On 8 May 2019 the Committee on Health Care of the German Federal Parliament (Deutscher Bundestag) organized a hearing attended by 17 experts and representatives of interest groups. The subject were the motions of the Green Party, the Left Party and the Free Democratic Party on a reform of the financing of the nursing care insurance. Heinz Rothgang had written an expert opinion on the issue and Thomas Kalwitzki answered questions at the hearing itself.
Rothgang and Kalwitzki point to a significant amount of unfairness between the two branches of the statutory nursing care insurance: the private obligatory nursing care insurance and the public nursing care insurance. This effects an unequal burden of financing the insurance for the different memberships of the two branches. Since the privately insured members on average include both the lower risks as well as the higher incomes the premiums covering the costs would be only one fourth of the premiums in the public insurance. Privately insured members are, hence, considerably less financially burdened than publicly insured members. This, however, contradicts the judgement of the German Federal Constitutional Court which called for a balanced burden-sharing between the two branches of the nursing care insurance for the people.
In order to distribute the financial burden fairly Rothgang and Kalwitzki advocated the introduction of a so called Citizen Nursing Care Insurance. It not only integrates the two existing branches of insurance but also adds additional forms of income (for example rental revenues or profits from interest) to the roster of incomes from which compulsory insurance premiums have to be deducted. And it increases the assessment ceiling up to which premiums have to be deduced. This will lead to a financial relief for the members of the public insurance branch and for the low-income members of the private insurance branch.
Rothgang and Kalwitzki also pointed to the fact that such a citizen insurance system can be implemented more easily in the realm of nursing care than for example in the realm of the normal health care system. Both the private as well as the public branches of the nursing care insurance are already based on similar regulations concerning services and service delivery. This reduces greatly possible resistance and implementation problems compared for example to the health insurance system.
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Phone: +49 421 218-58557