Austria's health insurance fund is planning drastic savings of 650 million euros!

Austria's health insurance fund is planning drastic savings of 650 million euros!

The Austrian Health Insurance Fund (ÖGK) has ambitious goals with regard to its financial situation. Small newspaper reports that the ÖGK wants to reduce its deficit by 650 million euros this year. ÖGK director McDonald made it clear that the budget forecast only reflects measures that have already been implemented and that the long-term aim is to achieve a black zero in 2026.

In order to achieve the financial goals, various measures are planned in the double budget for 2025/26. These include an increase in the health insurance contribution for pensioners from 5.1% to 6.0% and an increase in the e-card service fee from 13.80 euros to 25 euros. These strategies have not yet been taken into account in the current preview.

Strategies for cost reduction and oversupply

A central aspect of the reforms is the reduction of medically unnecessary oversupply. McDonald emphasized the need for such services not to be financed by the insured community. Positive feedback came from professional groups such as the physiotherapist association and orthopedics. In order to promote the separation between medically necessary and unnecessary services, an exchange takes place between the ÖGK and the Medical Association in a working group.

The forecasts for the ÖGK's financial situation are worrying: a deficit of 906.7 million euros is expected this year, which will rise to over 1.3 billion euros by 2028. The total deficit of all three statutory health insurance companies could increase from 1.073 billion euros to 1.596 billion euros by 2029, which underlines the importance of the planned savings.

Overprovision in healthcare

Parallel to the developments in Austria, studies in Germany also show that oversupply is an urgent problem. Loud PM report The Technical University of Berlin, the Techniker Krankenkasse and the Central Institute for Statutory Health Care carried out a study that identified 24 medical services whose benefits are questionable. These services are still billed regularly and cause unnecessary costs.

Particularly frequently affected are the measurement of the thyroid hormones fT3/fT4 in cases of known hypothyroidism and the determination of tumor markers without a cancer diagnosis. Every year in Germany, between 430,000 and 1.1 million of these services are classified as medically questionable, which costs between 10 and 15.5 million euros per year.

Health care financing

The context of these problems can also be seen in general healthcare spending and financing. Federal Agency for Civic Education reports that healthcare spending in Germany was 498 billion euros in 2022, which corresponds to about 12.8% of gross domestic product. Statutory health insurance (GKV) bore the majority of these costs, accounting for 53% of the expenditure.

An increase in health spending can be observed in many countries, not least due to the effects of the corona crisis. In Germany, the expenses of the statutory health insurance are financed primarily through equal contributions from the insured and employers. Administrative costs account for 5.3% of total expenses. There are also political discussions about possible citizen insurance in order to eliminate injustices in the current system.

The developments in Austria and Germany highlight the challenges that the healthcare system in both countries must overcome, particularly in relation to oversupply and sustainable financial stability.