Berlin. The GKV deficit in the first half of 2024 amounts to 2.2 billion euros. The umbrella association of 95 health insurers is sounding the alarm: contributions for GKV policyholders would continue to rise if the government does not take preventive measures soon. The average additional contribution rate was already 1.78 percent in August.
On Friday evening, the Federal Ministry of Health (BMG) released figures for the financial development of the GKV in the first half of the year. They confirm what Ärzte Zeitung reported about a week ago: that Financial hole among the 95 health insurers is increasingly larger.
Replacement funds with the biggest financial hole
According to BMG, the funds’ financial reserves amounted to around 6.2 billion euros at the end of the semester. This corresponds to 0.23 monthly expenses, the legally required minimum reserve is 0.2 monthly expenses.
Revenues amounted to €159 billion, compared with expenditure of €161.3 billion. By August, 22 health insurers had already increased their additional contribution rates during the year.
The replacement funds recorded the largest deficit: almost 860 million euros. The local health insurance funds have a deficit of 721 million euros, the corporate health insurance funds 366 million euros, the corporate health insurance funds 161 million euros and the Knappschaft 43 million euros.
Hospital treatment costs rise by eight percent
Between January and June, health insurance expenditure rose by 7.6 percent or almost 11 billion euros, “and therefore significantly more than in recent years,” writes BMG. Expenditure on hospital treatment increased by almost eight percent (3.6 billion euros).
BMG cites the dynamic price component due to changing values, the increase in the number of cases and “in particular nursing staff costs” as the reason for the increase, which “once again rose extremely dynamically by around 10.9 percent or €1.05 billion” in the first half of the year. In addition, around €181 million in treatment costs were “reserved” under the hybrid DRG.
Health insurance companies spent ten percent or 2.5 billion euros more on pharmaceuticals. “When interpreting this extremely dynamic development, it should be noted that it is particularly influenced by the expiration of the statutory manufacturer discount from 7 to 12 percent, which was increased once in 2023 by the Financial Stabilization Act GKV,” writes BMG.
Health insurers pay five percent more for outpatient care
As regards outpatient medical treatment, health insurers recorded an increase in expenditure of 5.3 percent or 1.3 billion euros. According to BMG, expenditure on extra-budgetary psychotherapy services in particular showed “above-average growth”, namely an increase of 6.8 percent. Expenditure on outpatient operations according to the AOP catalogue also grew more dynamically than the overall area, with growth of around 9 percent.
Expenditure on home treatment and nursing care (up 12.4 percent) as well as on preventive and rehabilitation services (up 11 percent) also increased sharply.
The health fund, which had a liquidity reserve of around €9.4 billion as of 15 January 2024, also recorded a deficit in the first half of the year: BMG estimates it at €6.3 billion. This is partly due to the fact that a total of €3.1 billion from the liquidity reserve will be distributed to health insurers in 2024 in order to stabilise the health insurers’ additional contribution rates.
Suggestions to politicians
Taking into account the ministry’s report on the water level, the National Association of Statutory Health Insurance Funds warned that contributions for policyholders will continue to rise if politicians do not take countermeasures. For 2025, health insurers already expect an additional contribution rate of at least 2.3 percent, i.e. 0.6 percentage points more than this year, according to a press release.
The impending wave of premium increases at the turn of the year could be avoided in the short term if health policy resolutely drew up a reform package that could be implemented relatively quickly, said association president Doris Pfeiffer. For example, VAT on medicines should be reduced. This would reduce the burden on health insurance companies by more than five billion euros.
As “another immediate measure”, the association refers to the increase in flat-rate contributions for recipients of citizenship benefits and the subsidy for non-insurance benefits. “This would not give us long-term stability, but it would give health policy and self-administration space to work together on the necessary structural reforms. In any case, continuing to ‘turn a blind eye and carry on’ is not an option”, says Doris Pfeiffer. (yuck)