"You Can't Always Get What You Want" -- MEDICA - World Forum for Medicine

"You Can't Always Get What You Want"

Photo: Sign for percent

The AOK does not believe that
premium rates of 15,5 percent will
be suffice for a long time; © SXC

MEDICA.de talked to Udo Barske, spokesman of the Federal Association of the AOK, about the attitude of the health insurance AOK towards the health fund, future premium rates and the Rolling Stones.

MEDICA.de: Mister Barske, the AOK was not always in favour of the health fund: when and why did you change your mind?

Udo Barske: When the legislator has spoken, the AOK makes the best for their insured out of the decided regulations. It was this way already in earlier cases, and it holds true just as well for the competition reinforcement law and the health fund included therein.

MEDICA.de: What exactly does the health fund mean to you as a statuory health insurance?

Barske: It means to us just the same as to any other statuory health insurance: the premium rates cannot be regulated by the insurancies any more. Now, the government takes the decision and the responsibility for it.

MEDICA.de: They say that the fund is juster that the previous health care system. From your point of view: was the old system unjust?

Barske: Each insured person is entitled to medically necessary benefits, not matter his or her income. This has already been the case and it will be just the same in future. In addition, each insured person now pays the same percental premium rate. That means more social justice, even though this could already have been put into execution without the fund.

MEDICA.de: Through the morbidity oriented risk structure compensation scheme (Morbiditätsorientierten Risikostrukturausgleich, or short: Morbi-RSA), insurancies receive more money for insured with certain illnesses than for others. Why is the Morbi-RSA thus important for you?

Barske: For the many seriously ill insured it is important that their insurancies have the necessary resources to provide for good medical treatment. With the Morbi-RSA, this will work out better. For many seriously ill in the AOK or other statuory health insurancies this is advantegous.

MEDICA.de: Primarily, widespread diseases as back pain should not be included in the Morbi-RSA. The AOK was in favour of it. Why?

Barske: If physicians have to do a lot to help ill people, then this has to be affordable. It would be nonsense if money was missing to pay physicians when they can help.

MEDICA.de: Since the fund has not built up a liquidity reserve for 2009 yet, the state is going to take over the financial risk for the fund in this year. If money is lacking, the state pays. The health insurancies are therefore safe througout the economy crisis?

Barske: Yes. At least in 2009. Financial needs are covered by a loan of the state in 2009. But the loan has to be payed back in 2010.

MEDICA.de: Exactly, in 2010 the fund and with it the health insurancies are to pay back the money to the state. Do you believe that this will be possible with a premium rate of 15,5 percent?

Barske: The gloomy market forecasts do not argue for that.

MEDICA.de: The insurancies have to budget economically to avoid additional premiums. Will healthy persons be neglected - will cost-intensive prevention schemes be cancelled?

Barske: Prevention is not only for healthy people. And for example to help an overweight person to live healthier does not have to be expensive. Prevention also means: averting that diabetic patients lose their eyesight. With the Morbi-RSA, this will also be possible in future.

MEDICA.de: Would you have preferred Morbi-RSA without health fund?

Barske: As the Stones sing: „You can’t always get what you want.”

The interview was conducted by Anke Barth.