Web-economic-crisis-health-systems-and-health-web

330 Economic crisis, health systems and health in Europe: country experience
• The health sector is to achieve a cost-containment of €3.4 billion between
2012 and 2016. This should be achieved through a global budget cap for
public spending on health (growth in health care expenditure should not
exceed predicted annual GDP growth): 60% of the savings are to be generated
by the regions (länder) and 40% by the sickness funds (2013).
• SHI figures for 2013 indicate a much lower level of indebtedness than
projected, largely because of higher than expected revenues but also
because of a slowdown in nominal health spending growth (5% a year
pre-crisis to almost 0% in 2012), a trend that is expected to continue.
• Introduction of a budget ceiling at the federal level requiring federal
ministries to adhere to multiyear spending ceilings (2011). As the federal
level only finances about 5% of total public spending on health (with the
biggest share of this amount allocated to hospital care), the impact of this
measure on health spending is likely to be marginal.
Changes to health coverage
Population (entitlement)
• Extended access to health insurance to recipients of a minimum income
scheme who were previously not entitled (about 35 500 people, mainly
children) (2012).
The benefits package
• Extended sick leave benefits to the self-employed, entitling them to €27 per
day after the 43rd day of sickness (2012).
• Expanded ambulatory dental care benefits for the whole population by
allowing dental clinics owned by sickness funds to offer a full range of dental
services, including dentures (2012).
• Expanded list of occupational diseases covered by SHI (2012).
• Expanded accident insurance coverage for foster children (2012).
User charges
• Capped user charges for prescription drugs at 2% of annual net income
per calendar year for people with low incomes and high drug consumption
(intended to benefit around 300 000 people); some lack of clarity as to who
will finance the cap (2008).
• Increase in the annual cost of the e-card proving eligibility for statutory
coverage from €10.00 to €10.30, with exemptions for non-contributing
dependants (2013).