Premium adjustment in private health insurance – “a lot is scare tactics”
In the coming days and weeks, the private health insurers will again announce how they will adjust their contributions in the coming year: in some tariffs, significant price increases are expected. Gerd Güssler, insurance consultant from Freiburg and founder of the market observer KVpro.de , warns in the interview messenger with alarmism and exaggeration: Many insured could respond to premium adjustments, if they only know their rights better.
Insurance provider: Our topic is the private health insurance and contribution increases. Consumer advocates warn partly before the “poverty trap PKV” because the premiums would explode. Is this, in your view, a scare tactic or even justified to some extent?
Gerd GüsslerNot everything is alarmist, but most of it. One likes to talk to private insurers of premium increases. It is correct that the premiums rise, because you have different factors that cause that. But even a statutory health insurance increases: because the annual contribution ceiling changes, because the additional contributions change, because the benefits change, are also cut. If one compares the premium increases for the employee, then we have in the last ten years with the legal health insurance funds per year an average contribution increase of five per cent, if we look only on the employee portion and consider that he must pay the additional contribution itself.
The second point concerns the question: What contribution do I have in private health insurance? If I pay too low a fee for my tariff, because some insurers with “dumping offers” attract new customers, then the increase is felt to be strong in percentage terms. And so some media panic, but do not say what an equivalent statutory health insurance would cost. Or one takes a high-quality private health insurance, which also has the appropriate premium, and looks at there because the contribution increase. Because it works differently! My own example, Gerd Güssler: I am a private health insurance company with the same private insurance company for 23 years, enjoying high-quality protection and an average adjustment of four percent a year.
The problem particularly affects older policyholders who are more threatened by premium jumps in private health insurance. How do you perceive this in your consulting practice? What would you advise an older insured person who has to cope with a high premium increase?
Güssler : This topic has been exaggerated by the media. It’s more of a headline fear that with the premiums they pay today – that is, 500 or 600 euros contribution – people assume that they will have to withstand a premium explosion of 40 percent in their old age, or which otherwise called astronomical numbers. Then consumers are actually scared.
To emphasize that: The private health insurance works. But it only works if you buy appropriately and as long as you as a consumer know what rights and options for action you have in old age. Insured persons often simply lack information about what is possible with regard to tariff optimization and change. The insured, who come into my consultation, actually come in the rule, because they are afraid of contribution explosions. If you then talk to them, that they will have access to the standard rate later, that the employer’s share is not necessarily exhausted, that there are contribution relief components, how the statutory health insurance develops, that brings clarity and deprives consumers of the fear of premium leaps. And then a time is determined from when action options are wise to set.
But the premiums in private health insurance are now rising somewhat more, because insurers have to apply lower interest rates. Here it would be fair in my view, Ross and Reiter to call: that a PKV must deal with a problem that has not caused them, namely a zero interest rate policy. The savers and the insured must personally pay the zero interest rate policy of the central banks, because now lack interest income, which are used as a contribution.
Returning to statutory health insurance is often not an option for many private individuals. Or if it is recommended, if it is suitable?
Gussler : Regarding the return to a health insurance, there is an important point to note. People are often denied that all retired earnings are to be contributed when I become a volunteer member. Depending on the revenue, this can be higher than in private health insurance or in the standard rate of private health insurance.
In addition, it should be remembered that there are people who have gone into private full insurance, because a statutory health insurance in their individual self-employment was too expensive compared to the sales and also have little pension.
But that is not a problem of private health insurance. That is a problem of the individual citizen. A response from the statutory health insurance is missing here, that you also contributed the lower income differently, not only with half the maximum rate. If there had the GKV an answer, then the “simple solo self-employed” would not necessarily in the simple tariffs of private health insurance and remain with the coffers. To scold private insurers is the wrong approach.
This is a problem that I also observe in the circle of acquaintances. The self-employed with small incomes, often in the creative scene, the statutory health insurance offers no cheap protection. You also have to raise the employer’s share. Since little consideration is taken on the income: often they are overwhelmed with the cash contributions. Do you see a need for reform here? That one says, for example, one must also force the health insurance companies to insure self-employed cheaper?
Gussler : I would argue the other way round . First, there is already the rule that self-employed with a small income can choose half the reference value as a basis for assessment. And if you just start and take the founders grant, further reliefs are possible, so that one would come out at about 276 euros including sickness benefits (KG) with start-up subsidy or hardship regulation and 414 euros incl. KG at the minimum contribution and about 880 euros at the maximum rate.
I am more likely to ask myself the question: is the person eligible for self-employment? Or is this an emergency solution so as not to slip into Hartz IV or unemployment? This is above all a dilemma of the so-called solo self-employed. So for small entrepreneurs without their own employees such as taxi drivers or operators of an online shop, which -why always not Hartz IV claim, but choose the way out self-employment. These are often those people who opt for a private health insurance because even half the maximum rate in the SHI is too expensive from the contribution. The need for reform would be rather to see what you take away from the people in Hartz IV. Those affected must use all their personal wealth if they want to receive appropriate support.
If one aims at reforms and the self-employed are to remain with the health insurance companies, beyond that a kind of graduated system of the contribution would be conceivable.
In the private health insurance this is calculated out, but in the GKV the self-employed would live on the costs of others if the contributions were set lower. That is so and could not be avoided. The self-employed must really think about whether his business plan is sustainable and not just say: “The contributions are too high”. Because some stumble through life and hang in retirement again in the public systems. It is also about self-responsibility. The community is the last resort and should not be released from personal responsibility. Only for the needy, that was once the basic idea of Bismarck at the introduction of social health insurance.
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