Rising own shares - Nursing home care even more expensive - pressure for reform
Home care is becoming increasingly expensive. According to an analysis by the Association of Statutory Health Insurance Funds, out-of-pocket costs for care-dependent individuals have risen despite cost containment measures in place. As of July 1, the average cost in Germany was 2,871 Euro per month for self-pay - an increase of 211 Euro compared to mid-2023. The burden also increases with enhanced relief contributions that depend on the duration of the stay in the nursing home. Demands for further easing in a nursing home reform before the 2025 federal election are growing louder due to this.
The highest supplement now amounts to an average of 1,865 Euro per month in the fourth year in the nursing home, which is 91 Euro more than on July 1, 2023. This amount includes the self-payment for care and supervision. The nursing insurance only covers a portion of the costs, unlike the health insurance. In addition, residents have to pay for accommodation, food, and investments in the nursing homes. Training costs were included in the evaluation for the first time and were also factored into the comparison values as of July 1, 2023.
Subsidies to offset costs
The new figures fuel the debate on the next major nursing home reform, which Health Minister Karl Lauterbach (SPD) has announced. Since last year, a reform has already been in effect. As of January 1, 2024, relief contributions, which are in addition to the actual payments from the nursing insurance, were increased. The self-payment for care will therefore amount to 15% instead of the previous 5% in the first year, 30% instead of 25% in the second year, 50% instead of 45% in the third year, and 75% instead of 70% from the fourth year.
The increases in payments could not be fully offset by the subsidies, as the new data show. As of July 1, the average cost for care in the first year in a nursing home was 1,426 Euro per month nationwide - a rise from the lower relief contribution in mid-2023, which was 1,295 Euro. According to the evaluation, accommodation and food costs in nursing homes have also risen. As of July 1, residents had to pay an average of 955 Euro per month for these costs, compared to 888 Euro in mid-2023.
Significant differences between federal states
There are still significant regional differences in the costs for the approximately 790,000 care-dependent individuals in nursing homes. The most expensive nursing home place in the first year of stay in North Rhine-Westphalia now costs an average of 3,200 Euro per month - the lowest self-payment in Saxony-Anhalt is 2,373 Euro. The data was evaluated based on contractual agreements between nursing insurance funds and nursing homes in all federal states, as explained by the Association of Statutory Health Insurance Funds. The Association includes, among others, the Techniker Health Insurance, Barmer, and DAK Health.
Lauterbach will present a concept for reform in the fall. This concept is about a comprehensive package for increased capacities in care personnel, stronger prevention of care needs, and closing a financial gap - as the long-term care insurance expects deficits for 2024 and 2025. Already last year, relief contributions at the care funds amounted to 4.5 billion Euro. The chairwoman of the Social Insurance Carriers Association, Ulrike Elsner, urged the states to take on the costs for investments as planned. This alone would relieve home residents on average by around 490 Euro per month.
"People are being driven into social welfare"
The German Social Association demanded that politics should not close their eyes to this dramatic development of contribution rates. "People are being driven into social welfare in their last years of life. That's a disgrace," said the Managing Director Michaela Engelmeier to the German Press Agency. Necessary is, among other things, an "appropriate federal subsidy."
The German Patient Protection Foundation stated that galloping wages and general price increases were leading to exploding contribution rates. "That's even uncalculable for people who want to make provisions and can," said Managing Director Eugen Brysch. The contribution rate for pure care should be capped and the relief contribution should be adjusted in parallel with cost development. Brysch emphasized that the cost explosion also affects home care.
Demand for a cap on contribution rates
The Alliance 90/The Left criticized that the horrendous contribution rates could only be described as expropriation now. "It's a simple state failure, how this generation is being treated, which built up this country," said party leader Sahra Wagenknecht. She demanded: "Contribution rates should not exceed the average pension and should be capped at 1,100 Euro."
The Employers' Association for Nursing stated that cost increases surprised no one. "Rising material costs and higher care wages are driving up prices," said President Thomas Greiner. The previous government had lured care recipients with the promise of higher care wages at the minimum wage. "The current government is ignoring the problem." Care workers deserve a good salary. However, if they have to deal with unnecessary paperwork, "we are wasting their valuable competence and burning money."
- Amidst rising costs for social assistance, especially for people in need of care, the SPD's Health Minister, Karl Lauterbach, is advocating for another nursing home reform before the 2025 federal election.
- The new nursing home reform, which has been in effect since last year, includes increased relief contributions, with care self-payment amounting to 15% in the first year and 75% in the fourth year.
- However, these increases in relief contributions cannot fully offset the rising costs, as shown in the latest data, with the average cost for care in the first year now standing at 1,426 Euro per month nationwide.
- In light of the rising costs, the German Social Association has criticized the dramatic development of contribution rates, stating that people are being driven into social welfare in their later years of life.
- The German Patient Protection Foundation echoes this sentiment, arguing that galloping wages and general price increases are leading to exploding contribution rates, which are becoming uncalculable for individuals who want to make provisions for their care.
- The Alliance 90/The Left has demanded a cap on contribution rates, proposing that they should not exceed the average pension and should be capped at 1,100 Euro.
