Federal Health Minister Nina Warken (CDU) has announced increased financial burdens for those requiring long-term care and warned of a massive, multi-billion deficit should no reform of the long-term care insurance system be implemented. It must be clearly defined “what the long-term care insurance system is capable of covering,” Warken told the Rheinische Post on Saturday. Meanwhile, patient advocates and the Left Party warned against making cuts at the expense of the most vulnerable—particularly children.
Long-term care insurance is “a form of partial coverage and cannot step in to cover the entire costs in the event of a need for care,” Warken clarified. For years, expenditures have exceeded revenues, yet nothing has been done to address this. “That is coming back to haunt us now.” Furthermore, an increasing number of people are being classified as in need of care—a trend, however, that can only be explained to a small extent by demographic developments, the Minister added.
Since the introduction of a new definition of care dependency in 2017, the number of eligible beneficiaries has doubled and, at over six million people, is now “far higher than was projected at the time,” Warken continued. The system now also covers groups that no one at the time imagined would be included—such as many children and adolescents with ADHD.
Warken put the projected deficit for 2027 and 2028 at a combined total of 22.5 billion euros. “Current spending trends are already jeopardizing the solvency of the long-term care insurance funds this year,” she added. Plans now include, among other measures, tightening the eligibility criteria for classification into care grades and “stretching out” the allocation of subsidies for residential care stays. Furthermore, the contribution assessment ceiling is to be raised in order to place a “slightly heavier” burden on higher incomes.
Eugen Brysch, Chairman of the Patient Protection Foundation, criticized the assertion that care-dependent children bear partial responsibility for the deficit. This amounts to “deliberate public deception,” Brysch told AFP. “After all, only around two percent of the six million people requiring assistance fall into this age group.” Brysch insisted that Warken must “under no circumstances” downplay the care needs of children. A significant proportion of those affected, he noted, have been assigned care grade 2 or 3 due to serious impairments.
Sören Pellmann, parliamentary group leader for The Left (Die Linke), told AFP that instead of tackling the “truly necessary fundamental reforms,” Warken intends to “make cuts affecting the most vulnerable.” What is needed, he argued, is a restructuring of the system into a comprehensive long-term care insurance scheme—one “that fully covers the risk of needing care” and to which everyone contributes. Pellmann added that he expects the announcement regarding asking higher earners to contribute more financially to turn out to be merely “cosmetic.”
The Association of German Elderly and Disability Care called upon Warken to provide “concrete solutions” and “genuine long-term care reform.” Such reform, the association argued, must provide answers to the two central challenges facing the care sector: how to ensure intergenerationally equitable financing for long-term care insurance, and how to guarantee nationwide coverage despite the persistent shortage of skilled staff.
The Association of Private Health Insurance (PKV) described the figures regarding long-term care insurance as “alarming” and welcomed Warken’s reform plans. “Long-term care insurance must focus its benefits on those who truly need them,” the PKV stated. It is therefore appropriate, the association noted, that Warken intends to re-prioritize the assessment criteria for care needs. The statutory long-term care insurance system “is—and will remain—a partial-coverage system,” the association continued. Consequently, additional private provision and greater personal responsibility are essential.
AFP