After years with billions in surpluses, the statutory health insurance companies are threatening to see deficits in a few years' time. In the year 2040, the minus would amount to almost 50 billion euros, if the policy does not counteract early, it says in a published in Gütersloh Wednesday on behalf of the Bertelsmann Foundation. Accordingly, the contribution rate would have to be gradually increased from the current 14.6 percent by the year 2040 to 16.9 percent in order to cover expected expenditure increases.
The policy should act before the gap between revenues and expenditures of the public health funds from the mid-2020s divide again, said Bertelsmann CEO Brigitte Mohn to the forecasts. The debate on meaningful instruments must now begin.
A major driver is the demographic trend - with an increasing proportion of older people who need more health services, as the authors of the Institute for Health and Social Research write. Above all, with the entry of high-birth-years into the retirement age, their contribution to the SHI income is falling.
Federal subsidy increases
Politicians have no direct influence on important influencing factors for the financial situation of the SHI - development of employment and incomes or the price development in health care, said foundation expert Stefan Etgeton. However, there are effective political instruments to counteract a deficit: For example, overcapacities in the hospital sector could be reduced in order to save costs.
The Federal subsidy - these are tax funds - for the SHI of currently 14.5 billion euros annually should gradually increase, the Foundation recommends. If one wants to keep the general contribution rate (without additional contribution) stable at around 15 percent, the subsidy must be increased every two years from 2028 - this would then amount to around 70 billion euros in 2040, the study calculates.
Currently, the contribution rate is 14.6 percent. The cash registers can also individually determine an additional contribution. For 2018, the Federal Ministry of Health had reported for the statutory health insurance funds a surplus of two billion euros, in 2017 it had been three billion. At the end of 2018, the reserves of the funds amounted to 21 billion euros. Despite the weaker economic outlook, the GKV Spitzenverband recently continued to expect robust revenues for the time being, but also warned against considerable spending risks in the summer.
