Rising costs: Lauterbach announces concept for nursing reform

In view of the rising billions in costs, Federal Health Minister Karl Lauterbach is aiming for further care reform before the federal election. “We will present a concept after the summer break,” said the SPD politician in Berlin. The plan is to include an overall package for more capacity among nursing staff, greater prevention of the need for care and closing a financial gap. The nursing insurance expects to be in the red in 2024 and 2025. Lauterbach spoke of a challenge that can be solved, however. There is “no explosion in costs” ahead. Patient advocates called for rapid proposals.

The minister said: “The traffic light coalition will present a major care reform.” Without reforms, care insurance would become more expensive. “The contribution rate would rise because we also have more people in need of care. We will react to that.” This includes legislative plans for better prevention of dementia and strokes, for example. “Many cases of needing care are preventable.” Lauterbach also referred to planned new regulations that provide more skills for nursing professionals in order to make the profession more attractive. New care services in the gap between care at home and in a nursing home are also to be made possible by law.

With regard to the financial situation, Lauterbach promised proposals “on how nursing care insurance can be well paid for in a spirit of solidarity.” He did not comment on individual proposals and components for a reform, but stressed: “The traffic light coalition has ideas for this and also the political strength.” The Federal Cabinet approved a report prepared by the Health Ministry on the “future-proof financing” of nursing care insurance, which is intended to show “scenarios and adjustment screws for possible reforms.” This does not involve a pre-determination, explained the Federal Government. It is a data-based basis for further consultations.

Billions in deficit expected

Another stabilization measure for nursing care is now in sight, after Lauterbach recently expressed skepticism about the chances of success in view of differences within the coalition. The traffic light coalition had already implemented a first reform. It brought relief for those in need of care, but also an increase in contributions as of July 1, 2023. The higher revenues contributed to the nursing care insurance recording a surplus of 1.79 billion euros last year.

The reform was supposed to secure finances until 2025. However, after the first quarter of 2024, there was already a deficit of 650 million euros, according to the umbrella association of statutory health insurers, which also represents the nursing care funds. A deficit of 1.5 billion euros is expected for the year as a whole, and a deficit of 3.4 billion euros for 2025. In purely mathematical terms, this would correspond to a further contribution increase of 0.2 points.

The German Foundation for Patient Protection demanded that Lauterbach’s announcements be followed up with legislative proposals immediately. For example, a tax subsidy must be set. “It is not enough for the future viability of elderly care to just talk about a new job profile in nursing and hope for possible synergy effects,” said board member Eugen Brysch to the German Press Agency. The vast majority of those in need of care are cared for at home by relatives. For them, the care allowance needs to be increased and adjusted annually.

A federal subsidy of one billion euros annually introduced by the previous government had been canceled as part of the 2024 budget consolidation.