Should Germany get rid of private health insurance?

There are fresh calls for reform on Germany's dual health system after a new study found many people would benefit if private health insurance was abolished.

Should Germany get rid of private health insurance?
Health insurance cards. Photo: DPA

Those with statutory health insurance – along with their employer – could save an average of €145 per year if the current dual system was abolished.

That’s according to a new study that believes the statutory health insurance scheme (GKV) would receive an extra €9 billion a year if privately insured people were included in it. 

The cash boost would allow the GKV to reduce contributions for both employers and employees, the study by the Iges Institute on behalf of the Bertelsmann Foundation found.

The findings are based on the latest data from 2016 that comes from an annual survey of around 12,000 households. In 2016 – as is currently the case – around 8.8 million people were privately insured. In 2016, the statutory system had about 70.4 million insured people.

Currently there are around 73.2 million people insured under GKV, mainly due to a surge in immigration to Germany, said Stefan Etgeton of the Bertelsmann Foundation.

According to the study, which fuels the discussion on the introduction of a so-called 'citizens' insurance', those insured in private health insurance (PKV) – mainly high-income earners, civil servants and self-employed – earn on average 56 percent more than those insured by statutory health insurance.

While statutory health insurance members have an average annual income of €24,149 per person, the figure for private health insurance members is €37,858.

Those who are privately insured also tend to be healthier. If they were covered by statutory health insurance, the study calculates this would result in an annual cash boost of €8.7 to €10.6 billion. The contribution rate could then fall by 0.6 to 0.7 percentage points for those in the system.

READ ALSO: German health care: Everything that changes for patients in 2020

Photo: DPA

If doctors were compensated for the loss of fees they would incur if there were no patients with private health insurance, the study believes contribution rates would still fall – by 0.2 to 0.3 percentage points.

In this case, GKV insured patients and their employers would still be relieved by an average of €48 per year.

Call for system overhaul

The supply of doctors would also likely shift if privately insured people were to switch to the GKV system.

The Iges Institute investigated a connection between the regional distribution of privately insured patients and the establishment of doctors' surgeries.

They found in Bavaria, for example, in areas with a large number of privately insured people, there's an above-average number of doctor practices.

A causal connection was not proven in the study. However, the authors assume that “the average two and a half times higher remuneration for medical services for private patients” strengthens the incentives for doctors to set up their practices in areas with a large number of privately insured patients.

READ ALSO: Everything you need to know about making a doctor's appointment in Germany

As a consequence of the dual system, the Bertelsmann Foundation warned of a loss of solidarity and a weakening of social cohesion.

“Every year, the average GKV insured pays more than necessary so that high-income earners, civil servants and the self-employed can escape solidarity compensation,” Etgeton said.

The foundation therefore calls for an overhaul of health and nursing care insurance. They also said it should become easier for people in Germany to switch from private to statutory health insurance.

The goal of the restructuring should be an integrated health and nursing care insurance, where all citizens are compulsorily insured. They believe contributions should be based on financial capacity, not on individual health risks.


Statutory health insurance – (die) gesetzliche Krankenversicherung (GKV)

Private health insurance – (die) private Krankenversicherung (PKV)

Citizens' insurance – (die) Bürgerversicherung

Average – durchschnittlich

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Monkeypox in Germany: Two teens ‘among new infections’

Two teenage boys between the ages of 15-17 have reportedly been infected by monkeypox, as the number of cases in Germany continues to grow.

Monkeypox in Germany: Two teens 'among new infections'

German news site Spiegel Online first reported the new cases – which are an anomaly for a virus as it has mostly affected gay men – following an inquiry to the Robert Koch Institute (RKI). 

They are among a total of 2,677 people who are confirmed to have contracted the virus in Germany to date. There have not been any fatalities.

Out of these, only five cases were women, according to the RKI. The public health institute said that it does not release information on individual cases.

READ ALSO: EXPLAINED: How Germany wants to contain the monkeypox

The disease – which is not usually fatal – often manifests itself through fever, muscle aches, swollen lymph nodes, chills, exhaustion and a chickenpox-like rash on the hands and face.

The virus can be transmitted through contact with skin lesions and droplets of a contaminated person, as well as through shared items such as bedding and towels.

Many of the cases known so far concern homosexual and bisexual men. However, affected people and experts have repeatedly warned against stigmatising gay communities.

How fatal is the disease?

The first monkeypox cases were reported in Germany on May 20th, as the disease continued to spread in West Europe.

At the weekend, the first two deaths outside of West Africa were reported in Spain.

READ ALSO: WHO warns ‘high’ risk of monkeypox in Europe as it declares health emergency

The RKI has urged people returning from West Africa and in particular gay men, to see their doctors quickly if they notice any chances on their skin.

According to the latest estimates, there are 23,000 monkeypox cases worldwide, and Europe is particularly affected with 14,000 cases.

There have been 2,677 monkeypox cases in Germany as of August 2, 2022. Photo: CDC handout

About eight percent of patients in Europe have been hospitalised so far, reported the World Health Association on Monday, mostly due to severe pain or additional infections.

In general, the mortality of the variant currently circulating in Europe is estimated to be low.

READ ALSO: More cases of monkeypox ‘expected’ in Germany

Will a vaccine make a difference?

Since July, a vaccine has been authorised in 27 EU member states and in Iceland, Liechtenstein and Norway. 

The Standing Committee on Vaccination (STIKO) recommends vaccination against monkeypox in Germany for certain risk groups and people who have had close contact with infected people.

So far, the German government has ordered 240,000 vaccine doses, of which 40,000 had been delivered by Friday. 

Around 200,000 doses are set to follow by the end of September. 

The German Aids Federation (DAH) on Friday called for one million vaccine doses, stressing that the current supplies will fall short of meeting need.

“The goal must be to reduce the number of infections as quickly as possible and to get the epidemic permanently under control,” explained Ulf Kristal of the DAH board in Berlin on Friday.

But this is only possible, he said, if as many people at risk of infection as possible are vaccinated.

“We don’t assume the epidemic will be over when the doses available so far have been vaccinated,” Axel Jeremias Schmidt, Epidemiologist and DAH Consultant for Medicine and Health Policy, wrote in a press release.

As long as there are monkeypox infections, he said, people who are at risk must be offered vaccination.