Scientific institute of the AOK
Berlin (ots)
The core elements of the solidarity principle of statutory health insurance (GKV) are widely accepted by the population. This applies to both statutory and private health insurance. According to a representative Forsa survey commissioned by the Scientific Institute of the AOK, 82 percent of those with statutory health insurance and 80 percent of those with private health insurance are currently in favor of healthy people paying the same premium for their health insurance as sick people. Compared to a survey from 2012, approval has once again increased significantly: At that time it was 71 or 74 percent.
The representative survey of around 2,000 people with statutory and private health insurance was carried out by the social research institute Forsa at the beginning of the year on the basis of a questionnaire developed by WIdO. In order to enable a comparison over time, some of the same questions were asked as in a survey from 2012. WIdO study director Klaus Zok, who had already carried out the previous study eleven years ago, explains: “The results show that the solidarity principle of statutory health insurance in is very popular with the entire population.”
This can be seen in many places: For example, the approval ratings for the non-contributory co-insurance of children and young people are still very high: among those with statutory health insurance they are 93 percent, and among those with private health insurance they are 83 percent (2012: GKV 94/ PCV 84). The same applies to income equalization, i.e. the heavier financial burden on higher earners than on low earners. 73 percent of those insured with statutory health insurance and 68 percent of those insured with private health insurance agree with this central feature of the principle of solidarity (2012: 76/71 percent). On the other hand, the approval of old-age compensation and the free co-insurance of non-working spouses is somewhat more reserved and differentiated: 61 percent of those insured with statutory health insurance and 49 percent of those insured with private health insurance are in favor of young people paying the same amount as older people (2012: 62/54 Percent). Only 63 percent of those insured with statutory health insurance and 47 percent of those insured with private health insurance agree that non-working spouses are also insured free of charge (2012: 71/54 percent). The statement “A health insurance company should have the right to reject new customers on the basis of their state of health” met with clear rejection in both groups. 85 percent of those with statutory health insurance and 80 percent of those with private health insurance reject this.
When assessing individual aspects of care such as quality, access to therapy or patient orientation, the current WIdOmonitor shows similar to identical survey results for those with statutory and private insurance, with both camps perceiving a lot of potential for improvement. There are also different assessments of people with statutory health insurance and private health insurance when looking back and when it comes to their expectations of the health insurance system. For example, 20 percent of those with statutory health insurance, but only 11 percent of those with private health insurance, see a deterioration in health insurance cover in recent years. 40 percent of those insured with statutory health insurance expect that the range of services will decrease in the future, which only 31 percent of those insured with private health insurance fear. The satisfaction values are correspondingly different: 42 percent of those insured by statutory health insurance say they are very satisfied or satisfied with the health system in Germany, but 22 percent are very dissatisfied or dissatisfied. This is even more true for people with statutory health insurance who classify their health as poor. Those with private health insurance, on the other hand, are significantly more satisfied with the healthcare system at 55 percent; only 15 percent are dissatisfied or very dissatisfied.
The concrete experiences of patients with the medical treatment are also different. For example, 41 percent of people with statutory health insurance report difficulties in getting a doctor’s appointment in a timely manner. For people with private health insurance, this is only 22 percent. 17 percent of those with statutory health insurance believe that they have been denied benefits, but only 3 percent of those with private health insurance. Conversely, 16 percent of those insured with private health insurance believe that they were offered unnecessary examinations, while the figure is only 6 percent among those insured with statutory health insurance.
Reform options: There is a lot of approval for the inclusion of other groups in the statutory health insurance system
“On the one hand, there is a high level of approval for the solidarity-based orientation of the GKV, but on the other hand there is also a need for improvement in the specific care provided in everyday life,” commented study leader Klaus Zok on the results. Against this background, the differentiated assessments of various reform options for the statutory health insurance are also interesting. The inclusion of additional income from rents, interest and capital gains in the calculation of the contributions found relatively high approval from both groups (statutory health insurance: 43 percent in favor, private health insurance: 50 percent). There is also a relatively high level of sympathy for the expansion of the community of solidarity to include civil servants, the self-employed or higher-earning employees (statutory health insurance: 75 percent approval, private health insurance: 46 percent). More than half of both statutory health insurance and private health insurance policyholders support raising the contribution assessment ceiling in statutory health insurance (GKV: 59 percent agree, private health insurance: 54 percent). A similar mood can be seen in the case of the contribution obligation for co-insured spouses with a family income above the contribution assessment limit (statutory health insurance: 55 percent in favor, private health insurance: 60 percent).
On the other hand, there was unanimous rejection of a flat-rate risk surcharge for sick people (statutory health insurance: 7 percent approval, private health insurance: 10 percent). Extended private co-payments or increased co-payments, as recently proposed by finance scientist Bernd Raffelhüschen and some medical officials, are rejected by the majority of those with statutory health insurance as well as those with private health insurance (GKV: 10 percent in favor, private health insurance: 21 percent). The reimbursement of costs already practiced in private health insurance is also clearly rejected, even by many private health insurers (statutory health insurance: 16 percent agreement, private health insurance: 32 percent).
Faced with the alternative of having to accept either a waiver of benefits or an increase in premiums in order to solve the financing problems, people with statutory health insurance and private health insurance clearly prefer the latter (statutory health insurance: 15 versus 77 percent; private health insurance: 21 versus 74 percent). The result for this question is even clearer than in 2012.
Large majority in favor of strengthening solidarity-based financing, including in long-term care insurance
The responses to the prospects for the development of statutory health insurance are also noteworthy: there is a clear preference for insuring the entire population in statutory health insurance instead of leaving the status quo of the two systems working side by side. The result does not only apply to people with statutory health insurance, who agree with 76 percent. Almost half (48 percent) of the privately insured people surveyed are in favor of it. Respondents also advocate strengthening solidarity-based financing with regard to social long-term care insurance. 86 percent of those with statutory health insurance and 64 percent of those with private health insurance are in favor of everyone, including civil servants, the self-employed and those with higher incomes, participating in the solidarity financing of care costs. 78 percent of those with statutory health insurance and 71 percent of those with private health insurance believe that the risk of rising care costs should be borne by the care insurance and not by those in need of care. Conversely, only 13 percent of those with statutory health insurance and 23 percent of those with private health insurance agree that the risk of rising care costs should be covered by private supplementary care insurance.
Study director Klaus Zok sums it up: “The empirical findings show – also when compared over time – that a clear majority of the population supports comprehensive health and nursing care within the framework of the solidarity-based insurance system and votes for the strengthening of solidarity-based financing elements. The almost consistently positive ones are remarkable A significant proportion of the privately insured persons surveyed voted for the principles of solidarity-based financing, which does not exist in their own insurance system, as well as their openness to a combination of both insurance systems.
Note for editors:
The WIdOmonitor for download: https://www.wido.de/publikationen-produkte/widomonitor/widomonitor-1-2023/.
event notice
The results from the WIdOmonitor will also be discussed at tomorrow’s WIdO symposium:
“The dual system of health and long-term care insurance – a German unicum with a future?”
May 4, 2023, from 4:00 p.m. to 6:30 p.m
The event can Livestream on be tracked. who personally on site If you want to take part, you can register online today register at: [email protected].
Press contact:
Scientific institute of the AOK
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Original content from: AOK Scientific Institute, transmitted by news aktuell