AOK: Instead of paying out the surpluses to the insured, it is better to invest in structural reforms
The Association of General Local Health Insurance Funds (AOK) is defending itself against political demands to use the approximately 22 billion euros in financial reserves from statutory health insurance (GKV) for premiums. Instead, investments should be made in structural reforms to make the health insurance companies crisis-proof.
Use financial reserves for structural reforms
The AOK is once again fighting against a premium repayment. The chairman of the AOK Federal Association, Jürgen Graalmann, appeals in the direction of politics to use the accumulated financial cushion of around 22 billion euros for "structural reforms of statutory health insurance". In the sign of the European fiscal pact and the associated debt brake on public budgets, the black and yellow federal government will no longer be able to fill the structural gap in statutory health insurance with the previous models, said the treasurer. For this reason, urgent structural reforms should be tackled. "To do this, the financial cushion in the SHI must be used instead of burning the reserve through short-winded activism." The AOK wants to make quality the standard for medical care, as the managing board of the AOK, Uwe Deh, explained.
According to information from the AOK Federal Association, there is already a structural gap between income and expenditure in the amount of "over four billion euros" in statutory health insurance. Because expenditure has increased by an average of 3.6 percent per year since 2004. In contrast, according to Graalmann, the cash contributions only increased by 1.5 percent annually.
Politics increasingly focused on fire brigade politics
Politicians have only used short-term measures to close the gap. These short-term effects include, for example, an increase in the contribution rate, cost brakes, higher government grants and cuts in health care benefits. The actual causes were “never properly addressed”. The "architecture of the GKV house has always remained unchanged," criticizes the AOK federal association chairman. With the unique and historical opportunity of billions in surpluses, the SHI could be renewed through sustainable structural reforms. Numerous reforms could take effect, especially on the expenditure side.
According to the AOK boss, "Rationality instead of rationing includes a consistent benefit assessment of health insurance benefits, such as that provided by (AMNOG) for medicines, and a strict focus on the quality of care."
"We have to turn Finanz-plus into a quality plus, for that there are around three billion euros more available each year," says Graalmann. At the same time, the chairman of the treasury pleaded to install a "uniform insurance market in the health system". The same competitive incentives, options for action and rules of the game should apply to all providers. "Then you will see who will be ahead of the competition for the best patient care."
The AOK board Uwe Deh suggests, among other things, a so-called incentive system that increases the quality of medical care. "We have a lot of good doctors and a lot of good nurses. With all their commitment, however, they cannot change the fact that the quality of medical care sometimes fluctuates greatly." Therefore, patients in Germany are often at random.
As an example of large regional differences in medical care, Deh presented the first results of the AOK Scientific Institute (WIdO) from the ongoing development of quality indicators for cardiac catheters. Thereafter, in regions with the highest mortality rate, catheterization is ten times more frequent than in the region with the lowest rate. "This is supply according to postcodes," criticized Deh. (sb)
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