Decision made: Healthcare reforms are now on track after a show of force

Chancellor Karl Nehammer (ÖVP) spoke of a “pact for the future” with a “major reform character” in which taxpayer money would be wisely distributed between the federal government, states and municipalities. Coupled with financial equalization is comprehensive health care reform.

According to the agreed financial equalization until 2028, the distribution key of tax revenues between the federal government, states and municipalities (68 to 20 to 12 percent) remains the same, contrary to the requirements of states and municipalities, but there is 2.4 billion euros annually additional money from the federal government. 1.1 billion euros of this will flow through a newly established future fund, the funds of which will be used for childcare, housing and climate protection. Healthcare and healthcare will also receive more funding.

The negotiations lasted almost a year
After almost a year of negotiations, national responsibility has been established by all negotiating partners, Finance Minister Magnus Brunner (ÖVP) said happily after the cabinet meeting. The established future fund initiated a “paradigm change”. For the first time it was also possible to combine extra money with goals, according to Brunner.

Two-thirds of the additional resources made available by the federal government are linked to specific objectives, but without the threat of sanctions for non-compliance. The incentive should be that if it can be proven that the goals are being achieved in one area, the money can be used for other areas, as Brunner explained.

A show of strength for healthcare reform
According to the government’s plans, the health care reform related to financial equalization, which Brunner praised as “probably the biggest health care reform of the last twenty years”, will be adopted by the National Council in December and enter into force on January 1, 2024 . . Health Minister Johannes Rauch (Greens) reported that the reform was a “show of force”. The central concern was to improve patient care, but doctors and other health professionals would also benefit.

Compromise with the medical association
Rauch defended the compromises made with the medical association on some points of the originally planned reform as a compromise, emphasizing that “the medical association had no veto power.” This was outdated and led to blockages. The motto that should apply to healthcare in the future is clear: “Digital, before outpatient, before inpatient,” says Rauch.

600 million for ambulances and structural reforms
Approximately EUR 300 million also flows annually to the private sector, and approximately EUR 600 million is intended for financial compensation for outpatient clinics in hospitals and for structural reforms. Part of the healthcare reform includes digitalization and innovations in the areas of health promotion, vaccination, medication supply and, last but not least, healthcare (with an increase in the healthcare fund from 455 million euros to 1.2 billion euros per year). The federal government has committed to the announced additional functions for statutory health insurers. The Austrian health insurance fund should conclude a national, uniform comprehensive contract.

The planned restrictions on physicians’ overall contractual sovereignty (including a fee freeze from 2025 in case of non-agreement) were ultimately eliminated. The fact that social insurance will be able to conclude individual contracts with doctors in the future has been deleted.

The medical association is spared from horror fantasies
This was a horror scenario for the medical association. She had talked about ending the social partnership, wanted to launch a multi-million dollar protest campaign and threatened a no-contract situation. Contrary to the original plans, there will be no obligation to prescribe active ingredients.