Health Insurance funds and German National Health Fund Surpluses: Abolishing Practice Fees, Reducing Contributions or Accumulating Reserves. What makes sense?

Germany's health insurance funds and national health fund are currently running surpluses of over 20 billion euros. For Daniel Bahr, German Minister for Health, these surpluses leave scope for the payment of bonuses, on top of the abolition of practice fees. However, in his view the central challenge facing a sustainable health policy is to make the provision of medical services in German financeable on a long-term basis by implementing competitively oriented reforms. According to Jürgen Graalmann from the AOK association, the coalition decision has largely exhausted any scope for distribution policy changes. According to Hendrik Jürges, Bergische University of Wuppertal, the health fund surpluses should be seen as an opportunity to re-adjust health insurance in a competition-oriented manner. The abolition of practice fees, on the other hand, is a healthcare policy aberration in his view. It would be better to lower contributions and to strengthen long-term competition between health insurance funds. Wolfgang Greiner, University of Bielefeld, sees the current health insurance fund surpluses as a "transitional phenomenon". To intensify price competition between the health insurance funds, different ranges of services should be offered. Mathias Kifmann and Maximilian Rüger, University of Hamburg, propose using the surpluses as the start-up capital for a "healthcare sustainability fund".