Billion surplus in the health fund

Health fund: Federal Minister of Health Philipp Rösler uses billions in surplus for reserves

Statutory health insurers ended the year with a massive deficit overall, even though the insured have paid more premiums than ever before and the health fund posted a significant surplus at the end of the year.

The health fund, in which the insurance premiums are collected and distributed to the individual statutory health insurance funds, closed last year with a billion surplus, while the statutory health insurance companies had to report a deficit of around half a billion euros. The surplus of 4.2 billion euros in the health fund will flow entirely into the reserves according to the plans of the Federal Minister of Health Philipp Rösler (FDP). An unscheduled discharge to the health insurance companies and / or the insured is not planned, according to the Ministry of Health.

Federal Minister of Health does not want to use the surplus to reduce contributions
Actually, according to the legal requirements, the Federal Minister of Health would only have to use around three billion euros to build up reserves, the remaining 1.2 billion euros would be available to relieve the contributors. But Federal Minister of Health Philipp Rösler (FDP) rejects possible contribution reductions with the help of the excess funds and will flow the entire amount into the reserves, a spokesman for the Ministry of Health said. Through this additional financial cushion, provision is made for worse economic times, the ministry spokesman continued. In any case, based on the available financial resources of 1.2 billion euros, only a contribution reduction of 0.1 percent would be possible (from 15.5 percent to 15.4 percent of gross wages).

Health funds with billions in surplus, health insurers with deficits in the millions
Although the reserves created also serve to secure health insurance, the contrast between the excellent financial situation of the health fund and the deficit in statutory health insurance as a whole raises new questions about the system. The individual health insurance companies such as the AOK (around 500 million euros deficit in 2010) or the Barmer GEK (around 300 million euros deficit) could not make do with the allocations from the health fund, since other health insurance companies, such as the Techniker Krankenasse, might be neglected (TK) were able to generate a significant surplus (just under 600 million euros) under the same conditions. However, the fact that the statutory health insurance companies posted a total loss of 445 million euros should also give politicians something to think about. The health insurers affected by a deficit primarily complained that their deficit had arisen from subsequent corrections to the financial compensation due to illness. For example, according to its own statements, the DAK would have generated an operating surplus of 62 million euros last year with the help of an additional contribution of eight euros, but this had turned into a financial deficit of 79 million euros due to the subsequent cuts in financial equalization.

Health insurance deficit structural problem?
According to the Ministry of Health, a structural problem is that the statutory health insurers ended up with a clear deficit despite record payments of contributions and a billion surplus in the health fund. Because the income of the health insurance increases more slowly than their expenditure, said the spokesman for the ministry. In 2010, the revenue increased by only two percent, whereas the expenditure increased by a good three percent, according to the ministry. The spokesman for the ministry explains that the resulting funding gap will be closed by insurance companies in the future by charging additional contributions. Some health insurance companies are already making additional contributions to compensate for the deficit, but as the example of the DAK often shows only limited success. In addition, the collection of additional contributions is usually associated with a significant loss of membership, as there are currently still sufficient statutory health insurances available that do not charge any additional contributions. For example, after the introduction of additional contributions last year, the DAK had a membership loss of well over 300,000 insured. Therefore, many health insurance companies such as the AOK and the Barmer GEK - despite the massive deficit in the past year - have so far fundamentally rejected the introduction of additional contributions. According to the Ministry of Health, a wave of additional contributions is not to be expected and the average additional contribution will continue to be “at zero euros” in 2011, the ministry spokesman said.

Reasons for the cost increases with the health insurance companies
The Ministry of Health cited the benefits in the area of ​​sick pay as the main reasons for the increase in costs, whereby in addition to the larger number of recipients, the “increase in lengthy mental illnesses” is explicitly mentioned. In addition, the administrative costs of statutory health insurance increased unusually sharply last year to a good six percent. The spokesman for the ministry said that the obligation to set up retirement provisions for their employees has brought health insurance companies significantly higher costs. In addition, spending on hospital treatment rose by almost five percent last year, which also contributed to the deficit in statutory health insurance. However, the spokesman for the ministry continued to say that the cost of outpatient treatment by a doctor only increased moderately compared to the previous year (2.6 percent in 2010 compared to more than seven percent in 2009). The development of the cost of pharmaceuticals, which slowed down significantly, should be viewed positively. The rate of cost increase was only 1.3 percent, which the Ministry of Health saw as the first sign of success for the drug saving package initiated by Federal Minister of Health Philipp Rösler. According to the Ministry, expenditure on pharmaceuticals even fell in January this year. (fp)

Also read:
Health fund: Only those who are sick bring money!
Billions of health insurance deficits expected
Healthy people go to the doctor too often

Image: Gerd Altmann /

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