In anticipation of the Federal-States Commission meeting, various organizations call for a comprehensive overhaul of the care system. - Prior to the gathering of the Federal-Lander Commission: Advocacy groups demand significant nursing system overhaul
Germany is grappling with a growing financing gap in its long-term care insurance system, as an aging population and rising costs threaten to strain the system. By 2029, projections indicate significant funding shortfalls unless reforms are enacted. Several major organizations, including Diakonie Germany, the GKV (National Association of Statutory Health Insurance Funds), and the BKK Association (a leading group of statutory health insurers), have put forward proposals to ensure the financial stabilization and sustainability of long-term care insurance.
## Proposed Solutions from German Organizations
**Diakonie Germany** - **Increase Care Insurance Contributions:** Diakonie advocates raising statutory long-term care insurance contributions to better reflect the cost of care, while ensuring affordability for low-income individuals. - **Targeted Subsidies and Reimbursements:** Proposes targeted support for those most in need, reducing out-of-pocket costs and preventing financial hardship. - **Expansion of Preventive Care:** Encourages investment in preventive and outpatient care to reduce future inpatient costs.
**GKV (National Association of Statutory Health Insurance Funds)** - **Broadening the Revenue Base:** The GKV suggests including additional sources of income beyond wage-based contributions, such as taxes or levies on capital gains, to make the system more resilient against demographic changes. - **Reform of Contribution Calculation:** Proposes a more flexible calculation of contributions, which could involve shifting from a payroll-based system to a model that includes other forms of income. - **Efficiency Improvements:** Calls for reducing administrative costs and improving coordination between health and care services to maximize resources.
**BKK Association** - **Long-term Contracts with Care Providers:** BKK promotes multi-year agreements with care providers to stabilize planning and pricing. - **Better Integration of Services:** Advocates for seamless integration between healthcare and long-term care providers to minimize duplication and improve service quality. - **Data-Driven Decision Making:** Supports the use of data analytics to predict care needs and allocate resources more efficiently.
## Complementary Recommendations from Institutional Analyses
**OECD Recommendations** - **System Reforms and Efficiency:** The OECD emphasizes the need for reforms in the pension, health, and long-term care systems to address demographic pressures. This includes improving the efficiency of spending and reallocating resources to where they are most needed. - **Simplification and Harmonization:** Suggests simplifying public procurement and planning procedures to enable timely and efficient implementation of care projects. - **Workforce Development:** Highlights the importance of addressing skilled labor shortages and reducing administrative barriers to ensure a sufficient and motivated care workforce.
**Funding and Governance Innovations** - **Hybrid Funding Models:** Combining insurance contributions with tax-based funding to diversify revenue streams and mitigate risks associated with demographic changes. - **Quality Assurance and Regulation:** Strengthening oversight to ensure high standards of care and prevent abuse of resources, while also supporting family caregivers.
## Summary Table
| Organization | Key Proposals | |----------------------|-------------------------------------------------------------------------------| | Diakonie Germany | Raise contributions, targeted subsidies, expand preventive care | | GKV | Broaden revenue base, reform contribution calculation, improve efficiency | | BKK Association | Long-term provider contracts, service integration, data-driven planning | | OECD | System reform, simplify administration, address workforce shortages |
## Conclusion
A sustainable financial stabilization of long-term care insurance in Germany requires a multi-faceted approach: increasing and diversifying funding sources, improving system efficiency, strengthening workforce capacity, and ensuring targeted support for vulnerable populations. The recommendations from Diakonie Germany, GKV, BKK Association, and international bodies like the OECD collectively point toward these necessary reforms to close the projected financing gap by 2029. However, it is crucial to avoid temporary debt-financed support that only shifts the problem into the future, as warned by GKV President Oliver Blatt. The first consultations on these reforms are scheduled to take place on Monday.
- In the context of Germany's long-term care financing, Diakonie Germany suggests integrating vocational training programs for healthcare workers to address skill shortages and improve the quality of long-term care (science, health-and-wellness).
- As part of their proposals, the BKK Association advocates for vocational training opportunities in the field of nutrition and fitness-and-exercise for care providers, enhancing their ability to support residents in maintaining a healthy lifestyle (health-and-wellness, fitness-and-exercise).
