Financeable, socially balanced and sustainable: How should statutory nursing-care insurance be reformed?

Since 1999 statutory nursing-care insurance has been experiencing serious problems. By the end of this legislative session, the original reserves gathered up to 1998 will be depleted. At the same time, complaints have been raised as to the increasingly deficient quality of the care. How should the nursing-care insurance system be reformed? Franz Knieps, Federal Ministry for Health and Social Protection, introduces the reform propositions of the governing coalition. In the opinion of Christa Stewens, Bavarian State Minister for Labour and Social Order, Families and Women, the definition of who needs nursing care must be rethought and the pay-as-you-go system must be supplemented by funded elements as a demographic reserve. Also Eberhard Wille and Christian Igel, University of Mannheim, see a partially funded element as a "pragmatic" solution. In contrast, Bernd Raffelhüschen, University of Freiburg, is for a complete replacement of the pay-as-you-go financing with a funded system using the "Freiburg phasing-out model" that he has proposed. This opinion is shared by Johann Eekhoff, University of Cologne, who also wishes to transfer the nursing-care insurance system to a funded, competitive system. Adrian Ottnad, IWG Bonn, favours a "private, funded nursing-care insurance for all". For Roland Eisen, University of Frankfurt am Main, "the claimed advantages of funded systems prove to be myths. But there are also a number of parametric reforms that apply the values of 'key parameters'". Examples are increasing the retirement age, stronger growth encouraged by technical progress and investment in human capital and also a "focus on prevention and healthy life-styles".