Social issues: Solutions for care until the end of the year

In view of ever higher billions of billions for care, the federal and state governments want to develop proposals for comprehensive financial security by the end of the year. “We do not need a reflection, we need a fundamental reform,” said Federal Minister of Health Nina Warken (CDU) after the opening session of a working group with the countries in Berlin. It is intended to develop key points in order to start legislation in early 2026.

“The citizens must be able to rely on the fact that they are supported in the case of care and not overloaded,” said Warken. “Care must not be a risk of poverty, not even for caring relatives.” It takes an honest debate, but also quick results. Two specialist working groups should now meet concrete ideas for the support of care at home. The key points of the reform concept should be available in December.

“Future Pact” as a goal

The AG intended in the coalition agreement of the Union and SPD for a “future pact of care” also includes family minister Karin Prien (CDU) and other ministries on the country’s heads responsible for care. The municipal umbrella organizations and the black and red coalition factions in the Bundestag are also involved.

The financial nuts in nursing have already become chronic. At the beginning of 2025, the next increase in contributions came after the previous one in the summer of 2023. This year, long -term care insurance expects a minus of 166 million euros. The federal government plans to stabilize a loan of 500 million euros and still one of 1.5 billion euros in 2026. So that premium increases will not have to come again next year, there is still no money.

The financial injections should now create time to tackle the large reform. Prien said that nurses at home were “the quiet heroes” of the system and rightly wished to be seen more strongly. Hamburg’s social senator Melanie Schlotzhauer (SPD) said that today the very complicated system overwhelmed many and should be made easier. Bavarian department head Judith Gerlach (CSU) said that it was a reform that in the best case is sustainable for the next decades. The construction sites at a glance:

The number of people who receive care benefits is increasing significantly – “to a stronger extent than is expected by the aging of society”, as the Federal Statistical Office explained. The background is a reform of 2017 that introduced further criteria for the classification of a need for care. There are currently 5.6 million beneficiaries after it was 4.0 million in 2019. According to a forecast by the official statisticians, there could be an increase to 7.6 million people in need of care by 2055.

Last year’s expenditure rose to 63.2 billion euros last year after just under 57 billion euros 2023. In 2014 it was still 24 billion euros and in 2019 a good 40 billion euros. A major cost factor are increasing personnel expenses for urgently needed nursing staff. Since 2022, the care contracts of the long -term care funds have only been possible with homes that pay according to collective agreements or similar.

For people in need of care and their relatives, care means that they have to pay part themselves – and it increases and increases. Unlike health insurance, the long -term care insurance does not bear the full costs. For the approximately 800,000 people in need of care in homes, accommodation and meals are added, and levies for investments in homes and training are also passed on. At the beginning of 2025, this added up to almost 3000 euros a month after cash data in the first year of the home stay in the national average.

Some cost dampers have already installed previous federal governments. In this way, residents of residents have now increased surcharges that are supposed to alleviate the increase in additional payments for pure care. The long -term care insurance funds cost more and more – for 2025, an increase to 7.3 billion euros is expected, according to a report by the Federal Audit Office. The care allowance for people who are looked after at home was increased again in 2024 after several years. A federal subsidy was deleted.

Various suggestions for a financial reform have long been on the table: from more tax billions to lids for your own shares to a conversion of the model to full insurance, which bears all care costs. The long-term care insurance companies also demand that the federal government will reimburse billions of bills from the Corona crisis and pay pension contributions for caring relatives. BUND-Länder-AG is also intended to check incentives for more self-provision-and the scope of services.

More money from the state or private provision?

The German Foundation for Patient Protection warned: “The future pact of the future can only succeed if the federal and state governments comply with their obligation to finance.” The federal government and the federal states are responsible for the fact that long -term care insurance and those in need of care would have been withheld from 15 billion euros annually. The Association of Private Health Insurance campaigned for promoting private provision. Value controls are now to be put to the test.