Health reforms in Germany legal interferences are called into the basic conditions of the legal health insurance (GKV). These (reforms) serve usually the stabilization of the rate of contribution and are usually with restrictions of the achievements and/or increase of the additional payments to otherwise the autonomy which is subject the insurance connected. The contribution was exhausted until 2004 in equal parts from employers and employees. The increase/reduction of the contributions affects themselves first the ancillary wages of the employers out and indirectly on those cost of living of the whole population.

The health reform

In the course of the conversion of the agenda 2010 government and opposition in the summer agreed 2003 on the "“law for the modernization of the legal health insurance"” (shortened GKV Modernisierungsgesetz, GMG). Changes, which became effective starting from 1 January 2004, are among other things the cancellation of the relieving and death benefit and the introduction of a so-called practice fee. A goal of the current reform is to lead back in the next years the average contribution of the legal health insurance on approx. 13% of the income (because of 1 July 2003 it was with 14,4%). Thus the ancillary wages are to be lowered. On a long-term basis however according to estimate of the Federal Government "“further switch positions will have to take place for the lasting financing of the GKV"”.

For the artificial dentures first a regulation was planned, after which starting from 1 January 2005 alone from the insured ones an additional income-independent contribution should be raised. Starting from 2006 the sickpay should be likewise financed without employer participation. On 1 October 2004 the Bundestag with the voices of the Red-Greens decided coalition that the contribution of the legal health insurance is lowered starting from July 2005 first around 0.45 per cent each for employers and employees, but at the same time the employees a income-dependent addition for artificial dentures around 0,4 per cent and for the sickpay around 0,5 per cent to pay must.

Beside the elements aiming at financial discharge of the employers beginnings are recognizable to structural changes. Both the duality principle (allocation of the social insurance contributions on employees and employers) and the solidarity principle (economically stronger one and healthy ones pay more as economically weaker ones and patient) are weakened.

Earlier health reforms in the Federal Republic of Germany

Behind the key word health reform usually stand economy measures, which mean a line clearing for the contribution-paying meant and. The financing of the majority of the costs of the health insurance did not secure evenly the decision sovereignty, which was to be made with the money for the contribution-paying. Here important cuts of the governments and parliaments under the heading health reform from 1976 on.

• 2004 health modernization law under Ulla Schmidt (SPD) (the self-participation of the patients increased comprehensively. Ten euro practice fee per quarter, ten per cent of additional payment with medicine and aids - at least five and at the most ten euro, for ten euro per hospital day limits to 28 days. Use up-requiring medicaments, travel costses and eyeglasses do not have to be carried completely by the patient, be become relieving and death benefit painted. The load upper limit for additional payments amounts to since then two per cent (for chronically patient a per cent) of the annual gross income)
• 2002 rate of contribution safeguard law "“BSSichG"” under Ulla Schmidt (SPD) (among other things shortening the death benefit, further aggravation of the budgets for doctor's fees and hospitals)
• 2002 law for the delimitation of the expenditures for medicament of the legal health insurance (expenditure for medicament - AABG)
• 2001 law for the separation of the medicine and cure budget (medicament budget separation law - ABAG)
• 2000 GKV health reform (among other things budget aggravation for doctor's fees, medicines and hospitals. Recourse during excess of the budget)
• 1999 GKV (the SPD Greens) (among other things re-establishment of the budgets for doctor's fees, hospitals, medicine and cure budgets. Also after 1978 the bearing had again requirement on supply of artificial dentures. The additional payments for medicines and cures were lowered.)
• 1997 GKV Neuordnungsgesetze under refuge Seehofer (CSU) (of among other things far increased additional payments for medicines and cures between 4,50 and 6,50 euro. One hospital day cost 7 euro "“hospital emergency relief taxes"”, cures up to 12,50 euro. Besides the cash subsidy for artificial dentures was painted with all before 1979 bearing except for exceptions. Increased self-participation with travel costses)
• 1996 contribution discharge law (among other things cancellation of the subsidy to the artificial dentures for Versicherte, which are born after 31 December 1978 (applied until 1998), no more refunding to eyeglass frames, increased additional payments for medicaments, cuts in welfare assistance and additional payment increases with cures, sinking of the sickpay)
• 1993 health structure law "“GSG"”, also Seehofer admits (CSU) as "“Lahn stone compromise"” under refuge (among other things free cash choice increased starting from 1997 for all insured ones, introduction of the budgeting, increased additional payments for medicines additional payments with artificial dentures and cures as well as for the hospital treatment. The amounts for medicines were graduated after package size)
• 1989 health reform law "“GRG"” - under Norbert Bluem (CDU) (among other things. "“Negative list"” for medicines (the patient must take over fixed amounts, with higher prices the difference), higher prescription fee for medicaments. With not price-bound preparations the impact amounted to 1.50 euro. The hospital additional payment was doubled. Introduction of the additional payment in the dental range)
• 1983 Haushaltsbegleitgesetz (now 1 euro per medicine, the day in the hospital cost - at the most 35 euro to 2.50 euro per day; Health insurance of the pensioners no longer noncontributory)
• 1982 curbing cost expansion auxiliary law (now 75 cent per medicine, for eyeglasses and with cures such as Massagen, baths 2 euro per regulation. Also for eyeglasses four Marks became due)
• 1977 curbing cost expansion law (among other things medicament maximum amounts and restrictions of achievement, trifle medicines are not introduced any more pay additional payments per medicine, federation and cure. In former times the insured ones had a fee of at the most 1.25 euro per prescription now 50 cent per medicine. The upper limit of the self-participation with artificial dentures of 250 euro was painted.)
• 1976 sinking of the contribution of the pension schemes to the health insurance of the pensioners of 17% to 11%. A pension increase would not have been possible without this measure in the election to the Bundestag year 1976. The responsible person at that time Federal Minister Herbert honour mountain (SPD) was therefore accused of the pension lie by the opposition.

Word of the yearly

1988 selected the society for German language registered association the word "„health reform "“for the word of the yearly.

Literature

• January supports, Martin Butzlaff, Andreas's ash (Hrsg.), reforms in the health service. Results of the international search Carl Bertelsmann price 2000, publishing house Bertelsmann donation 3. , edition revised 2003, ISBN 3-89204-515-1, Download under (pdf 910 KB)

• Elizabeth Niejahr: First assistance from the Hague. Health: In Holland the mixture from head lump sum and citizen insurance functions. In: The TIME 30.03.2006 Nr.14, page 27.

Related links

• www.die-gesundheitsreform.de - official side Federal Ministry for health
• Opinion to the head lump sum
• Summary and reason of the new legal regulations - (pdf file 73 KB)
• Clear list of the changes for the insured ones
• Economic and health effects of additional payments
• Health reform news type character and Presseschau of Redaktion24.info
• LobbyWatch about health reform
• "“Citizen appraisals"” with suggestions on the reform of the health service

See also

• took part institutions, follower controls: Ministry of Labour, citizen insurance, social security, health map, Ministry of Health,
• System effects: Public health policy, problems and reform suggestions of the health system, welfare cutses, welfare state

Articles in category "Health reform"

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