According to a study, including civil servants and pensioners in statutory health insurance would massively ease the burden on public budgets. If they were subject to the same compulsory insurance as employees, the public coffers could save around 60 billion euros by 2030, according to a study by the Bertelsmann Stiftung.
Two-thirds of the three million civil servants and pensioners currently covered by private health insurance would then have to be insured in the statutory health insurance system. In addition, the study ames that a further 21 percent would voluntarily switch to statutory health insurance for financial reasons, which would mean that nine out of ten civil servants would be covered by statutory health insurance. This would save the federal government 1.6 billion euros and the states 1.7 billion euros in the first year alone, according to Reuters.
The federal states would have to pay the usual employer's contribution for their legally insured civil servants. This would be less in the federal government and most of the states than what they currently spend on tax-funded aid. According to the study, 13 of 16 federal states would be relieved in the long term – only Saxony, Bremen and Mecklenburg-Western Pomerania would be slightly burdened. In 2014, the federal government reportedly spent 4.5 billion euros on civil servant allowances. The states had to spend 7.4 billion euros on it in the same year.
Statutory health insurance would also benefit. The additional expenditures for the care of civil servants and pensioners amounting to almost twelve billion euros would be offset by additional revenues from contributions of more than 15 billion euros. The positive balance of 3.4 billion euros could lower the contribution rate by 0.34 percentage points.
In return for the relief for households, doctors would have to forego income on a large scale, since the higher payment for privately insured civil servants would be eliminated for them, says health expert Stefan Etgeton.
The president of the German Medical Association, Frank Ulrich Montgomery, criticized the authors for coming up with a scenario "that lacks any legal, political or social sense of reality. The model has not been evaluated in terms of constitutional or civil service law. The model is nothing other than the "gravedigger of the dual health insurance system and the precursor to a single health insurance fund". Standardized systems lead to rationing, waiting times and benefit limitations.
The health policy spokeswoman of the CDU/CSU parliamentary group, Maria Michalk, also attested to the study's shortcomings. In addition, the coexistence of private and statutory health insurance and the associated system competition would have proven its worth with regard to the quality of health insurance in Germany. SPD parliamentary group vice-chairman Karl Lauterbach explained meanwhile, against the inclusion of officials into the GKV neither constitutional nor financial reasons speak. The study shows: "The time is ripe for an orderly introduction of citizen insurance."This is also desired by most citizens.