met several times” since June 2023. The Green-led family and economics ministries and the SPD labor ministry were also involved. But there are obviously different opinions about the problem analysis too.

Health Minister Lauterbach is sounding the alarm: There is an “explosive” increase in the number of people in need of care. Patricia Wiedemeyer reports from the capital studio.27.05.2024 | 1:02 min

The starting position is already shaky: Lauterbach spoke this week of an “explosive” increase in the number of people needing care. Instead of the expected 50,000 per year, there are now 361,000 additional people in need of care. “The figures are very new to us, at least,” he told ZDF.

This is how differently the care requirement is calculated

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However, since 2017, the nursing care funds have been expecting 326,000 more people each year to apply for benefits from the nursing care funds for the first time. The only thing that is unclear is where the 35,000 additional people in need of care will come from. One explanation could be that the medical services were able to assess fewer people during the Corona pandemic.

Every year plus a city like Münster

So every year there is an additional number of people in need of care, which corresponds to a city the size of Münster. And on the other hand, according to the nursing care funds, it will cost 1.7 billion euros if the contributions to nursing care insurance are to be reduced by 0.1 contribution points.

A discussion that actually comes at just the right time for the traffic light coalition: the new budget is to be approved at the beginning of July. The three parties are already wrangling loudly and vigorously over their ideas on how to save a double-digit billion amount.

So the only way out is to increase contributions? More than the current 3.4 percent or 4 percent of gross income for those without children? It certainly looks like that. That would be a done deal for the next government.