Erich Koch, a representative of the German Farmers' and Agricultural Workers' Health Insurance Fund, visited the Lithuanian National Health Insurance Fund under the Ministry of Health (NHIF) nd shared his experience of nursing and long-term care organization as well as funding in Germany.
NHIF Director Gintaras Kacevičius, Deputy Director Viačeslavas Zaksas as well as other representatives from NHIF and Territorial Patient Funds, greeted the delegation from Latvia.
The guest said that in Germany the provision of long-term care and funding is regulated by a separate law. Long-term care and nursing services are funded from a separate long-term care and nursing fund. Separate long-term care insurance institutions-nursing funds are responsible for administration of such fund. The long-term care and care insurance in Germany is a separate type of social insurance.
According to Erich Koch, 90 percent of all German residents are insured by the public social insurance, whereas 10 percent are insured by public long-term care and nursing insurance. Currently, the long-term care and nursing fund's income amounts to EUR 36.1 billion. 3,3 million people used the services of this fund in 2017.
Long-term care and nursing insurance contributions amount to 3.05 percent from income. A part of this contribution is paid by the employer, the rest part- by the employee. The part paid by the employee is 1.53 percent. The guest emphasized that each year the amount of the contribution increases slightly, as the need for such services increases. By 2050 it is projected that the number of people over 80 years of age will triple and more care services will be required as life expectancy increases. It is estimated that 0.6 percent of people under 60 years of age, 3.9 percent of 60-80 years old, and 32 percent of over 90 years old use this type of services. In order to meet the growing demand, it is planned to gradually increase the contribution to 8 percent from income.
In Germany, there are 5 levels of nursing, depending on the degree of self-sufficiency and, the necessary social and health care services. A team of doctors and nurses decide to which level a person shall be assigned. While performing assessment, particular attention is paid to the individual's ability to self-care, socialize and participate in society. The higher the level of care a person is assigned to, the more complex assistance and the more health care he receives. The amount of benefits depends on whether the services are provided at home or in a specialized institution, as well as whether they are provided by relatives or by qualified professionals.
Long-term care and nursing insurance funds also finance the adaptation of housing, if due to disability a person needs to have his home renovated. Moreover, this insurance covers training and psychological assistance for informal nurses - family or community members.
According to E. Koch, 36.57 percent of long-term care and nursing insurance funds in Germany are used to finance long-term care in hospital, but the insurance does not cover accommodation and catering services - they have to be paid by a person at his/her own expense. 28.12 percent of insurance funds are used to pay cash for nursing benefits. A resident has a right to choose whether to receive long-term care or cash benefits, or a combination of both.
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