Sunday 8th October 2006
compromise on health reform found
Photo: Associatet Press (AP) A top round
the grand coalition of CDU and SPD, consisting of Federal Chancellor Angela Merkel, SPD - party leader Kurt Beck and the Bavarian Prime Minister Edmund Stoiber (CSU) has negotiated in the early hours of Thursday, October 5, a compromise on health reform. The compromise was difficult, because the CDU / CSU and SPD, with very layouts on different ideas went into the negotiations. The Union wanted a uniform independent capitation fee for all insured from personal income with a social justice through grants from taxes for low-income insured. The SPD argued for a caring citizen with income-related insurance premiums for all, including the privately insured.
The result is now an extremely complex work of reform. The main points are now displayed in short
health insurance
early 2007, the insurance premiums to rise by about 0.5%, to close a looming billion hole in the statutory health insurance funds. The average contribution rate for insurance customers would increase to 14.7%. The funds will also use this extra revenue to unburdened by debt in 2009 with the Health Fund (see below) to start.
The labor is so expensive and in addition to missing the original target of reducing labor costs.
child insurance
children should continue to be covered without any contribution. In the long term funding completely through taxation. This would require 16 billion euros needed, but so far no one knows where the money will come. The compromise provides only the 2008 tax review to increase gradually, initially, 1.5 billion euros planned in 2009 will have 3 billion.
Health Fund
The health fund is the core element of the reform. In the fund are to be paid from 2009 contributions for employees and employers; show any subsidies from taxpayers' money. The statutory health insurance funds received under this fund a unit review. Health insurance companies that do not so may bring an additional contribution, which, like the SPD enforced but must be not more than 1% of insured income. By this 1% limit to the socially disadvantaged are protected. However the funds charge an additional contribution of € 8 per month, regardless of this 1% limit. In the Union, this is welcomed as an introduction to the originally proposed capitation. The SPD-Left rejects for the same reason in particular from this scheme. If an additional premium charged, it shall conform to their health insurance members actively aware of the possibility of a cash exchange. The aim of the competition between the public health insurance to be strengthened.
The health fund also takes on the risk compensation between health insurance, health insurance companies that are having a relatively higher proportion of insured persons with "expensive" diseases compensated financially. The risk compensation should be based on characteristics such as 50-80 Crane cardiovascular diseases, cancer, AIDS, etc..
Private health insurance
The private health insurance companies must offer a basic tariff in the future without a medical examination, which will be based on the maximum contribution of public health insurance, which currently amounts to 500 € per month. Does this contribution to the need for assistance, it is cut in half and if you still financial difficulties exist, it will give grants from the state. This base rate is all voluntarily insured and also be open to previously uninsured.
The removal of insured persons with a higher risk of disease to the public health insurance through the private is so limited. be
A change of the insured to another private health insurance, the accumulated retirement provisions in the amount of the base rate "taken". This should also increase competition between private health insurers. However, it remains the cash exchange at a loss for those who are insured through the base fare.
The position of the insured will be improved as a result something which may be reflected in better medical services, to maintain or gain new members. So, a little more market for the benefit of the people.
When changing to a public health insurance can no retirement provisions are taken over.
doctors' fees
As of 2009, introduced a new fee for the doctors order. Instead of the current points system be introduced flat-rate prices. The budget will be abolished and replaced by a so-called supply management. This means that the packages are reduced if the doctor treated too many patients with the corresponding disease.
further task is to create financial incentives for doctors to settle in underserved areas.
drug
The drugs do CDU and the SPD in the year 2007 to save another 500 million euros. Cash and pharmacies are obliged to price negotiations in order to achieve this goal. The pharmacies are to negotiate with the pharmaceutical companies extra discounts that they should share fully with the statutory health insurance. Find the pharmacies in the pharmaceutical industry not listen, they must necessarily special discounts in the appropriate amount to pay to health insurance.
The previous fixed prices for prescription drugs will be replaced by ceiling prices. This gives the possibility of health insurance with drug manufacturers to agree on lower prices than before. The pharmacies have the option to the legal drug co-payments in whole or in part, to abandon "voluntary", as these are part of the price of prescription Azneimittel.
This would have life-threatening consequences for many pharmacies, as the legal co-payments in the same Magnitude as the trade margins on prescription drugs are. Many pharmacies would certainly not survive. The nationwide supply of medicines and also many jobs would be jeopardized.
when prescribing innovative and expensive drugs, the attending physician is required to obtain a second medical opinion in the future. Furthermore, the benefit assessment of drugs in a cost-benefit evaluation will be expanded.
This point is especially bad in my opinion, and was previously seen in the Öffentlchkeit enough. As of yet at least in theory and according to the Hippocratic Oath of doctors on the patients, it is now the life of the patient are weighed against money. Welch inhuman consequences it can have, one could take a message from the UK: There rejected the National Institute for Health and Clinical Excellence (NICE) the reimbursement of the two innoativen and effective cancer drug Avastin (Roche) and Erbitux ( Merck KG) for the high prices from. Scale, the costs that are necessary to an additional years in good quality of life (utility) are to win. If these costs exceed the equivalent of 44,000 euros per year of life, then a Reimbursement is not recommended (source: internal market 08/30/2006). In Germany, evaluated the Institute for Quality and Efficiency in Health Care (IQWiG) the benefit and in future the cost of medicines.
funds and associations
The self-management of health insurance is maintained. In the future there should be only one uniform national governing body instead of seven. The merger will be completed by end of 2007. Mergers between public health insurance should be possible.
Other The
of the Standing Committee on Vaccination (STIKO) recommended vaccinations are converted to a standard benefit, which must be paid by health insurance. Also apply to parent-child treatments have the cash to pay the future. For elderly and dependent people, there is a legal right to rehabilitation. This can be done by place of residence or mobile rehabilitation team. Critically ill patients receive special care in their familiar home Umfeld.Geistig and physically severely disabled residents are from the health insurance to provide them with tools so that their participation is assured in social life. Members of residential communities and other new Living forms have a legal right to home care patients as in normal households. contributors who can not medically necessary services (eg cosmetic surgery) to make are not entitled to reimbursement by health insurance, even if complications do not occur.
The health insurance must offer special rates for insured physician who visit your GP first, rather than immediately consult an expensive specialist. Regular screening and early detection measures can be rewarded by health insurance.
in hospitals to out-patient care can be improved. To ensure funds and hospitals to spend more money.
Jens Christian Heuer (own report comments in red )
Sources: Federal Ministry of Health, Financial Times Germany Internet edition
0 comments:
Post a Comment