Germany's free spouse health insurance faces calls for reform over fairness concerns
Health economists have expressed understanding for the proposal to abolish the free co-insurance of spouses under Germany's public health system.
Martin Albrecht of the Iges Institute told Der Spiegel that it was "difficult to justify why contributors should finance the premium-free co-insurance of spouses." Unlike raising children, he argued, forgoing gainful employment within a marriage is not a prerequisite for safeguarding the pay-as-you-go financing model. He also noted that "balancing family and work is now a widely recognized sociopolitical goal."
According to calculations by the Iges Institute based on data from the German Socio-Economic Panel (SOEP), only 43 percent of households with co-insured spouses have children under 14. For households with young children under six, just 20 percent include a partner covered without premiums. However, spouses with children of an age requiring care represent only a minority among adult dependents in the system.
Heinz Rothgang, a health economist from the University of Bremen, also criticized the co-insurance arrangement, citing "a question of fairness." Currently, couples with identical household incomes face vastly different financial burdens. "The greater the disparity in the partners' earnings, the greater the advantage," Rothgang explained, adding that this contradicts "the principle of horizontal equity."
From a regulatory policy perspective, however, he deemed the proposal poorly executed. "This doesn't solve a single structural problem at its core," he said. Instead, he argued, the coalition's move is "clearly just about raising a little extra money in the short term."
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