Long-term care leads to poverty. That’s already the case today. The out-of-pocket cost for inpatient care now averages 3,254 euros per month. Many people in need of care and their families cannot afford such sums.
The result: About 37 percent of those in need of care rely on social assistance, as a study by the DAK health insurance provider shows. The federal government’s current long-term care reform does not solve this problem.
On the contrary: Federal Health Minister Carsten Linnemann (CDU) is making long-term care even more expensive for many people. The draft bill currently under consideration in the Bundestag is little more than yet another austerity and burden-shifting law—just as the most recent health care reform was.
Cut, cut, cut?
The common thread running through the bill is: cut, save, eliminate.
For example, the federal government plans to:
- Higher thresholds for classification into a long-term care level:
Redesigning the long-term care levels will not reduce the need for care. It will only cut benefits for those affected.
- An increase in the supplementary contribution for childless individuals to0.9 percent:
This measure does not solve the structural problem of long-term care insurance and discriminates against childless individuals.
- A 0.52 percentpremium surcharge for the co-insurance of spouses or domestic partners.
Those who bear the brunt of all these measures are the insured, those in need of long-term care, and their relatives. IG Metall rejects such a long-term care policy.
“The long-term care crisis continues to be merely managed, with additional financial burdens placed on childless individuals or co-insured persons, for example,” says Ralf Reinstädtler, Social Affairs Director at IG Metall. “The fundamental and structural problems in long-term care are not being solved. Employees face higher out-of-pocket costs, no contribution from privately insured individuals, no state coverage of COVID-19 costs, and no fairer financial basis.”
The fact that large-scale social protests can achieve a great deal is demonstrated by Health Minister Linnemann’s concession on a key point: at least when it comes to pension contributions for family caregivers, he will not make cuts. Originally, the pension contributions paid by the long-term care insurance fund to family members were supposed to decrease . This would have primarily affected women, as they provide about 70 percent of private long-term care.
Plugging financial gaps—but fairly!
One thing is clear: the long-term care insurance system is facing a severe financial crisis. The Federal Ministry of Health projects a deficit of around 22 billion euros for 2027 and 2028.
This trend is driven by a rapid increase in the number of people in need of long-term care. According to the Federal Statistical Office, there are currently 5.7 million people in need of long-term care in Germany. Forecasts indicate that this number could rise to as many as 7.6 million by 2028.
Eighty-six percent of all people in need of long-term care are cared for at home—either by care services or by family members. Fourteen percent are cared for in nursing homes.
Family caregivers often reduce their working hours or give up their jobs entirely to provide care. There is no compensation for the loss of income.
Long-term care insurance therefore needs a fundamental reform. But laws aimed solely at cutting costs do not solve the problems. They merely postpone them into the future and are socially unjust.
How the “Care Restart” Can Work
IG Metall proposes a different approach to long-term care policy: a fairer one.
Step one: a cap on so-called “co-payments”—that is, the portion of long-term care costs that insured individuals or their family members must cover themselves.
Step two: The federal government must repay the long-term care insurance system the funds that were used for other purposes during the COVID-19 pandemic.
Step three: The federal states must finally honor their commitments and cover the so-called investment costs—that is, the costs of maintaining nursing homes.
And finally, the biggest and most important step: the introduction of a universal health insurance system into which all working people contribute. In the future, it should cover all long-term care-related costs, not just a portion: comprehensive coverage instead of partial coverage.
It would be a major step toward greater social security in an increasingly aging society. A large majority of IG Metall members support this demand.
Ending a Two-Tier Society
A citizens’ insurance system puts the financing of long-term care on a broad base. So far, privately insured individuals are not included in long-term care insurance. However, they often have above-average incomes and fewer health risks. Because of this separation, the statutory long-term care insurance system is fundamentally at a disadvantage.
A universal insurance system would end this division. A true community based on solidarity would emerge.
The Alliance for Comprehensive Long-Term Care Insurance Based on Solidarity, of which IG Metall is a member, has demonstrated in an expert report that switching to a universal insurance system would allow for comprehensive coverage to be financed in a virtually cost-neutral manner.
Long-term care would then no longer drive people into poverty, as has often been the case up to now.
It would be thepath of solidarity toward good long-term care and greater justice.
