Citizens’ insurance: Are contributions really falling for everyone?

Citizens Insurance

Are contributions really going down for everyone?

The idea of ​​uniform health insurance for everyone is back in the political discussion. What is behind the concept?

The Statement by Friedrich Merz on the German healthcare system came as a surprise: The dual system, consisting of private and statutory health insurance, is perceived by many people as unfair, said the Chancellor after the meetings of the CDU party committees. He himself shares this view.

After these words, observers asked themselves: Is the Chancellor questioning one of his party’s positions here – the coexistence of private and statutory health insurance? Was Merz advocating the introduction of so-called citizens’ insurance here?

A government spokeswoman subsequently tried to summarize Merz’s statements – but the debate about the future of the German health system had already begun. But what is citizens’ insurance anyway? What would be the advantages and disadvantages of introducing it? And would it really make the healthcare system fairer?

While the health system today is divided into private and statutory health insurance, citizens’ insurance is intended to ensure that everyone in Germany is part of a uniform system. Regardless of their income, they should receive the same health care. An idea that has been discussed politically for around 20 years and has found supporters in several parties.

However, there is no uniform concept: the proposals of the proponents (SPD, Greens, Left) differ from each other. What is controversial, among other things, is what happens to private health insurance, whether those who are currently privately insured should receive grandfathering protection and on what income insurance contributions are to be paid.

All employees pay into citizens’ insurance – regardless of whether they are employees, civil servants or self-employed. How much you pay depends on your income. Some concepts for citizens’ insurance provide for a significant increase in the contribution assessment limit – meaning the income limit up to which insurance contributions must be paid.

Other concepts even provide for the complete abolition of the contribution assessment limit. That would mean: insurance contributions are due on the entire income – regardless of how high it is. This puts a greater burden on high earners in particular, who would therefore pay more than with private health insurance. Regardless of the amount of their contributions, all citizens’ insurance members receive the same benefits.

Proponents of the concept expect contributions to fall. In a report for the Left Party’s parliamentary group in the Bundestag, Bremen health economist Heinz Rothgang calculated possible reductions in contributions of up to 3.8 percentage points. While the majority of insured people would be relieved, privately insured people in particular would have to pay more than before because middle and higher incomes would be burdened more heavily.

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