Students call for reform of the healthcare system

It is the first time that students of a German university have called strongly for a fundamental and rapid reform of the German healthcare system. About 1,800 freshman students at Leuphana University of Lüneburg were opposed to any further delay in initiating urgently needed reforms because of unbridgeable conflicts of interests. Within the scope of the Leuphana Kick-off Week, which traditionally kicks off the winter semester in Lüneburg, the young students developed proposals for a comprehensive healthcare reform and its potential characteristics during a period of five days and discussed them with about 100 experts from the field of healthcare, politics, self-administration, scholarship, and health insurance. Today, the proposals have been assessed by a prominent jury. The proposal rated best has been the one submitted by the student group called “German Insurance.” This group developed a model of a statutory basic health insurance for all, abolishing private health insurances as full-service providers. Even the great majority of the students themselves spoke out in favor of this proposal when being discussed in the audience. About 120 groups of up to 15 students each participated in developing a new, fundable and fair healthcare system. The head of the jury, Peter Clever, Chief Managing Director of the Federal Confederation of the German Employers’ Associations, praised the “high quality” of the proposals submitted and attested to the students’ high level of “professionalism.” “The results gained during the Kick-off Week have far surpassed the expectations”, the jury unanimously stated.

All proposals for reform share a common focus on solidarity-based basic health insurance, transparency in service provision and invoicing, quality assurance, and the use of new media such as the introduction of an electronic healthcare card or increased use of the Internet in caring for sick people. A solidarity-based basic health insurance provided for all people living in Germany is at the heart of the proposal rated best by the jury. Additional healthcare benefits provided by statutory health insurances as well as by private health insurances can be agreed upon. The scope of benefits provided under the new healthcare system will, to a large extent, be equal to the one currently provided. The system will be funded by the insured, the employers, and through public subsidies. Insurance contributions will be shared equally by employees and employers; they will be linked to the employees’ gross salary.

The award-winning model has been inspired through innovative approaches in the healthcare systems in Sweden and Switzerland. Students advocate the establishment of healthcare centers while also expanding out-patient healthcare services. The specialization and networking of service providers would improve medical care for patients. Special emphasis is placed on transparency and quality assurance within the system. The students are convinced that public rankings of healthcare providers will stimulate increased competition among clinics, entail a higher degree of specialization, promote more efficient use of resources and hence lead to improved quality of medical care. Finally, students call for debureaucratization of the administrative apparatus as well as for new ways of distributing medication. They also advocate the creation of a prevention fund.

In view of the complexity of the topic, the jury was surprised of the quality of the individual proposals for reform. The discussion had delivered “good results” and politicians could learn from them, the jury said. The proposals delivered by the students would not only provide fresh ideas for future debates on healthcare, but also send a strong signal of solidarity without entering into any ideological conflict. Apart from Peter Clever, the jury consisted of the following members: Ursula Engelen-Kefer, the former Deputy Chair of the German Labor Union Association; Axel Heinemann, Executive Director of Boston Consulting Group; Jürgen Kluge, Chief Executive Officer of Haniel Holding; and Raimund Becker, Member of the Board of Directors of the German Federal Employment Agency.

The simulation project was carried out against the background of a fictitious ruling by the European Court of Justice, having far-reaching consequences for public health insurances. The German Federal Government requested the major healthcare agents in Germany to develop a sustainable healthcare system. Students slipped into the role of leading representatives of statutory and private health insurances, the accident and pension insurance, the medical profession, hospital operators, the pharmaceutical industry as well as leading healthcare associations to set the cornerstones of a fundamental reform from their respective perspective.

For Holm Keller, Vice President of Leuphana University of Lüneburg and Leuphana Kick-off Week Coordinator, the hypothetical scenario of the Kick-off Week is “very realistic.” With increasing age and through advances in medicine, the percentage of people suffering from multiple diseases is increasing. Medical treatment is becoming very expensive especially during the last stage of a patient’s life. At the same time, the number of young people funding the solidarity-based healthcare system is decreasing. Moreover, changes in the labor market account for why more and more employees pay only the lowest health insurance premium possible. In the Lüneburg Innovation Incubator, a Leuphana and Lower Saxony project funded by the European Union, the topic of health is one focal area of research.

The winning team will present its proposals to the Members of the European Parliament at the Representation of the Federal State of Lower Saxony in Brussels in the spring of next year.

Within the scope of the Kick-off Week, ideas for establishing a new healthcare system were also discussed by scholars at Leuphana. During the 1. Leuphana Healthcare Discussions they met with leading health sector representatives from insurance companies, health insurances, and clinics to discuss the challenges of privatization of the German healthcare system. They, too, came to the conclusion that privatization is not a cure-all for a fundable, high quality healthcare system.