Berlin Health Minister Karl Lauterbach (SPD) wants to get several large-scale health policy reforms underway by the autumn, which have apparently been left undone during the peak phase of the pandemic. “The time over the summer must be used to vigorously push reforms that could no longer be pushed in the fall,” said Lauterbach in Berlin.
So far, the preparations for the actual health policy could only have taken place in the background. Several projects will therefore be launched in the coming months. Specifically, Lauterbach mentioned the financing of the statutory health insurance companies (GKV), the digitization of the health system, a hospital structure reform, cannabis legalization and a pandemic control law for the fall.
The reform of the disastrous cash register finances is considered to be particularly urgent. The coffers have been warning for months of a huge financing deficit of 17 billion euros for the coming year. Already for this year, the then grand coalition had to support the coffers with a record subsidy of 28.5 billion euros in order to avert a higher average additional contribution for the insured.
This is currently 1.3 percent. Lauterbach had announced a GKV financing law “in the coming days” at the spring reception of the AOK last week, but had to postpone it again. The reason is apparently the Ukraine war. “We are in the process of examining the imponderables,” said Lauterbach.
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The war will have a drastic effect on cash register receipts and expenditure. Lauterbach did not give any details. Health insurance circles say that it is currently difficult to estimate how much the war will affect the GKV finances. The receipts of the funds depend heavily on the labor market, the development of which in turn is influenced by possible sanctions such as a gas embargo.
From June, refugees are to be included in the basic security system
The consequences of this could no longer be cushioned by measures such as short-time work, warned employment agency boss Detlef Scheele on Tuesday in view of the continued good employment figures. If unemployment rises, the health insurance companies lose contributions and thus income. On the expenditure side, on the other hand, there is concern about higher costs, for example due to rising energy and production prices.
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In addition, needy Ukraine refugees are to be insured via basic security from June. Funds have been complaining for a long time that the contributions for recipients of basic security do not cover costs and therefore mean additional expenses.
According to Lauterbach, votes are currently being taken on what the Ukraine war means for the law. But he didn’t want to be pushed either. This month, possibly in two weeks, he wants to present a corresponding law.
At the beginning of March, a first draft of the law had already become public, but the Ministry of Health distanced itself from it. Among other things, this provided for the federal subsidy to be increased by five billion euros to 19.5 billion euros annually from 2023. Without additional measures, the additional contribution would increase by one percentage point, the draft said. This also included cuts for the pharmaceutical industry to reduce drug spending.
Digitization of the health authorities is imminent
As a further project, Lauterbach announced that it would advance digitization in the healthcare sector. As an example, he named the electronic prescription, which is currently in a test phase but is scheduled to be launched this year. This was originally planned for January of this year, but had to be postponed indefinitely due to technical problems. With the start, the digitization of the healthcare system can be “experienced”, said Lauterbach. So far, 10,000 e-prescriptions have been issued.
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Lauterbach also called on the health authorities to invest more in digitization. “This can now be made up for in the intermediate sprint so that they are well prepared in the autumn,” said the minister. As early as 2020, the then federal government promised the health authorities 800 million euros for digitization.
Lauterbach also announced that he would lay the foundation for the start of electronic patient records with a proposal for a so-called “opt-out” rule. Such a rule was agreed in the coalition agreement. It states that you must actively object if you do not want to use the electronic patient file.
In addition, Lauterbach announced that it would start the legal process for cannabis legalization. In a first step, the drug commissioner will discuss the topic in technical discussions with experts. “I’ve changed my mind on that over the past two years,” Lauterbach said. “I’ve always been opposed to cannabis legalization, but I revised my position about a year ago.” He now believes the dangers of non-legalization are greater.
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