Like his CDU predecessors Gröhe and Spahn, SPD Health Minister Karl Lauterbach is not thinking of fundamentally tackling the skyrocketing expenditure and deficits of statutory long-term care insurance. The draft "reform" that has just been presented does not deserve the name. After all, Lauterbach is only concerned with listening to annual calls for an expansion of services to the best of his ability – without critically questioning the justification of these demands.
But Lauterbach would have every reason to do so, because the nursing care fund was designed in 1995 only as a partial comprehensive insurance. Larger parts of the foreseeable risk for everyone to be dependent on care in old age should therefore continue to be insured on one's own responsibility. This restriction was intended to appease the warners of the time.
They had pointed out the financial difficulties of the pay-as-you-go pension and health insurance and predicted a similar fate for the nursing care fund. Once there, the entitlements to care services would hardly be politically limited, especially in an aging society.
The warners see themselves confirmed. Expenditure on long-term care is also rising dynamically because – whether black-led or red-led – governments create additional entitlements to benefits with each "reform" and weaken the partial comprehensive character. The financing becomes a sausage: Trickery is done with federal loans and the long-term care fund, which is supposed to save a small reserve for the baby boomers. On the contributors wait again higher rates, from July they could be twice as high as when the care fund was founded.
"Those in need of care deserve our full solidarity," says Lauterbach. Anyone who disagrees is quickly left as heartless. But contributors and taxpayers have the right to know how far their "full" solidarity should go and how the minister intends to limit the cost of care. Social need must again play a greater role in the question of who the community of solidarity helps. After all, care also competes with other state and private tasks for scarce resources.