Pity the poor statutory insurers
publication date: Mar 11, 2010
Feel sorry for the statutory insurers who pay for healthcare for the citizenry of France, Germany, Belgium, the Netherlands, Switzerland and the Czech Republic. No one loves them.
We look in-depth at the future for these insurers in our first issue out at the end of the month. What is clear is that they are perceived by the left as a barrier to the building of a state-run NHS.
In Germany, Ulla Schmidt, the Social Democrat Health Minister in the last coalition hardly bothered to conceal her disdain. She introduced a new law which with effect from January 2010 robbed them of almost all of their powers to differentiate their offering and to control pricing.
The Socialist Party in Switzerland is pushing for a referendum on replacing them with a single unitary payor. Paul Rhyn at Sante Suisse sighs and says: “If the referendum was held now it would probably pass – everyone hates banks and insurers.” Thankfully it is not likely to see daylight for three years.
But the right hardly loves the concept of mutuality. They may also see these insurers with their limited powers and quasi public sector culture as impediments to the introduction of a free market. Everyone in Germany is waiting with bated breath to see what young Stefan Rosler, the new health minister decides. The bet is that he may give them more freedom. But with healthcare budgets looking increasingly tight it is far from clear that he will give them back their autonomy.
Meanwhile, in Belgium, mutuals face direct competition from aggressive private sector insurers led by German multinational DKV. Within two years they will have been stripped of special their tax privileges.
Part of the problem is that their customers do not exactly love the insurers. Says Rhyn at Sante Suisse: “When rates went up sharply last year, all the commentators and consumers focused on the very small amount we spent on administration and marketing and completely ignored the bigger picture.”
This tends to leave the insurers impotent to make real changes and losing their powers. The only exception is the Netherlands where insurers are allowed to strike special deals in a larger and larger part of the market (30% today and eventually 50%) and are even contracting with providers in Germany and Belgium.
We look in-depth at the future for these insurers in our first issue out at the end of the month. What is clear is that they are perceived by the left as a barrier to the building of a state-run NHS.
In Germany, Ulla Schmidt, the Social Democrat Health Minister in the last coalition hardly bothered to conceal her disdain. She introduced a new law which with effect from January 2010 robbed them of almost all of their powers to differentiate their offering and to control pricing.
The Socialist Party in Switzerland is pushing for a referendum on replacing them with a single unitary payor. Paul Rhyn at Sante Suisse sighs and says: “If the referendum was held now it would probably pass – everyone hates banks and insurers.” Thankfully it is not likely to see daylight for three years.
But the right hardly loves the concept of mutuality. They may also see these insurers with their limited powers and quasi public sector culture as impediments to the introduction of a free market. Everyone in Germany is waiting with bated breath to see what young Stefan Rosler, the new health minister decides. The bet is that he may give them more freedom. But with healthcare budgets looking increasingly tight it is far from clear that he will give them back their autonomy.
Meanwhile, in Belgium, mutuals face direct competition from aggressive private sector insurers led by German multinational DKV. Within two years they will have been stripped of special their tax privileges.
Part of the problem is that their customers do not exactly love the insurers. Says Rhyn at Sante Suisse: “When rates went up sharply last year, all the commentators and consumers focused on the very small amount we spent on administration and marketing and completely ignored the bigger picture.”
This tends to leave the insurers impotent to make real changes and losing their powers. The only exception is the Netherlands where insurers are allowed to strike special deals in a larger and larger part of the market (30% today and eventually 50%) and are even contracting with providers in Germany and Belgium.