The BARMER Care Report, which is published annually, assesses current care policy and documents the care situation in Germany. For the report, Professor Heinz Rothgang, Corinna Burfeindt, Dr. Jonas Czwikla and Dr. Rolf Müller from the SOCIUM at the University of Bremen comprehensively evaluated data from long-term care and health insurance statistics as well as from the BARMER health insurance company.
Rise in Number of People Needing Care Mainly Due to Expansion of Long-Term Care Insurance Benefits
Over the past ten years or so, the number of people in need of care in Germany has risen sharply. According to BARMER data, the proportion of the population in need of care has nearly doubled, rising from 3.21 percent in 2015 to 6.24 percent in 2023. However, only around 15 percent of this increase can be explained by demographic developments.
This year’s main chapter focuses on the extent to which the increase can be attributed to a higher incidence of illnesses in the population – also known as the disease burden. The report distinguishes between sudden, acute events, such as a stroke or cancer diagnosis, which require immediate care decisions, and the slow, gradual changes caused by progressive illnesses such as Parkinson’s disease, which can be challenging or overwhelming for relatives to manage over time. The likelihood of becoming dependent on care within twelve months of diagnosis varies by type of illness.
While the suddenness of care-triggering events can influence the type of care and the duration of care dependency, the reasons for the overall increase in care needs lie largely outside of demographic trends and disease prevalence. The increasing number of people requiring care is primarily due to the expansion of benefits provided by the long-term care insurance system and broader eligibility criteria for these benefits. The introduction of the new definition of “care dependency” in 2017, which more accurately accounts for people with dementia and other cognitive or psychological impairments, has contributed significantly to this increase. This finding is politically significant because the federal government has stipulated that the planned “major care reform” should only include expenditure increases caused by demographic change. However, if demographic factors play only a minor role in rising costs, this stipulation by the government would ultimately result in benefit cuts.
Financing Problems of Long-Term Care Insurance Persist – No Concrete Reform Proposals Yet
The financing problems of the long-term care insurance system persist. Nationwide, the average personal contribution for care in a residential facility now exceeds �3,100 per month in the first year – far more than people with average retirement incomes can afford. According to the report’s authors, the long-term care insurance system is increasingly failing to achieve its goal of preventing impoverishment due to care needs. At the same time, the system is facing a deficit this year, which is expected to grow further next year. The federal government’s coalition agreement calls for a federal-state working group to develop the foundations of a “major care reform.” “The contribution rate for long-term care insurance has increased at ever shorter intervals in recent years. Politicians must find ways to effectively reduce and cap personal contributions without raising the contribution rate,” says Professor Heinz Rothgang. “There are numerous proposals to limit personal contributions by changing benefit rules and financing regulations within the existing social insurance system, and policymakers need to consider and evaluate these,” adds the care economist.
Further Information:
Contact:
Prof. Dr. Heinz Rothgang
SOCIUM – Research Center on Inequality and Social Policy
Mary-Somerville-Stra?e 3
28359 Bremen
Phone: +49-421-218-58557
Email: rothgangprotect me ?!uni-bremenprotect me ?!.de
Dr. rer. pol. Rolf Müller
SOCIUM – Research Center on Inequality and Social Policy
Mary-Somerville-Stra?e 3
28359 Bremen
Phone: +49-421-218-58554
Email: rmintprotect me ?!uni-bremenprotect me ?!.de
