Artabana
| ARTABANA Deutschland Solidargemeinschaft e. V. (AD e.V.) |
|
|---|---|
| purpose | Health care support facility |
| Chair: | Dreessen, Petra-Maria Klettner, Karla Philipp, Thomas |
| Establishment date: | May 1, 2001 |
| Number of members: | 163 communities 2,150 members (as of December 31, 2011 in AD e.V.) |
| Seat : | Magstadt |
| Website: | http://www.artabana.de |
Artabana is a community based on solidarity for health care and emergency aid in addition to health insurance companies and private insurance companies or private health insurance companies , which was initiated in Switzerland in 1987 and has existed in Germany since 1999. Artabana sees itself as a solidarity community for protection in the event of illness and aims to create legal and economic framework conditions on the basis of personal responsibility, self-determination and solidarity, which enable individual and personal health care as well as the free choice and implementation of an individual recovery path. Artabana wants to work on a new, holistic understanding of the implementation of social security.
Artabana is named after Artaban according to a legend of the "Fourth Sage" next to the Three Kings. (See, inter alia, the story of Henry van Dyke , an American writer , "The Other Wise Man" (German: The Fourth Wise Man).) Artabana describes himself as politically, ideologically and religiously neutral. Artabana Germany e. V. (AD e.V.) office is in Wennigsen (Lower Saxony).
So far there is no generally recognized equality with statutory health insurance. See: Legal Status
Similar solidarity communities are the Samarita Solidargemeinschaft , founded in 1997, Solidago , founded in 2013, and the Freiburg Solidarity Art .
history
The basic impulse for security in solidarity communities goes back to the time of the medieval guilds, journeyman's brotherhoods and the cooperative self-help that arose from them. Another station of today's solidarity communities were the professional benefit funds, which were founded in the 1920s and 1930s. Even if the historical roots of the basic idea of solidarity communities go back a long way: ARTABANA was developed in Switzerland in 1987 by a group of anthroposophically educated people based on the experience of successful neighborhood help as a model with the mechanisms of action lived today. The impetus was that after a house fire, mutual, neighborly help was more effective than a legal claim against the insurance company. In Germany, the association Gesundheitskasse e.V. has been involved since the 1970s . V. (VGK) for the establishment of a fund for holistic and alternative healing methods as well as for the development of a database with knowledge about alternative and naturopathic healing methods. In this way, among other things, a contribution to cost savings in the healthcare system should be achieved. In 1999, both initiatives came into contact and a synergy emerged from both models: On the one hand, the conscious striving for a healthy lifestyle and the knowledge of alternative healing methods, on the other hand, an ideal basis and a financial concept. The first health and safety community (GSG) is founded. In 2001 the ARTABANA Deutschland Solidargemeinschaft e. V. as a Germany-wide association of Artabana communities.
organization
From a sociological point of view, Artabana forms a social network supported by voluntary, civic engagement . The organization is characterized by decentralized, subsidiary structures at local, regional and national level. Decisions are generally made by consensus or at least with a qualified majority of 75%. Local communities consist of at least 5 to about 30 members who are classified as e. V., as ne V. or as a GbR. These local communities are grouped together to form regional communities (alliances), which consist of between three and around 20 communities. The regional alliances form the social network between the local groups. Most of the local communities are national members of Artabana Deutschland AD e. V., some communities are not part of the AD e. V. connected. In total there are over 200 local communities (163 of them in the AD e.V.) and 23 regional alliances.
Image of man
Artabana members assume that every person is an individual and that they remain healthy or sick individually. Everyone should be able to find and walk their own path to health. Therefore, the members grant each other individual freedom of choice and responsibility in questions of health care and coping with illness, also in financial terms. With every decision-making process, Artabana members practice their maturity, responsibility for themselves and for the community alike.
membership
There are no age limits and no health exclusion criteria. In order to be accepted, it is important that the people fit together - like good neighbors. If, after several meetings, a solid basis of trust has been established for both sides, interested parties can apply for membership. The local community decides on admission. In Germany in 2012 around "[...] a quarter of the members were also in regular health insurance ". Because encounter and living experience are important, new Artabana groups are usually created by dividing an existing group. Like natural cells, larger communities occasionally divide and form new communities in order to be able to accept new members. With the support of a sponsoring community, new communities can also be founded. This requires at least 5 people. The initial risks are shared by the existing communities.
insoles
Members have financial autonomy, i. H. full decision-making power and responsibility for the financial deposits and their use. They redefine their monthly contribution once a year, whereby this is made up of the expenses they can expect to pay for health care and coping with illness, as well as an additional amount for the local solidarity fund and national emergency aid fund.
Scope of services
There is a free choice of therapy. In the event of illness, all members actually enjoy at least basic coverage, the type and scope of which is comparable to that of statutory health insurance (GKV) according to SGB V, Chapter 3. In particular, alternative healing methods can also be financed that are usually not reimbursed by statutory and private health insurance companies. However, there is no legal entitlement to payment. Instead, the commitment of solidarity services manifests itself in an annually updated solidarity promise from the local community and the solidarity promise of the individual members, a kind of oral contract. The emergency z. B. liability anchored in the statutes in the event of major losses extends to the obligation of local communities to make additional financial contributions. There is no catalog of services that regulates the reimbursement of costs. The concrete scope of the solidarity services is determined by the lively and benevolent dialogue between the members, by the individual and case-related balance between personal responsibility or personal contribution according to the performance of the members on the one hand and the solidarity responsibility of the community or their solidarity contribution on the other Support. For three quarters of the members, Artabana is the only cover in the event of illness.
reimbursement
In the event of illness or health care, Artabana members pay for themselves. You choose your therapy and treatment form yourself, can freely negotiate fees and fees with doctors and therapists and receive an invoice. This also applies to treatment in clinics and sanatoriums. If the amounts required to cope with illness due to unforeseen events (accident, sudden illness, need for care) exceed the projected, individual deposits, the solidarity fund can be used (without legal entitlement).
Reserves and development
Artabana's per capita reserves are rising steadily (+ 10% annually), the annual benefits per capita are constant with a usual range of fluctuation. The number of members has increased by an average of more than 20% in the last 3 years. Income (solidarity contributions + administrative contributions) from all communities amounted to € 1.8 million in 2010, aid amounts to € 1.5 million, and reserves € 2.55 million (as of December 31, 2010). According to the annual actuarial report ( actuary = publicly appointed and sworn actuarial expert), Artabana's security means are sufficient to cover the greatest possible statistical costs. They amount to "... at the end of 2010 approx. 240% of the funds required to insure against extreme damage - that is, such amounts of damage as can only be expected every 5,000 years for the number of people at Artabana at the end of 2010."
Mechanisms of Action
The interdisciplinary economist Mancur Olson (sociology and political science) concludes "that in many cases small groups are more effective and more viable than large ones." This finding is confirmed by the Artabana communities. The main mechanisms of action include the encounter between people and the resulting bond with each other - as with good neighbors who support each other when the individual is overwhelmed in an emergency.
Legal status
It has not yet been decided what legal status solidarity communities will have. According to Section 5, Paragraph 1, No. 13 of Book V of the Social Security Code (SGB V), someone is exempt from insurance if they have "another claim to coverage in the event of illness". The positions of the central associations of health insurance companies (GKV, PKV), the Federal Ministry of Health (BMG) and the Federal Ministry of Justice (BMJ) as well as the individual parties are inconsistent. According to the central associations of the health insurance companies, the statutes of AD e. V. the range of services available to the members is insufficient. Only general principles would be formulated, which are supposed to guarantee a general supply when necessary, based on an individual decision. Specific descriptions of services, such as those provided for in the fifth book of the SGB for statutory health insurance, would be missing. Furthermore, it should be questioned whether and to what extent care can be permanently ensured in the event of so-called "major incidents", so that "recourse to welfare or statutory or private health insurance is not necessary". Therefore, in the opinion of the central associations of the health insurance companies, Artabana Germany is not "any other protection in the event of illness", since the members not only have no legal entitlement, but also no factual entitlement to cover in the event of illness that can be permanently fulfilled.
The Landshut Social Court ruled similarly in 2009. It denied the health insurance in Artabana as a legally valid replacement for the health insurance coverage of a statutory health insurance. The court rejected an application for a suspensive effect of the action against a statutory health insurance decision, "since the court is convinced that this membership does not justify any other claim to coverage in the event of illness in accordance with Section 190 (13) sentence 1 no. 1 SGB V." . No appeal was made against the judgment.
The Artabana Deutschland Solidargemeinschaft e. V. sees itself as a non-supervisory support facility in accordance with Section 1 (3) no. 1 Insurance Supervision Act (VAG). A legal opinion from June 5, 2009 by Eckart Stevens-Bartol, presiding judge at the Bavarian State Social Court a. D., confirm that it offers its members other protection in the event of illness in accordance with Section 5 (1) No. 13 SGB V or Section 193 (3) No. 2 VVG.
Web links
Individual evidence
- ↑ actuarial report on the follow-up assessment by Artabana Deutschland Solidargemeinschaft e. V. - Long version - from April 13, 2013 (PDF; 1.4 MB) Retrieved on April 24, 2013 .
- ↑ Articles of Artabana Germany solidarity e. V. (No longer available online.) Archived from the original on September 2, 2011 ; Retrieved June 29, 2011 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ Henry van Dyke: The fourth sage . Ogham, Stuttgart 1984, ISBN 3-88455-020-9 .
- ↑ The story of the Samarita. Retrieved August 28, 2013 .
- ↑ Doctors' newspaper of December 23, 2014. Accessed January 1, 2015 .
- ↑ PDF document of solidarity art
- ↑ Michael Simon: The health system in Germany: An introduction to structure and functionality - Bern: Verlag Hans Huber, 3rd, revised. and updated edition 2010. - ISBN 978-3-456-84757-3 - page 15ff
- ↑ Roger W. Dufern: Civic engagement in health care: Free solidarity communities in South Baden - Marburg: Tectum Verlag, 1st, edition 2011, scientific contributions from Tectum Verlag Volume 47 - ISBN 978-3-8288-2602-1 -
- ↑ Ulrike Henning: Nothing for the anxious. Artabana: Mutual help in case of illness. In: New Germany . September 21, 2013, accessed December 6, 2013 .
- ↑ a b contribution and solidarity deposit regulations of the AD e. V. (No longer available online.) Archived from the original on September 2, 2011 ; Retrieved June 29, 2011 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Roger W. Dufern: Civic engagement in health care: Free solidarity communities in South Baden - Marburg: Tectum Verlag, 1st, edition 2011, Scientific articles from Tectum Verlag Volume 47 - ISBN 978-3-8288-2602-1 -, Page 241.
- ↑ actuarial report on the follow-up assessment by Artabana Deutschland Solidargemeinschaft e. V. - Major loss coverage, long-term care insurance, old-age provision - dated May 30, 2011. Accessed on November 28, 2015 .
- ↑ Mancur Olson: The logic of collective action: collective goods and the theory of groups - Tübingen: Verlag Mohr Siebeck, 5th through. Edition, - ISBN 3-16-148504-1 - page 3
- ^ Minutes of the discussion of the working group on insurance and contributions from the central health insurance associations on June 12, 2008 in Bochum. (PDF; 913 kB) (No longer available online.) Archived from the original on September 17, 2010 ; Retrieved August 26, 2009 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ SG Landshut · Decision of August 10, 2009 · Az. S 4 KR 124/09 ER. Retrieved August 28, 2013 .
- ↑ Legal opinion of June 5, 2009 on other coverage in the event of illness by Artabana Deutschland e. V. (No longer available online.) Archived from the original on March 14, 2011 ; Retrieved December 30, 2009 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
