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Health Care for All

Uwe Hessler (ncy)January 13, 2007

Health insurance will become obligatory for all German citizens in the wake of a landmark reform of the country's healthcare system to come into effect in April.

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Finding a compromise on healthcare reform was like pulling teethImage: AP

The breakthrough announced by Health Minister Ulla Schmidt on Friday wasn't the first, and maybe isn't the last, in the seemingly never-ending saga of Germany's health reform. The health experts of Chancellor Angela Merkel's conservatives and their coalition partners from the Social Democrats have met on various occasions only to see their compromises unraveled by inner-party critics and from outside. Now they've come up with obligatory health insurance for all in Germany as a panacea for the ailing healthcare system.

Ulla Schmidt described the new plan as an historic move capable of resolving a series of current problems.

"As a result of rising health costs even the more affluent Germans have no longer been able to pay treatment costs without insurance," she said on Friday "And an obligatory health insurance scheme is also the best protection against abuse, because individual health costs can no longer be passed on to society as a whole."

Mit dem aufgehaengten Arztkitteln protestieren am Donnerstag, 14. Dezember 2006, Demonstranten vor dem Reichstag in Berlin gegen die Auswirkungen der Gesundheitsreform.
Last year, Doctors protested the changes already made to the healthcare system for monthsImage: AP

Obligatory health insurance was Schmidt's idea in her attempt to break an impasse in the talks over the future of private insurance companies. In contrast to public health insurance funds in which the majority of Germans are insured, the wealthiest 10 percent of the population can get private insurance which offers better services.

Insurance regardless of health or age

Until Thursday night there had been a huge dispute about whether or not private insurance companies must open themselves to uninsured people without being allowed to check on an applicant's health.

The Social Democrats (SPD) were strongly in favor of the plan, saying it was a contribution to national solidarity. The conservatives rejected it, arguing it would ruin private insurance companies.

The SPD finally dropped their demand, putting off a decision for later.

"I'm convinced the agreement we've reached no longer threatens the existence of the private insurance companies," Wolfgang Zöllner, the conservatives' chief negotiator, said. "They will remain an essential part of the German healthcare system."

A reform only for now?

Experts estimate that 200,000 to 300,000 people in Germany do not have health insurance.

Bundesgesundheitsministerin Ulla Schmidt für Frauengalerie
Ulla SchmidtImage: AP

The health experts from both the Social Democrats and the conservatives expect the reform to pass parliament in a vote in February and get approval in the upper house of parliament, which represents the federal states, soon thereafter.

Critics of the reform say that in spite of parliamentary support, the proposals are unlikely to remedy the health system's chronic cash-shortage. It will do little to reign in spiraling health costs, they say, and increase health fund revenues in view of a dwindling and ageing German population. They believe that in less than 10 years, the latest healthcare talks will turn into emergency sessions.