The myth of cheap statutory health insurance
The topic of citizen insurance is boiled up again and again. Politicians and the media rarely save with criticism of private health insurance. Above all, premium adjustments and the high premiums in old age are the focus. Many points of criticism are polemical and at least unfair. A column by Dr. Rainer Reitzler, CEO of the Munich Association Insurance Group.
Even if the Federal Health Minister Karl Lauterbach praised the corona services of the PKV at the PKV annual conference on June 2, 2022 and the latter had always been a part of his health policy heart, as he emphasized, he and many MPs of the SPD remain Greens and left continue to be sympathizers of a citizens’ insurance. These repeatedly call for the abolition of private health insurance and the introduction of socialist-style citizen insurance. It is too expensive, the private health insurance, too unsocial and no longer affordable in old age. In addition, the increases in contributions were significantly higher than in the GKV. These allegations are unfair and simply wrong.
A look at the current figures from the scientific institute of private health insurance shows: from 2012 to 2022, premium income in private health insurance per fully insured person increased by 29.7 percent. In the GKV by 37.8 percent, which is another 27.3 percent more. A 30-year-old single self-employed master craftsman without children would have to pay an average minimum contribution of 211.66 euros per month as a person with statutory health insurance who is entitled to sickness benefits including social long-term care insurance. Depending on income, the maximum GKV contribution including social long-term care insurance would be EUR 933.64 per month. With the “Master Care” KV full tariff from the Munich association, he only pays EUR 458.03 per month, including private compulsory nursing care insurance and a needs-based daily sickness benefit.
In the period under review from 2012 to 2022, the burden on those insured with private health insurance increased to a much lesser extent than in the statutory health insurance system. Viewed over the entire period, there is an average annual increase in premiums and contributions of 2.6 percent in private health insurance and 3.3 percent in statutory health insurance.
In addition, regular increases in the contribution assessment ceiling and high growth in income subject to contributions in the statutory health insurance system lead to significantly increasing contribution payments, while benefits are repeatedly reduced. The latter is also the reason why more and more people with statutory health insurance are using private supplementary health insurance to top up the benefits of the statutory health insurance. According to information from the PKV Association at its annual conference on June 2, 2022, the number of supplementary insurance policies rose by 3.5 percent to a total of 28.4 million in 2021. The total number of insurance policies increased by almost a million to 37.1 million. On balance, there was also a plus of 23,600 insured persons in favor of private health insurance in 2021. That speaks for itself.
Again and again, private health insurance is accused of increasing the premiums “as the mood takes you”. However, the legal basis is very different: the legislator obliges private health insurers to check the so-called triggering factors that are relevant for a premium adjustment in private health insurance every year. These can be rising benefit expenses due to medical advances and the longer life expectancy of the insured. This review is subject to strict legal requirements. It takes place on the basis of the statutory Health Insurance Supervision Ordinance, the Insurance Contract Act and the Insurance Supervision Act. The resulting calculation is then checked by an independent trustee. The respective premium adjustment can only take effect with his consent. A private health insurance company cannot decide on the amount of the change in contributions on its own. The private health insurance association called on the legislature to reform the calculation regulations at an early stage. Consumer protection groups also support such a reform, but unfortunately the legislature has not yet taken up the matter.
In the GKV, however, increases in contributions are relatively easy to understand: the health insurance company charges a fixed contribution rate and, if necessary, an additional percentage of the income. This rule applies to every paying member. In private health insurance, the contribution is calculated differently and is independent of income. Here the contributions are as individual as the respective tariff.
As far as the accusation is concerned that private health insurance is no longer affordable for many in old age: many tariffs, e.g. B. also our KV full tariff “Master Care”, also offer a reduction in old-age contributions: A good opportunity to reduce the contributions in old age.