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Electoral programs: What the parties are planning to do in the care sector

2021-08-27T05:49:48.889Z


Actually, the parties in the corona crisis are in agreement: They want more caregivers, and they should be paid better. But how is that supposed to work? And where does the money come from?


Enlarge image

Intensive care nurse at the ventilator of a corona patient: more specialists, more money

Photo: Christophe Gateau / dpa

The Minister of Health presented the agreement alone. After a long struggle, the Union and the SPD managed to adopt a joint nursing reform, thereby delivering on an important promise made in the coalition agreement - shortly before the legislature came to an end. But when it came to presenting the work to the public, Minister of Social Affairs Hubertus Heil left the stage to his cabinet colleague Jens Spahn. Heil preferred to visit a nursing home, together with the SPD chancellor candidate Olaf Scholz.

A clear sign: coalition or not, Union and SPD have arrived in the election campaign.

And in this apparently never-ending pandemic, care is likely to play a not entirely insignificant role.

But what are the parties planning in this area?

What is in the election manifestos?

SPIEGEL took a closer look at the ideas and promises.

More caregivers, more money - that's what everyone wants

Basically, almost all parties have drawn similar conclusions from the corona crisis, which has demanded everything from the caregivers: Germany needs more caregivers, and these caregivers must be paid appropriately for their hard work.

More nurses and better pay - the parties had already promised that in the 2017 election campaign, recalls nurse Nina Böhmer.

Böhmer became known in the pandemic when she wrote an angry Facebook message: "You can put your applause anywhere else".

A book of the same name was later published.

“At that time, Chancellor Angela Merkel publicly promised intensive care nurse Alexander Jorde that the working conditions would be better.

But then nothing happened, ”says Böhmer today.

In the parties' election manifestos, she complains, a lot is always promised.

“But when it comes to the coalition agreements in the end, we nurses only get around the minimum.

Because we just don't have a lobby. "

"The politicians still haven't understood that the nurses have run out."

Nursing scientist Martina Hasseler

Will everything get better this time?

Nursing scientist Martina Hasseler has little hope.

Hasseler is of the opinion that the parties have not drawn any lessons from the pandemic: "The politicians have apparently still not understood that the nurses are at the end of their work and are leaving their jobs."

Hasseler sees too few concrete ideas and plans for how this should change in the parties' election manifestos.

In its program, for example, the Union praises itself for having gradually improved the pay of nurses and sees its work more or less as done.

It is also true: Health Minister Spahn has initiated a number of things, such as the “Concerted Care Action”, the results of which he recently presented.

»In the hospital, the nurses no longer save money.

The minimum wage was raised.

And old people's homes will also have to pay according to the tariff in the future, ”he praised the results at the presentation.

According to Spahn's report, the number of employees subject to social security contributions in care has risen continuously during the legislative period.

In geriatric care, for example, by ten percent by 2020. But the truth is also that of the 13,000 additional positions in geriatric care that Spahn promised in this context, just 3000 are filled.

Spahn was unable to remedy the shortage of nurses.

more on the subject

  • GroKo decision: Who will benefit from the care reform - and who will pay by Milena Hassenkamp

  • The Saturday question: Hollow promise by Cornelia Schmergal

  • GroKo compromise: The care disappointment An analysis by Markus Dettmer and Cornelia Schmergal

  • Before braking costs: care in the home will become even more expensive

Spahns und Heils care reform stipulates that only care facilities are permitted that pay according to the tariff.

But which tariff they choose is up to the operators themselves.

The SPD had recently failed in its attempt to have a collective agreement declared generally binding.

In the election manifesto, only the left mentions specific figures at all.

The party calls for 100,000 additional nursing staff in the care of the elderly, 100,000 in hospitals, 500 euros more basic salary and a generally binding collective agreement.

Hasseler fears that these calculations will probably still be too small: "In the coming years, significantly more nursing staff will be missing."

Where should more nurses come from?

If more nurses are needed, then not only must they be paid appropriately, but working conditions must also improve.

In their programs, the SPD, the Greens and the Left are proposing a staffing procedure designed to improve staffing levels and working conditions on the wards of hospitals and nursing homes.

The FDP is also calling for such a model; the Union has promised it in the “Concerted Care Action”.

The procedure provides that assistants and helpers relieve the specialists so that they can devote themselves to care.

It is now to be introduced gradually.

The Greens are also calling for a 35-hour week for caregivers.

Is it possible to attract thousands, if not tens of thousands, of new caregivers?

Hardly likely.

How the deficiency can be compensated on a large scale, but neither party has a recipe for this.

"They apparently deliberately left out the topic because they don't know how to win it over," says nursing scientist Hasseler.

"There is nothing in the program about how to keep workers in the job."

Nationalize nursing homes and hospitals?

The pandemic has raised fundamental questions about the hospital and care system, which the parties want to address in various ways.

The responses from the SPD, the Left and the Greens are similar:

  • All three want to revise the system of flat rates per case, which reached its limits during the crisis.

    Experts have long complained that flat-rate billing for certain operations provides wrong incentives for hospitals.

  • The SPD wants to "end the commercialization of the health care system" by making it compulsory and as far as possible to allow profits that are generated from funds of the solidarity community to flow back into the health system.

  • The left wants to nationalize all private nursing homes and hospitals.

    However, the facilities were once privatized because the state system was ailing.

Hasseler believes that it will not work entirely without profits.

However, it must be ensured that no staff is cut or paid less.

What will happen to the personal contributions for the care?

On average, those in need of care in German nursing homes pay more than 2,000 euros out of their own pocket.

In a study for the German Salaried Health Insurance Fund, the nursing economist Heinz Rothgang has shown how capping the co-payments could reduce the number of welfare recipients among the residents by a third.

At the moment, two thirds of them cannot afford the costs alone.

The cap was originally in the draft for the nursing reform, but was then thrown out again.

The SPD, the Left and the Greens now want to get their own shares again:

  • The left wants the own shares to be completely eliminated.

  • The Greens want to reduce their own shares quickly and permanently with the "double care guarantee".

  • The SPD wants the cap for people with lower and middle incomes

  • In the election manifestos of the AfD, Union and FDP there is nothing to be found for one's own contribution

Who does something for family carers?

The majority of those in need of care are still cared for at home.

At the same time, family carers are often forgotten in politics.

According to the advocacy group “We care”, the relatives are likely to be particularly enthusiastic about the programs of the Left and the Greens.

Above all, the promised wage replacement benefits for 36 months for (part) time off for caregiving relatives, the introduction of a freely available relief budget and social security, explains Frank Schumann from »Wir pflege«.

  • With the “PflegeZeit Plus” program, the Greens are planning a wage replacement benefit for employees who leave their job for three months or partially for three years.

  • The SPD also advocates a 15-month wage replacement claim if the working hours for caring for a relative are reduced.

  • Linke wants all employees to have a legal right to six weeks of care leave with continued wages

  • FDP, AfD and Left are demanding more places in short-term care.

After the Federal Labor Court decided that foreign carers must be better placed in 24-hour care, the SPD, Greens and Left want to ensure good working conditions and fair pay.

However, the parties are not getting any more precise.

Is the citizen insurance coming?

The next legislature will initially be about how the reform passed by the Union and the SPD is to be paid for - before a new government can readjust it.

In order to guarantee the financing, the SPD, the Greens and the Left want private insured persons to pay into the statutory insurance.

Nursing economist Rothgang is convinced that the improvements cannot be implemented without elements of the citizens' insurance.

He considers everything else to be unjust.

By integrating the privately insured into the statutory health insurance, Rothgang has calculated, the contributions could be reduced by 2.3 percent.

  • The left, the Greens and the SPD want exactly that: Long-term care and health insurance, into which civil servants and the self-employed also pay.

  • The Union is strictly against citizens' insurance - it was one of the points of contention in the discussion about the care reform.

    In the election manifesto it is stated once again that steps towards a "uniform insurance" cannot be taken with the Union.

  • The FDP also rejects such an insurance.

    Like the Union, the FDP relies on additional company insurance.

  • In addition, Linke and SPD want to convert long-term care insurance into full insurance.

Should a left-wing alliance be able to form a government after the election at the end of September, this health and long-term care insurance should therefore be converted into a citizen's insurance.

With the Union or the FDP in government responsibility, there would be no such change.

Source: spiegel

All news articles on 2021-08-27

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