Chief physician treatment only possible at the PKV?

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Elective tariffs are to be abolished by the statutory health insurance companies in favor of private health insurance. Health insurance companies protest against this step: These cuts are "clientele policy" towards private insurance companies.

(22.08.2010) In the course of the health care reform, the tariffs of the statutory health insurance companies are to be severely restricted. Numerous additional insurances such as the treatment of chief physicians, international health insurances and single bed occupancy are to be reserved for private health insurances (PKV) from January 1st 2011. The health insurance companies are opposed to this project, here the private health insurance would be greatly favored at the expense of the statutory health insurance funds.

The plan of the Federal Minister of Health Philipp Rösler (FDP) is obvious. Insured persons who earn an excessive amount should be deprived of all arguments to continue to be insured under the statutory. In this context, the black and yellow federal government also plans to make it much easier to switch from statutory health insurance to private health insurance. This means that very good premium payers are lost to the statutory health insurance funds. As a result, the parity system of health care begins to falter. Especially those who are young and unattached and have a high net income will switch from the SHI to the PKV. But it is these contributors who create social compensation for the elderly and the chronically ill. The latter are very expensive.

The plans of the health insurance companies also come up against these plans. So the head of the Barmer GEK, Birgit Fischer, told "Rheinische Post" that it was fundamentally wrong to limit the scope of the statutory health insurance funds significantly. Fischer warned not to destroy the competition. It is "not about who makes the offers, but who makes the best offers," said Fischer on Thursday.

The Barmer GEK chairwoman warned the federal government against strengthening the market position of private health insurance at the expense of the statutory. In their view, the coalition is "to set up an aid program for private health insurance". The head of the AOK Rhineland-Hamburg, Wilfried Jacobs, also expressed clear criticism. The abolition or legal restriction of the electoral tariffs with the PKV is a "clientele policy par excellence".

The federal government has since confirmed its plans. In the course of the health reform, restrictions on the electoral tariffs are to take place. Here it was found that there will be no general abolition of the electoral tariffs. Rather, the task of "statutory and private health insurance" to "define more clearly". This means that essential elective tariffs, which are used primarily by "high earners", should be abolished by the statutory. By abolishing international health insurance, the company also wants to favor private individuals so that their policy sales rates increase.

The Federal Minister of Health's project is also criticized by the opposition. The SPD health expert Karl Lauterbach criticized that the reforms were one-sided. The private insurance companies are divided in favor of the private ones, according to Lauterbach. The SPD politician fears "further desolidarization in the health care system" due to the planned easing of the switch from statutory to private health insurance. From January 2011, better earners no longer have to wait three years before they can switch to private health insurance, but only one year. In addition, those affected need only have exceeded the minimum earnings limit in a single month in order to be able to switch to the private sector. The minimum wage is currently 4162.50 euros gross to be able to change.

The private insurers naturally like the planned changes to the law. The head of the association for private health insurance, Volker Leinenbach, said that the statutory health insurance funds should concentrate on the health services that are medically necessary. Because, according to Leinenbach, the health insurance companies with their optional tariffs and additional offers would compete directly with private health insurance companies. This of course displeases the private and the PKV association sees no need for this. Supplementary insurance is a matter for the private and not the statutory. The plans of the Minister of Health Rösler are to be decided in the cabinet in September and will be implemented from January 2011. (sb)

Also read:
No additional contributions for Hartz IV recipients
Health insurance additional contributions also in 2011
Health insurance companies criticize the restriction of optional tariffs
Black and yellow want to attract high earners to the private health insurance
Social organization: Additional contributions have to go

Photo credit: Andreas Morlok /

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