Basic principles
In Germany, around 90 percent of people are covered by statutory health insurance (SHI).
The statutory health insurance funds, which operate independently as public corporations, are the responsible bodies. An important basis for this is the principle of self-administration. The state is relieved by delegating tasks and areas of responsibility to the providers. As social insurance providers, the health insurance funds therefore fulfill all tasks on their own responsibility under the legal supervision of the state. To this end, they have the right to self-administration by elected representatives, usually of insured persons and employers.)
Historically, there are still so-called health insurance types today:
– Allgemeine Ortskrankenkassen (AOK),
– Ersatzkassen
– Betriebskrankenkassen (BKK)
– Innungskrankenkassen (IKK)
– Deutsche Rentenversicherung Bahn-Bundesknappschaft-See
– Sozialversicherung für Landwirtschaft, Forsten und Gartenbau
Even within one type of health insurance fund, the health insurance funds are still in competition, with the exception of the AOKs.
Two other fundamental principles of statutory health insurance are the principle of solidarity and the principle of benefits in kind. The principle of solidarity ensures that every insured person receives the necessary benefits regardless of income and health risks. The principle of benefits in kind means that the benefits are provided without any financial outlay on the part of the insured person.
Financing
The distribution of financial resources for the health insurance funds is ensured via the Health Fund, which is managed by the Federal Social Security Office as a special fund of the federal government. All contributions received by the health insurance funds, including those from the individual supplementary contributions, flow into the health fund. In addition, there is a federal subsidy from tax revenue to cover the numerous non-insurance benefits such as non-contributory insurance periods for women on maternity leave.
The general contribution rate is 14.6% and, like the individual supplementary contribution, is borne equally by employers and employees. The supplementary contribution covers the gap between the flat-rate allocations from the general contribution rate based on the age, gender and morbidity (illnesses) of the members and the actual costs of a health insurance fund. The average supplementary contribution announced annually by the legislator on November 1 is only a purely statistical figure for the entire SHI system and does not reflect the actual average of all individual supplementary contributions.
More information
Further information can be found on the website of the GKV-Spitzenverband at www.gkv-spitzenverband.de