In Berlin, the struggle for care financing is in full swing behind the scenes. Federal Minister of Health Lauterbach wants to reduce the personal contribution for home places and strengthen home care. However, the FDP-led Ministry of Finance does not want to strain the Treasury.
In view of the growing pressure in the care of the elderly, the SPD insists on fresh tax billions for reforms from Finance Minister Christian Lindner. The five million people in need of care and their relatives and friends expected the traffic light coalition to stand by their side – “especially when times are difficult,” said Deputy Group Leader Dagmar Schmidt in Berlin.
The government’s care representative, Claudia Moll, sees the load limit of those in need of care and their relatives “long since exceeded”. In many places there is a lack of suitable offers, Moll told the “Bild am Sonntag”. Home and professional care must be strengthened and voluntary work expanded. “Above all, we need a clear timetable. People need to know what to expect.” Health Minister Karl Lauterbach had planned reforms for elderly care.
In mid-January, headlines were made by the fact that the proportion of people in need of care and their families per place in a home continued to rise – by 278 euros within a year to an average of 2411 euros per month. A relief surcharge was introduced in 2022 to limit this. In the coalition agreement, the SPD, the Greens and the FDP announced that they would examine a reduction in their own share.
When asked, Schmidt did not want to comment on the problem of own shares. According to the coalition agreement, the traffic light also wants to finance the pension contributions for relatives from taxes and strengthen home care. The care allowance that flows for home care should be dynamic from 2022. Social associations had criticized the fact that the care allowance had not been increased at all since 2017 despite inflation.
Schmidt now ranked care with health care, mobility or further training: investments in these areas soon paid off. “It is the job of the finance minister to make the necessary funds available now and finally to take responsibility for the revenue side.” The care policy spokeswoman for the SPD parliamentary group, Heike Baehrens, considers relief in home care to be extremely urgent. “It has to be started quickly and we need the necessary funds from the Federal Minister of Finance,” she told the “Bild am Sonntag”.
Schmidt said the relatives did great things every day. “We have to support them and make their lives easier,” said Schmidt. The ideas in the coalition agreement must now be implemented. “This includes stable financing, also from taxes, as well as the adjustment of services to the needs of those affected.” The SPD is thus siding with the health and nursing care insurance funds. “Fair nursing care financing also means that the non-insurance services that the nursing care insurance takes on in place of and on behalf of the federal government are fully counter-financed,” said Gernot Kiefer from the board of the National Association of Statutory Health Insurance Funds.
He referred to the approximately 3.3 billion euros that care insurance pays each year for social security contributions from relatives. “In the future, the long-term care insurance would have to be refinanced every cent via a reliable and dynamic federal subsidy.” 3.3 billion euros is the amount that the nursing care funds get from 0.2 contribution rate points.
More taxes for care have been discussed for some time. On January 1, 2022, a permanent federal subsidy of one billion euros per year for long-term care insurance was introduced. Increasing care contributions are already foreseeable. Lauterbach had admitted that increasing contributions would be unavoidable. Since the beginning of 2022, the care contribution has been 3.05 percent of gross wages, 3.4 percent for childless people.
Behind the scenes, the struggle over care funding has long since begun. According to a report by the Handelsblatt on Thursday, the Ministry of Finance said that Lauterbach’s reform proposals would bring “further increases in performance amounting to billions of euros”. There is still a “considerable need for advice”. FDP nursing expert Nicole Westig demanded in the “Bild am Sonntag” that medical treatment care in homes will be paid for in future from health insurance and that personal contributions will be reduced.
The board of directors of the German Foundation for Patient Protection, Eugen Brysch, accused Lindner of wanting to break the coalition agreement. “Because Christian Lindner rejects an appropriate federal subsidy from the bubbling budget funds for those in need,” said Brysch. “The federal government’s hesitation in supporting those in need of care must come to an end.” Every person affected needs an additional 300 euros per month from now on. An adjustment for inflation should also be “introduced immediately”.
The Bavarian Minister of Health Klaus Holetschek also called for additional help for care due to the current inflation and energy price crisis. It was “shameful that the federal government did not consider outpatient care facilities when it came to helping with the energy crisis”. The chairwoman of the Social Association Germany, Michaela Engelmeier, said: “People are thinking: Can I afford one more minute of help? Or do I buy a loaf of bread instead? Then you just book the small body wash.” According to a study by the Scientific Institute of Private Health Insurance, the number of people in need of care could rise from almost 5 million to almost 5.5 by 2025.
