Neue Diskussionen um Zusatzbeiträge in der gesetzlichen Krankenversicherung

Die gesetzlichen Krankenversicherungen haben schon längerem das Problem der Unterfinanzierung. Denn die Höhe ihrer Einnahmen hängt im Wesentlichen von einem festen Beitragssatz ab, der die Beiträge der Mitglieder (einschließlich Arbeitgeberbeiträge) über den Gesundheitsfond an die einzelnen Kassen verteilt. Anders als früher ist die Möglichkeit für Beitragssteigerungen stark begrenzt: 8 Euro monatliche Zusatzbeiträge für Mitglieder ist zwar ohne Einkommensprüfung möglich, doch scheuen sich viele gesetzliche Krankenkassen dieses Instrument der Zusatzbeiträge zu nutzen, weil dann die Gefahr besteht, dass die Mitglieder zu einer anderen Krankenkasse wechseln. Wie auf welt.de berichtet wurde, ist es bisher zu einer regelrechten Wechselwelle nach Zusatzbeiträgen in der gesetzlichen Krankenversicherung gekommen.

Denn mit einer solchen Einführung  von  Zusatzbeiträgen wird das Mitglied einer gesetzlichen Krankenkasse geradezu motiviert, über die Möglichkeit nachzudenken, ob nicht ein Wechsel  zu einer günstigeren Krankenkasse nun angesagt ist. Dabei sollte man aber genau die Alternativen recherchieren, denn es ist durchaus denkbar, dass eine Krankenkasse trotz Zusatzbeiträgen interessanter für das jeweilige Kundenprofil ist. Es wäre wenig sinnvoll, wegen der 8 Euro Zusatzbeiträge zu einer Krankenkasse zu wechseln, die dann nicht die Leistungen bietet, die man für seine persönliche Gesundheitsfürsorge benötigt.

Längerfristig könnte es zu einer starken Ausweitung der Zusatzbeiträge kommen, die dann den Wechsel der Krankenkasse noch uninteressanter machen. Dieser Punkt ist in der Regierungskoalition sehr umstritten, denn die CSU will Veränderungen bei Zusatzbeiträgen nur zustimmen, wenn stärker soziale Gesichtspunkte berücksichtigt werden. Dies könnte so aussehen, dass auch die Zusatzbeiträge an das Einkommen der Mitglieder der Krankenkasse prozentual gekoppelt würden. Eine Idee, die der Koalitionspartner FDP komplett ablehnt, denn dort wollte man die Krankenkasse mittels Gesundheitspauschale ursprünglich komplett von der Einkommenshöhe abkoppeln.

Wie Nicola Kurt in ihren Blog berichtete, bemüht man sich mit hohem Aufwand seit Monaten in der Regierungskommission zur Gesundheitspolitik über Sparmaßnahmen sich zu einigen, damit das Defizit der gesetzlichen Krankenkassen begrenzt bleibt. Doch auch hier scheint man nicht recht voran zu kommen, weil die Interessenlagen der Beteiligten nicht unter einen Hut passen.

Nun wird mit Bezug auf die Frankfurter Rundschau berichtet, wie die Gestaltung der Zusatzbeiträge aussehen könnte. Bis zu einer Einkommenshöhe von 1400 Euro könnte der maximal mögliche Zusatzbeitrag auf ein Prozent des Einkommens begrenzt bleiben. Darüber hinaus könnten dann die Zusatzbeiträge bis auf 2,5% des Einkommens ansteigen.  Für Gutverdienende könnten damit die monatlichen Zusatzbeiträge auf bis knapp unter 100 Euro ansteigen, womit bei diesen die Motivation zur Mitgliedschaft in einer gesetzlichen Krankenkasse tangiert wäre.

Insgesamt verunsichert diese Diskussion um Zusatzbeiträge bei der gesetzlichen Krankenversicherung die Mitglieder, die bereits jetzt durch Praxisgebühr und Einschränkungen der Versorgungsleistungen verärgert sind.

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