Recently, I wrote about the planned reforms that the German Health Minister, Karl Lauterbach, wants to introduce with the act to stabilise the SHI finances (GKV-StFinG).
The Green Party and the BÄK had already raised their concerns about the proposed changes, but now the GKV-SV and individual SHI funds (such as the AOK) also have criticised the plans.
AOK comments on the draft law to stabilise the SHI finances
The AOK representatives said that the SHI’s financial situation is more dramatic than estimated. Already now, the health care system notices the higher energy costs and the inflation, but the deficit will increase even more and will exceed the €17 bn estimated by Lauterbach.
That means that an even higher increase in insurance premiums might be needed. The 0.3% increase (from 1.3% to 1.6%) proposed by Lauterbach won’t be sufficient. The AOK estimates that with only 0.3% now, the premiums would need to be raised even more in the coming years, despite all proposed measures in the draft law to stabilise the SHI finances.
If there will be a recession in Germany, the SHI funds would be in a crisis that they are not prepared for. This will be even worse because the Health Minister is planning to reduce the reserves of the SHI funds.
This restricts the solvency of the SHI funds and prevents investments in better health care. In addition, it could lead to serious difficulties and might even mean that some SHI funds have to file for bankruptcy.
Already now there is no room for further spending, such as for the health kiosks announced by Lauterbach and parts of the hospital reform.
There also is no money for many well-intentioned plans in the coalition agreement. This applies, for example, to more money for nursing staff in hospitals, the removal of paediatric medicine and obstetrics from the flat-rate DRG system, or coverage of medical care for residents in nursing homes. The cost of these projects alone amounts to €10bn. “And these are all projects that Lauterbach still has to implement.”
These large deficits in SHI finances might also mean that there will be even more downward pressure on the prices of new therapies in the negotiations between the GKV-SV and manufacturers.
Further reading related to HTA in Germany
- Which endpoints are important to the G-BA and IQWiG?
- How does the G-BA pick the appropriate comparator?
- When can an off-label drug be the appropriate comparator therapy?
- Regular and abbreviated early benefit assessments – Is this the end of orphan drug privileges?
- HTA guide
- EUnetHTA21 starts preparation for joint HTA from 2024
- G-BA assessment of orphan drug gene therapies, Zolgensma and Libmeldy
- Why did the G-BA assess Trimbow now?
- IQWiG methods version 6.0, English
- The biggest SHI fund, the AOK, proposes an end to free pricing in Germany
- New government coalition plans AMNOG, pricing and other reforms
- Prof. Dr. Karl Lauterbach is the new German health minister
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