Which health insurance is better, the private or statutory? Hardly a question, experts and politicians argue harder, and little is at the same time to answer is so difficult. Because in the maze of tariffs, those who have been for years intimately acquainted with the matter get lost.

Others, such as Karl Lauterbach, keep the Coexistence of the two systems is fundamentally problematic: “Many of the disadvantages that we complain of, currently, stem from the fact that there are in addition to the statutory health insurance is still private,” explains health expert of the SPD against the MIRROR.

The Green, in turn, the consulting Institute premium circle officer, in order to compare the performance of catalogues of Private (PKV) and Statutory (Shi)and to conclude, by means of which the Insured are better supported. Result of the study: The Legal are much better than their reputation.

performance difference

“The recurring statement, the statutory health insurance was only second-rate, this study clearly reflected,” said the Green-health expert Maria Klein-Schmeink the editorial network Germany (RND). Instead, a number of the surveyed private rates could not guarantee even the most basic services.

The study also presents, according to the RND, that private Tariffs offer health insurance even in the expensive Premium consistently fewer benefits than the statutory health insurance funds. Then the Top Rates of the private insurers are not met for an average of more than a quarter (27 percent) of the essential minimum requirements defined. In the case of the statutory health insurance, it was only three percent.

However, the authors of the study themselves admit, that a precise comparative assessment of the two insurance models given the many different factors of influence: “We point out explicitly that, in the evaluation of some performance criteria weighed had to be made of whether the respective services of the GKV are in scope with those of the PKV comparable.”


For the study, a premium circle defined 103 minimum criteria, 100 of which were part of the performance catalogue of the GKV. In addition, among other things, a higher level of services for dentures and the cost of eyeglasses without age restriction, which should belong, according to the study authors, to a comprehensive health insurance were included.

Large gaps in comparison to the GKV, there is, according to the study in the private tariffs, in particular, in the case of cures and Rehabilitation. Worse conditions were also frequently the case with palliative care, home health care, psychotherapy, as well as vaccinations.

the evaluation of The performance of the private health insurance tariffs according to the authors, relatively easy: “What is not contractually guaranteed right, is not insured.” It is a classic insurance model, which can be configured with the insurer individually.

The Shi a is a model of Solidarity: All the numbers according to income and get, in the case of sickness benefits according to a relatively uniform catalog. According to the study, the evaluation of the performance of the solidarity model Shi is also difficult.

complex matrix

The current structure is very complex and continuously from the decisions of the legislature and a joint Commission of experts. Moreover, there are reports, according to which Insured persons have problems to get legal services in the practice. The timely access to specialists is often significantly more difficult than in the PKV, according to the study.

Green, the SPD and the Left to aspire to for a Long time and in varying degrees, a uniform, citizens insurance, which would probably mean the end Of private health insurance in the present Form.

nevertheless, the SPD expert, Lauterbach feared that the opponents of the PKV have done with the study. “The arguments, which provides a premium circle, the supporters of the PKV too easy to invalidate,” he explains. The biggest advantage of Private is that the private insured in the event of a serious disease Top were specialists available, the greater chances of a cure offer.

This Institute in the treatment of defects in The clinic-TÜV

For those with statutory health insurance it is, however, hardly possible to get a date identified – although they have contributed over the contributions to the financing of hospitals, research institutions and universities. And that is exactly where the real injustice lies not in the System. “We should stay honest,” he says. “And not in the competition to occur, and who provides, within this questionable system worthy of the better offer.”

More: This 18 health insurance companies wanting to from January the contributions

With Material from dpa


Sam Yoon has many years of experiences in journalism. He has covered such areas as information technology, science, sports and politics. Yoon can be reached at 82-2-6956-6698.