Germany takes crisis measures to cap health spendingBMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7374.1194/a (Published 23 November 2002) Cite this as: BMJ 2002;325:1194
Within weeks of re-election, the German health minister, Ulla Schmidt, is trying to stop the rapid increase in the health budget by introducing a bill of emergency measures
Health insurance companies face a deficit of several billion euros if her emergency actions fail. They would be forced to raise their fees in 2003, which would put an extra load on employers and might cause further unemployment.
Under her proposed bill, budgets for both general and specialist practitioners and for hospitals will be frozen at the 2002 level, despite probable pay rises of at least 3%. Administration costs of health insurance companies are also to be frozen at the 2002 level because they rose by 5% in 2001 and have already risen by 4% this year.
The pharmaceutical companies, drug retailers, and pharmacists will have to lower their drug prices by a total of €1.35bn (£0.86bn; $1.36bn). New drugs with existing patents will be sold at a fixed price. It will also become more difficult to change for an employee to transfer from an obligatory, state supervised health insurance scheme to a private health insurance company. The salary level at which transfer is allowed will be raised to €5100 a month.
This emergency operation is supposed to keep costs within budget in 2003. However, at least 30 of the 350 obligatory health insurance schemes have already raised their fees at the last minute.
Last week the government was confronted with a massive protest action at the Brandenburg Gate in Berlin. Professor Jörg Hoppe, president of the German Medical Association, complained that the “German health system was in acute danger of dying” and said in an open letter to the minister: “If the government wants a situation like in England, the patients should at least be told.”
The German Hospital Association foresees the loss of at least 40 000 jobs at a time when hospitals already cannot adhere to the legal working hours. Parts of the pharmaceutical industry that have not already moved their research and development to other countries, such as the United States and the United Kingdom, have threatened to leave the country.