Reforms needed – Minister: ‘Otherwise the system will get stuck’

“crown”:In an interview with the “Krone” you announced the end of all corona measures and laws. By when should this be implemented?
Health Minister Johannes Rauch: Like many other EU countries, we are currently preparing to return to regular activities. All measures to finance corona vaccinations, tests and Covid-19 medication are currently limited to June 30. Integrating these services into the regular structures of the Austrian healthcare system requires extensive legal and organizational preparations.

Returning to normal will not be their only concern in 2023, it is also in the health and care sectorin huge staff shortage, how do you intend to deal with this?
We have a blatant, increasing labor shortage in many industries. There are many reasons for this, it has to do with demographics. You can discuss that very well, but the fact is that there is a lack of people everywhere. In the triumvirate of those responsible – social security, federal states and federal government – we urgently need to reform. I can only do that through financial equalization. That’s the key. The distribution of resources must necessarily be linked to the fact that reforms are taking place.

Do you really think healthcare can be reformed?
It will have to be reformable. We can go on like this for another five years. If we fail to take reform measures, things will get stuck.

Because it’s getting too expensive?
Of course and because it becomes inefficient. Healthcare expenditure of currently 18 billion will increase enormously as a result of demographic developments.

How much money is in it?
Don’t pin me down on amounts, but I’ll give you an example: if all federal states and all state hospitals agreed to jointly purchase medicines throughout Austria, we would save millions of euros.

Reforming the healthcare system is a bold undertaking. Do you dare?
The probability of failure with this reform project is high. I’m so realistic. But someone has to have the grace to try this. And if I break my skull, I will break it. I would always blame myself for not trying. “After me the deluge” – that’s why I didn’t get into politics.

Is federalism still relevant?
In financial settlement, greater uniformity and consistency should be ensured. That is a common concern of mine and the Minister of Finance. This is a difficult exercise. It’s about power and national interests. I am in favor of modernizing the federal system. It’s broken into. Nothing has changed in the last 20, 30 years. We need to stop sharing responsibilities. The federal government has some responsibility and the states have some responsibility. We need to talk about responsibilities and funding.

Do we have medicine on two levels?
I can’t refute that in some areas. That’s true. But my goal is to change that. At a doctor’s visit, the e-card should suffice and not the used check card.

The government has given one billion euros to improve the healthcare sector. 570 million euros were for the Salary subsidy for nurses meant. Instead of friendsde, hat the caused problems for many because they got less than promised. The “Krone” reported about it. What went wrong?
The nurse salary subsidy is a much-needed signal. We wanted to use the care billion to increase salaries and have made a lot of money available to the federal states for this purpose. I was able to earn money for two years. The fact that these payments continue afterwards is part of the talks about tax equalization.

Couldn’t this have been managed centrally and not through nine countries, which set their own guidelines for payment?
Every country has to do this because every country is responsible. I cannot interfere in the responsibilities of the federal states. I raised the money, but the implementation is a matter for the states. But in 2023, the subsidy will become part of the salary and money from 2022 can also be paid out in 2023. I understand there are concerns. You can correct that later. There is a high degree of flexibility and design options.

Should health care continue to be financed from the budget or is health insurance mandatory?
I will enter into negotiations openly. But one thing is clear: more money is needed. That is beyond dispute. As we get older, there will be more people who need care. This means that we need more workers, and we are not getting them in Austria. Active recruitment of nurses abroad will be necessary, otherwise we cannot do this.

Worrying reports have been coming out of the hospitals lately, and the “Krone” is also reporting on this. What do you know?
The three disease waves corona, RSV and flu have overlapped. This has come up against a situation where hospitals have been overburdened for years anyway. We also need to bring more staff into the system in the hospitals. But I can’t conjure that up overnight. There are improvements in the training, there are incentives. It works, but it takes time.

What do you do with the medicationn– Eliminate shortage?
I like to compare it to food. We were 80 percent dependent on Russian gas. For individual medicines, we are 90 percent dependent on one or two manufacturers in China. This applies to all of Europe. There is a European strategy for joint procurement and storage of medicines. The aim is to make Europe a more attractive location again. It was not wise to outsource everything to low-wage countries. The situation cannot be solved by one country alone. This must be done together at EU level.

The government is working on ways to keep people working longer. The blocked partial retirement was abolished, which led to criticism. Why is the government scrapping this popular model?
Blocking semi-retirement was a good idea, but it has led many people to retire at age 63. I want to make the switch attractive for employees and employers. That must be voluntary. No one will be forced. We want to make it more attractive to retire and continue working for a few hours at the age of 65. There are smart solutions and we are going to find them now. But what I don’t want is a pure debate about retirement age. That’s not the point.

What else do you have planned for 2023?
Inflation and how people can deal with it keeps me very busy. I think it’s important that people can pay their bills. I don’t care how people are. This is my main concern in 2023.

The government has spent tens of billions of euros on anti-inflation measures. Experts have criticized the fact that these were distributed haphazardly. Will 2023 be another year of the spend money?
I understand the criticism that the watering can was promoted too much. She is partially entitled. The decision was to help quickly and accept waste. Otherwise it would have taken too long. Yes, I am all for giving those people the help they need. If there is new support, it will be paid out in a more targeted way. The money will not be abolished. It will be a challenge to balance the budget. I hope that the economic situation remains as good as it is and that we can start the new year with more optimism.