KBV Proposes Removal of Non-Insurance Benefits from Statutory Health Insurance

The National Association of Statutory Health Insurance Physicians (KBV) has announced plans to address mounting financial pressures on Germany's statutory health insurance system (GKV) by calling for the elimination of non-insurance-related benefits. These proposals come amid growing concerns over demographic shifts and rising healthcare expenditures that threaten the long-term financial stability of the GKV.

The federal government has established an expert commission tasked with formulating reform strategies and identifying cost-saving opportunities for the health insurance system. The commission's initial findings are expected to be presented to the public in March.

In recent months, a number of political and healthcare organizations have presented their own ideas for alleviating the financial burden on the GKV. Among the more controversial suggestions was a proposal from the CDU's Economic Council to remove all dental services from the statutory benefits catalog, which drew widespread criticism. Similarly, suggestions from the SPD to extend social insurance contributions to all forms of income, including capital gains, have met with considerable debate.

At a press conference in Berlin, the KBV leadership highlighted what they view as a key issue: the significant financial gap caused by non-insurance-related services covered by the GKV. According to the KBV, the shortfall resulting from insufficient federal funding for these services could amount to as much as 45 billion euros, representing a sum nearly equivalent to the entire budget for outpatient medical care in Germany. Expenditures by the GKV on recipients of basic social security alone are estimated at approximately 9 billion euros annually.

To address these imbalances, the KBV supports ongoing legal action initiated by the GKV's central association against allocation directives from the Federal Office for Social Security. The KBV argues that federal funding should adequately compensate for non-insurance-related benefits, which currently contribute significantly to the system's financial strain.

In addition to immediate financial measures, the KBV advocates for broader health policy reforms. Key among these is the support for increased taxation on products such as alcohol and tobacco, as well as the introduction of a sugar tax on beverages. The KBV believes that revenue generated from these taxes should be allocated directly to the healthcare system to bolster its funding. Furthermore, such measures are intended to promote public health by discouraging the consumption of unhealthy products.

The federal government is also developing a primary care model that would require patients to obtain referrals from general practitioners before visiting specialists. This system is designed to promote coordinated care and strengthen preventative health services. The KBV has previously presented its own concept for a primary care system, emphasizing that while such changes may only yield long-term benefits, they are crucial for the sustainability of healthcare provision in Germany.

The KBV leadership also stressed the need to reduce administrative burdens faced by medical practices. Among their recommendations are the introduction of minimum thresholds for economic audits, the removal of barriers to vaccination through the elimination of associated financial risks, and the abolition of penalties for minor administrative errors on otherwise medically justified prescriptions. The KBV warns that current regulations not only increase bureaucracy for healthcare providers and insurers but may also pose existential risks to practice owners and deter new physicians from establishing practices.

These proposed reforms and cost-saving measures reflect ongoing efforts to ensure the financial viability of Germany's statutory health insurance system while maintaining access to comprehensive medical care for the public. The outcome of the expert commission's review and subsequent policy decisions will be closely watched by healthcare professionals and policy makers in the coming months.