206 tips to save money
Austria - 206 tips for administrative reforms, given by the Austrian Court of Audit to the finance in August, have created a bit of a stir. Almost half of the envisaged total savings potential of €4-5 billion is expected to result from a reform of the healthcare sector.
Simply by aligning the number of hospital beds with the European average, a considerable number of expensive acute beds could be saved and around €2.9 billion could be spent on out-patient care and surgeries, rather than on in-patient care. However, currently the structural conditions for this implementation are not ready and need to be created.
The number of acute beds in Austria has been continuously reduced over the years. However, with 6.1 beds per 1,000 people it is still high compared with the European average: 3.9 beds.
The Court of Audit is basically demanding a reorganisation of competencies in healthcare and hospital funding. One suggestion is to determine a fixed proportion of the gross domestic product (GDP) to be spent on healthcare (currently 10.2% including nursing). The Court of Audit has also targeted regulations on medical fees and special charges for potential savings.
The response from the Department of Health and representatives from the medical world has been partly positive, partly negative and partly acrimonious. Shifting the provision of medical services is unlikely to result in huge savings and would at best help to contain costs. Nobody can quite envisage a savings potential of around ¤2.9 billion whilst maintaining the quality of medical services. However, the approach taken by the Court of Audit has certainly resulted in a debate on principles.
A new concept for 24-hour care
A fierce debate around the illegal employment of foreign care workers in Austria resulted in a new concept for 24-hour care.
An estimated 40,000 nursing assistants, most from Eastern European countries, were being employed illegally in Austria. Since July 2007, the country has had a new, controversial concept for 24-hour care developed by the Ministry of Social Affairs. This system allocates care services to those who need them, or to their relatives, from a support fund for the disabled.
This aid can be worth up to €800 per carer for those in regular employment, or up to €225 for contractors (self-employed carers). The carer can either be directly employed by the person in need of care or their relative, can be a contractor working for somebody entitled to that care, or may be employed by a charitable organisation. By 1 July 2008, at the latest, carers will have to demonstrate that they hold qualifications in the theory of care to maintain quality assurance. Applicants must be able to prove that they are entitled to a level three (or higher) nursing allowance. Applicants’ incomes are taken into consideration and the income limit is €2,500 net a month, excluding payments such as nursing allowance, special grants, family allowances, child benefits and housing benefit. This upper income limit increases by €400 for each dependant, and by €600 for each disabled dependant. Assets up to a cash value of €5,000, along with the value of the home if this is the main residence for the disabled person claiming, are excluded from the calculations.
This rule is applicable until 31st December 2007 and there are currently negotiations with the individual Austrian Länder to develop a system that can be implemented after the current system expires.
31.08.2007
