In the healthcare sector, the term monistic refers to the financing of hospitals from a single source. According to this principle of hospital financing, the decision-making and financing responsibility for investment and ongoing operating costs of the hospitals rests solely with the cost bearers ( health insurance companies ).
The Hospital Financing Act of 1972 stipulated that the states should be required by law for the first time to participate in the financing of hospitals. The investment costs should be borne by the federal states and the operating costs should be borne by the cost bearers via the care rates .
Soon, however, the demand arose to return the financing to the monistic form. The Federal Administrative Court criticized in 1993 in his ruling the division of costs for the ongoing operation of the investment costs. The court added the expenses for repair and maintenance measures to the eligible costs. After this ruling, all federal states with the exception of Bavaria stopped their payments for maintenance measures.
In 1997, the second GKV reorganization law came into force, in which the maintenance measures were recognized as eligible for care. As a result, the health insurances were obliged to finance major repairs from 1997 to 1999 with the "maintenance flat rate". To finance these measures, the so-called "hospital emergency victim" was introduced. This provided for an additional payment of DM 20 per year for each insured person. This payment was repealed in 1999 by the GVK Solidarity Strengthening Act. The draft law for the GKV health reform 2000 provided for the system of dualistic hospital financing to be gradually converted back to monistic financing by 2008. Up to this point in time, all investment costs should be refinanced by the health insurance companies. At the same time, the federal states should be released from funding from 2003 onwards and from 2008 onwards they should be obliged to provide counter-funding by compensating maternity and death benefits. However, this was rejected by the federal states.
- The monistic represents a model for hospital financing in which the health insurance companies are the only financing providers for the hospitals.
- Klaus Goedereis: Financing, planning and controlling the hospital sector. Dualistic and monistic in structural comparison. Eul, Lohmar 1999, ISBN 3-89012-664-2 .
- Marc Bataille: Monistics in hospital financing - have you made a start? Springer, Heidelberg 2009, doi : 10.1007 / s10273-009-0898-7 .
- Jens Flintrop: POLITICS - hospital care. Conversion to monistic is not a done deal. (= Deutsches Ärzteblatt. 104, no. 7). Deutscher Ärzte-Verlag, Cologne 2007, ISSN 0012-1207
- Bert Rürup (report from 2008): Conversion to monistic financing of hospitals on Sozialpolitik-aktuell.de (PDF)
- Hospital financing: Monistics yes, but ... on aerzteblatt.de (2006)
- Michael Simon: Monistic financing of hospitals on med.uni-magdeburg.de (PDF)
- ↑ a b c d Lexicon: Monistik on aerzteblatt.de, accessed on May 14, 2014.
- ↑ 1997: Contribution Relief Act as well as 1st and 2nd NOG ( Memento of the original from May 15, 2014 in the Internet Archive ) 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. at aok-bv.de, accessed on May 14, 2014.
- ↑ 1999: Statutory Health Insurance Solidarity Strengthening Act ( Memento of the original from May 15, 2014 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. at aok-bv.de, accessed on May 14, 2014.