On the recently presented nursing care reform by Federal Minister of Health Nina Warken and the subsequent criticism by the Saarland Minister of Health Magnus Jung, the health policy spokesperson of the FDP Saar, Dr. Helmut Isringhaus, states:
„Minister Warken's draft reform has a regulatory Janus face. While it contains fundamentally correct structural reforms, it fails in terms of financing and one-sidedly shifts unresolved problems onto contributors, care-dependent individuals, municipalities, employers, and care facilities.
Particularly critical is the impending burden on our Saarland cities, municipalities, and districts. If inpatient care subsidies are slowed down, personal contributions will continue to rise. The inevitable consequence is that more and more people in need of care will fall into assistance for care. These costs ultimately end up in the municipal social budgets – in Saarland, this means indirectly also for cities and municipalities through district and regional association levies. Those who reform in this way are restructuring the long-term care insurance at the expense of the municipal level.
What is also remarkable, however, is the reaction of Health Minister Magnus Jung. Germany is once again witnessing public disputes within the Berlin coalition. When an SPD health minister from Saarland openly criticizes the plans of the CDU Federal Health Minister, it primarily shows one thing: this coalition has no unified approach to care. Especially on such a crucial future issue, those in need of care, relatives, institutions, and municipalities need reliability rather than public coalition skirmishes.
Also Jungs Gegenfinanzierung is not convincing. Linking the care reform with the inheritance tax is inappropriate and politically transparent. Care does not become intergenerationally fair by opening another tax barrel. Those who want to use the inheritance tax to finance care ultimately affect family businesses, owner-occupied homes, and the middle class – precisely the substance that urgently needs to be preserved in Saarland.
Equally unhelpful is the blanket call for the takeover of additional services from tax funds. Of course, non-insurance benefits must be clearly identified. But those who simply call on the federal government are only shifting the problem to the federal budget. There, it is obviously not supported by the SPD-led Ministry of Finance. Long-term care insurance does not need new transfer points between contributors, taxpayers, and municipalities, but an honest structural reform.
Warken not only shifts the costs onto those in need of care and municipalities, but also onto employers. Higher contribution assessment limits mean higher ancillary wage costs. This is poison for employment, small and medium-sized enterprises, and competitiveness – especially in Saarland with its already strained economic structure. A care reform that makes work more expensive is not a reform, but a burden program.
The draft on the issue of personnel is an absolute shot in the dark. The minister is ignoring the imminent worsening of the staff shortage as the baby boomer generation retires. At the same time, the proven collective agreement refinancing is at risk, and it is becoming more difficult for facilities to pay their employees well, which threatens the very existence of the provider landscape. We finally need genuine debureaucratization: a non-bureaucratic presumption of competence for international nursing staff, faster recognition procedures, and a pragmatic flexibilization of the skilled worker quota, so that facilities do not have to close beds due to rigid regulations even though qualified assistant personnel are available.
From a liberal perspective, it is correct to more closely scrutinize access to lower care levels and to critically question the relief amount at care level 1. In the past, care services were sometimes offered far too aggressively by providers. This promoted mismanagement and free-rider effects. Long-term care insurance must not be comprehensive insurance for every minor impairment. The focus must once again be more strongly placed on prevention, rehabilitation, personal responsibility, and targeted assistance in cases of genuine need for care.
The FDP Saar therefore calls for a fundamental revision of the draft. Neither Warken's tax increases nor Jung's tax fantasies solve the problem. What is needed are generationally fair, funded pension schemes, a clear limitation of non-insurance benefits, genuine deregulation, more personnel recruitment, and protection of municipalities from further exploding social expenditures.”
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