The latest reform of long-term care insurance in Germany (Pflegeversicherung), due to take effect in 2021, is likely to be more extensive than initially thought - and Federal Health Minister Jens Spahn is looking to both the state and childless people to foot the bill. 

Germany to enact wide-reaching reform of long-term care system

According to a key issues paper that was made available to the Redaktionsnetzwerk Deutschland, Spahn wants to enact wide reaching reforms to long-term care insurance to relieve those in need of care and their families. The paper states: “Almost 25 years after the introduction of long-term care insurance in Germany, it is time to rethink the basic structures and make them fit for the future.” 

The paper states that the system’s sustainability can only be ensured by providing relief to family carers in the form of benefits, and reducing the personal contributions of those in need of care. 

The first proposed measure is therefore to cap the individual contribution for inpatient care to 700 euros per month (excluding rent and meals) for a maximum of 36 months. Spahn also plans to increase both the care allowance (Pflegegeld) and the home care assistance allowance by five percent from July 1, 2021. From 2023 onwards, these allowances will continue to rise in line with inflation. Subsidies for care aids would also be increased. 

Individuals who act as full-time carers to their relatives will also benefit from the proposals, since Spahn wants to put them in a better position when it comes to pensions: “As in the case of time taken off to raise a child, the federal government will in future pay contributions to pension insurance for people who care for relatives,” the paper states. 

Reform looks to childless people to foot the bill

So who’s going to pay for all of these changes? In a nutshell: childless people. Individuals aged 23 and above who do not have children already pay a long-term care contribution rate that is 0,25 percentage points higher than those who are mothers and fathers (3,3 percent of their annual salary, compared to 3,05 percent). From 2021, this could go up by an additional 0,1 percentage points. 

The key points paper justifies this increase on the following grounds: “In its 2001 ruling, the Federal Constitutional Court emphasised the special importance of families with children for the functioning of the social security system and called for this to be taken into account in the financing of the long-term care insurance system.” 

Spahn is also asking for additional funding from the federal states, who are being requested to put up a monthly allowance of 100 euros for every person in need of full inpatient care.