“Genuine Structural Reforms Needed”

In a report to the Bundestag’s Budget Committee, Germany’s federal court of auditors, the Bundesrechnungshof, has warned that supplementary contributions to Germany’s statutory health insurance system (GKV) will increase sharply. Simon Reif, head of the Research Group “Health Care Markets and Health Policy” at ZEW Mannheim and professor at the University of Erlangen-Nuremberg, comments:

“The structural financing problem of statutory health insurance has long been known and is becoming increasingly acute. The warnings of the Bundesrechnungshof about rising supplementary contributions to the GKV are justified and come as no surprise.

Many of the solutions proposed so far have focused on redistribution between public budgets, for example by reducing VAT on pharmaceuticals or providing higher coverage of health care costs for people receiving basic income. Such measures are relatively easy to implement in times of a relaxed debt brake, but they do not solve the fundamental problem of Germany's expensive health care system. In comparison with the EU, Germany has the highest per capita health expenditure; accordingly, genuine structural reforms must start on the spending side.

Reforms on the spending side mean that hospitals, ambulatory practices and pharmaceutical companies will receive less additional funding. Such reforms are politically unpopular, which is why it is an important signal that the Bundesrechnungshof is at least calling for reforms in this direction in its statement. The financial problems of the statutory health insurance system can neither be resolved by continuing to ignore them nor by calling for more tax money.”