The nursing care reform is one of the largest reform projects that the black-red federal government has undertaken. And it is one of the biggest challenges for Carsten Linnemann. The CDU politician has been health minister for just two months. The draft for the reform came from his predecessor Nina Warken. And the plans should actually be approved in the Federal Cabinet next Wednesday - the first hurdle so that they can go to the Bundestag for a vote. But in recent days the loudest resistance to the reform package in its current form has come from the coalition partner SPD.
Therefore, in the “Report from Berlin” the Minister of Health tries first and foremost to emphasize the common line. “When it comes to caring relatives, I don’t cut corners,” emphasizes Linnemann. That's around four million people nationwide who care for relatives at home. These people “support the entire system, they are the silent heroes of our everyday life.”
SPD wants to block “pure austerity package”.
But despite such assurances, the SPD fears exactly that: that the reform package will become a “pure austerity package.” And the party's parliamentary group in the Bundestag will not support that, warned its chairman Matthias Miersch in Bild. Means: The SPD threatens to block the proposed law if no further changes are made.
And the line of critics within the SPD is getting longer and longer. These include General Secretary Tim Klüssendorf, SPD parliamentary group deputy Dagmar Schmidt, Saarland's head of government Anke Rehlinger, Mecklenburg-Western Pomerania's Prime Minister Manuela Schwesig and, most recently, the Lower Saxony state leader Olaf Lies. “First and foremost, it must be about reforming the structures - and not about cutting services and increasing burdens,” warned the latter.
A swipe at the Ministry of Finance
“So nobody wants cuts,” admits Linnemann - but one thing is certain: savings have to be made. Because long-term care insurance is “structurally underfunded”. Every year there was a shortfall of around ten percent in their coffers, so “a thumb’s up around ten billion”. And then the CDU minister passes the ball back to the SPD, specifically to the Ministry of Finance under the leadership of Lars Klingbeil. Because during the corona pandemic, “the state reached into the nursing care fund” by borrowing five billion euros to finance emergency aid. With the promise that “the money will come back,” emphasizes Linnemann. And if this money came back now, “then we would have a lot more leeway.”
Linnemann had already moved away a little from the original draft for the nursing care reform. This envisaged reducing pension insurance subsidies for caring relatives. He wants to collect this point again. But that also needs to be counter-financed, "and that's what we're struggling with these days."
“‘Care cover’ does not solve the problem”
But that is not enough for the SPD. She insists on two changes in particular as a prerequisite for a yes to the reform plans. Demand number one: a kind of citizens' insurance, a system into which everyone pays. Because private nursing care insurance has a structurally more favorable insured structure, said SPD parliamentary group vice-president Schmidt. "That's why we want a common solidarity system or at least a fair financial balance between private and social care insurance."
Demand number two: a “care cap”, i.e. a limit on the personal contribution to be made. Saarland's Prime Minister Rehlinger has already given a specific figure: 1,500 euros. From their point of view, it is a “realistic and affordable” concept that helps “those in need of care and their relatives”.
Linnemann says that such a “care cover” can be discussed. “But we wouldn’t solve the problem,” he immediately adds. Because: According to Linnemann, the 1,500 euros brought into play by the SPD refer to the so-called institution-wide own contribution. This only makes up part of the total contribution to be made and, according to the Association of Substitute Insurance Funds, is currently around 1,800 euros in the first year of stay in a care facility. According to the CDU minister's calculations, the cap would only save 300 euros.
Dispute over reforms “nothing unusual” for Linnemann
Linnemann himself advocates setting up a commission at the end of October to “make the nursing reform structurally fit” for the 2030s. Instead of just “providing first aid and putting on plasters” with measures now.
The fact that there are arguments about reforms is “nothing unusual” for the minister. The reform of statutory health insurance companies was only agreed upon two hours before the cabinet meeting. Nevertheless, in his opinion, the discussion should take place “behind closed doors” instead of “in front of the door”.
Coalition meeting planned for Monday
The SPD and CDU probably want to talk to each other sooner than planned. According to media reports, a meeting of the coalition partners is scheduled for Monday.
The central association of nursing care funds is putting pressure on these discussions to lead to a result and for the reform to be initiated. “Not acting would be fatal,” emphasized association boss Oliver Blatt in an interview with the dpa news agency. Because “there is a red alert in nursing”. By the end of the year, a deficit of 4.4 billion euros will accumulate. “In a few months the money will simply run out,” warns Blatt.
The appeal from the head of the German Patient Protection Foundation, Eugen Brysch, sounds completely different. The coalition should take its time to find a solution. Drawing “apocalyptic scenarios” only scares people. Nursing care insurance doesn't run out of money that easily. In such a case, the federal government steps in with loans. The Union and the SPD could reach a compromise “that would last for a year or two.”
