Health care reform: drug discounts for private health insurance.
The extension of drug discounts to private health insurance (PKV) as part of the health care reform was already sharply criticized in the previous version. It was one of the main reasons why Federal Minister of Health Philipp Rösler (FDP) had been exposed to allegations of clientele policy in recent weeks. Now it is clear that in addition to the compulsory discounts, the federal government is apparently also planning to extend the manufacturer's discount of 16 percent to private health insurance (PKV).
Adjustment in the sense of private health insurance While the black and yellow federal government has so far opposed any adjustments to health reform brought forward by critics from the opposition, trade unions, social organizations, etc., the CDU / CSU and FDP seem to willingly continue to follow the PKV's demands at this point. Because even if the discounts granted are to be restricted with the fact that the savings achieved in this way can only be used to "limit premium increases or reduce the premium", the planned adjustment is probably entirely in the interests of the private health insurance. The spokesman for health of the Union group, Jens Spahn, does not want to hear from clientele policy justifies the proposed changes: "We want the drug savings to reach the individual insured and not the profits of the insurance companies." Why the manufacturer discounts - in addition to the compulsory discounts - to which private insurers must be transferred, Spahn does not explain.
Private health insurance benefits from health care reform In any case, private health insurance has so far come off quite well with health care reform. Facilitating the switch from statutory health insurers to private health insurance and the abolition of supplementary insurance with statutory health insurance (SHI) are just two examples in which private health insurance companies clearly benefit from the previous reform decisions. And the amendment to transfer manufacturer discounts to private insurers, which the health experts of the coalition groups decided yesterday, also points in the same direction. The compulsory discounts are negotiated by the statutory insurance companies with the manufacturer when a new drug is introduced. In the next three years (until August 2013), the pharmaceutical manufacturers are obliged to grant the SHI an additional manufacturer discount of 16 percent. In addition, the previous drug prices for the same period were fixed in order to make the development of the costs for drugs at insurance companies more predictable. According to the now-known plans of the black-yellow government coalition, the manufacturer discount will also apply to private health insurance in the future.
Pharmaceutical industry expects loss of sales As expected, the pharmaceutical industry reacted immediately with harsh criticism, because pharmaceutical manufacturers fear massive sales losses and a slump in their profits. Cornelia Yzer, managing director of the Association of Research-Based Pharmaceutical Manufacturers (VfA), speaks of a loss in sales of around EUR 500 million that will result from an expansion of the discount scheme how compulsory discounts are justified only to stabilize the state solidarity system. However, since the PKV are profit-oriented companies, they cannot slip under the umbrella of the semi-public health insurance companies in order to benefit from state support in accordance with the GKV.
"State support package" for private health insurance The public health insurers also received considerable criticism after the proposed changes became known. The new regulations are a "state support package" for private health insurance companies, said the spokesman for the umbrella organization for statutory health insurance companies, Florian Lanz. It is now officially confirmed that private health insurance can no longer do without the negotiating skills of the statutory health insurance companies. Lanz also finds it remarkable that private health insurance as a niche provider for high earners and civil servants does not have to face the challenges of a solidarity system, but is still dependent on the help of the legislature.
Private health insurance companies criticize administrative burdens Despite the advantages, there are also critical voices among private health insurers. Because the reform will result in increased administrative expenses for the private health insurance, since in future they should set up a central collection point for the discounts to be collected from industry. Here, the receipts submitted by the insured for reimbursement of costs must be collected and evaluated to ensure that the discount is only granted within the intended framework. However, this could mean that a large part of the savings will be needed for the additional administration required, said a spokesman for the association. The fact that the private health insurance is using an extra use of the additional income to "limit premium increases or reduce the premium" is, like the criticism of the pharmaceutical manufacturers, based more on self-interest than the concern for the well-being of the insured. (fp, 08.10.2010)
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