German Insurance met with applause

The German Federal Ministry of Health, social partners and experts welcome the student model of a fundable and fair healthcare system with a focus on a solidarity-based basic health insurance.

Lüneburg – Within the scope of this year’s Kick-off Week, 1,800 freshman students at Leuphana University of Lüneburg developed various models for a radical reform of the public healthcare system in the Federal Republic of Germany. The students call for a statutory basic health insurance for all and hence for abolishing the right of leaving the “community of solidarity” granted to higher-income recipients and specific professional groups. Experts from the fields of politics and society are deeply impressed with the results.

The proposals developed by the students met with great interest by the German Federal Ministry of Health. State Secretary Thomas Ilka praised not only the students’ commitment, but also the Kick-off Week concept of Leuphana University of Lüneburg. “When you have highly committed students and a university with a good concept and organization, you can obviously achieve a lot more. This commitment has also brought a great number of new and remarkable proposals for a reform of our healthcare system. Even if you don’t support all proposals, you should at least discuss them. What I particularly like about the award-winning concept is the degree to which students emphasize transparency, quality assurance and debureaucratization in the healthcare system. Although the legislature has already initiated important measures, all agents in the healthcare system are called upon to do even more to pursue this goal.”

Peter Clever, Chief Managing Director of the Federal Confederation of the German Employers’ Associations (BDA), who actively participated in the discussions with the first semester students, praised them for their work: “In developing their proposal, students have succeeded in resolving what seems to be one of the most complex socio-political problem in a practical common-sense manner. To unite nearly all stakeholders on a joint position is an achievement that shouldn’t be underestimated. I’m sure that you will come across the basic elements of the proposal in the public discussion about the development of the healthcare system in Germany.”

Ursula Engelen-Kefer, the former Deputy Chair of the German Labor Union Association who evaluated the students’ ideas in her capacity as member of the jury, sees great potential in the award-winning proposal: “The students at Leuphana have done a great job without getting bogged down in institutional turf wars. The proposal places the idea of solidarity at its center. I would be glad if politicians learned from the students and their consensus-focused work.”

The proposal has also been praised by Rainer Hess, the impartial Chairman of the Joint Federal Committee, in which service providers, cost centers and patient representatives decide on healthcare issues in Germany: “The approach to solving healthcare problems by creating a broad discourse among students with support from experts gave great pleasure not only to me, but apparently also to the students, and it finds my explicit approval.”

The key points of the award-winning proposal – it received the majority of the votes cast by the students in an audience voting procedure – is a solidarity-based basic health insurance, transparency in service provision and invoicing, quality assurance, and the use of new technologies such as the introduction of an electronic healthcare card or increased use of the Internet in caring for chronically sick people. However, great importance should be attributed to the issue of personal data protection.

A solidarity-based basic health insurance provided for all people living in Germany lies at the heart of the proposal. In the future, arrangements on additional healthcare benefits should be possible only with private health insurances. The scope of benefits provided under the new healthcare system will, to a large extent, be equal to the one currently provided and is intended to be continuously expanded. A committee such as the Joint Federal Committee (GBA) will determine the scope of benefits provided under the solidarity-based basic health insurance. Key criteria for the benefits catalogue should be social acceptance and valid methods of treatment. Innovations should always be evaluated in terms of their actual usefulness to patients before they are admitted as a standard treatment. In particular, incentives should be provided for pharmaceutical companies to further strengthen their research and development activities instead of promoting existing drugs.

As before, the system will be funded by the insured and the employers. On the employer’s side, insurance contributions will be based upon the gross salary paid by the employer, whereas on the insured’s side, insurance contributions will be based on his or her total taxable income, which also includes income from capital gains or lettings. In addition, income received from taxes on alcohol, tobacco and other semiluxury food should be used to finance the system; the same should apply to parts of an increased inheritance tax.

The award-winning model has been inspired by innovative approaches in the healthcare systems in Sweden and Switzerland. Students advocate establishing healthcare centers and strengthening the position of the general practitioner as a first point of contact for patients while also expanding out-patient healthcare services. Specialization and networking of service providers would improve medical care for patients.

Students place special emphasis on transparency and quality assurance within the system. They are convinced that public rankings of healthcare providers will stimulate increased competition among clinics and physicians, 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 trading in drugs and medical aids.

They also advocate creating a prevention fund the funding of which will be guaranteed jointly by the employers (through the accident insurance), the pension insurance companies, and the health insurance companies.

Holm Keller, Vice President of Leuphana University of Lüneburg and in charge of the Leuphana Kick-off Week, is very pleased with the reactions to the students’ work: “I am very impressed with the unanimous support that the proposed model has received from both social partners and leading representatives of the healthcare system.” According to Keller, the positive reactions showed that the students had done a good job and had presented a realistic proposal for reform of the German healthcare system.

Every year, the Kick-off Week at Leuphana poses a real challenge for all freshman students right at the beginning of their studies: During one week, they work with an interdisciplinary team to find a solution for a complex problem. This semester kick-off event is part of Leuphana’s College model introduced in 2007 – a prize-winning model that is unique within the German academic landscape.