Samarita solidarity community
| Samarita Solidargemeinschaft eV | |
|---|---|
 |
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| purpose | Solidarity coverage in the event of illness |
| Chair: | Urban Vogel (speaker) Christian Werner |
| Establishment date: | 4th December 1997 |
| Seat : | Bremen |
| Website: | http://www.samarita.de |
According to its own statements, the Samarita Solidargemeinschaft eV represents a new form of coverage in the event of illness. State recognition as a substitute for membership in a statutory or private health insurance has not yet existed.
On the basis of the "7 principles" of freedom of therapy, responsibility, solidarity, transparency, care instead of entitlement, the cooperative principle and a social network, the members guarantee each other comprehensive and flexible health care that is at least the level of statutory health insurance in terms of quantity and quality . Furthermore, the personal responsibility and solidarity of the members should be strengthened by the fact that the members support each other not only materially but also ideally in questions of life balance, health and nursing care, as well as disease treatment.
history
The Samarita Solidargemeinschaft was founded in 1997 after a two-year preparation period, initially as a GbR around Urban Vogel and Christian Werner from the financial services company "Other Paths" with eight members in Bremen . The founding motivation is a reaction to the increasing focus of the existing insurers on profitability instead of providing assistance and to create a coverage offer that also covers treatments beyond conventional medicine. With the turn of the millennium the Samarita grew, lectures were organized all over Germany and regional groups were formed. In 2004 the Samarita Development Group was founded.
After extensive restructuring, the Samarita GbR was converted into a registered association in 2007 and helped initiate the founding process of the BASSG (Federal Working Group of Self-Help Institutions - Solidar Communities in Health Care eV) and was significantly involved in the development of quality standards . In 2008 the Samarita Solidargemeinschaft eV was certified by the BASSG.
In the course of the health reform in 2007, an obligation to provide coverage in the event of illness was introduced. Since then, BASSG has been campaigning intensively for BASSG members to be recognized as other forms of protection in the event of illness. The publication of a catalog of criteria developed jointly with the National Association of Statutory Health Insurance Funds (albeit not legally binding), under which conditions a solidarity community is to be regarded as other protection in the event of illness, failed due to the resistance of the Association of Private Health Insurance and the Federal Government, as there is no legal claim to protection in the Illness would exist.
According to its own statements, the Samarita Solidargemeinschaft eV has been running a model process since 2011 in which it fights for legal recognition as "other protection in the event of illness". The negative decision of the Munich Social Court on January 4, 2013 (AZ: S 3 KR 291/11) was appealed to Bayer. Regional social court filed under the case number: L 4 KR 27/13, but this was rejected on June 9, 2015. The appeal before the Federal Social Court was, however, allowed because of "fundamental importance". The appeal against the judgment of the LSG was then rejected as inadmissible by the 12th Senate of the Federal Social Court by decision of April 18, 2017 (B 12 KR 18/15 R) due to insufficient reasons. A constitutional complaint is pending at the Federal Constitutional Court against this and against the decisions of the lower court (Az. 1 BvR 2062/17).
organization
The Samarita Solidargemeinschaft eV is divided into the following organs:
- The general meeting
- The general assembly is the central organ that basically orders all affairs of the association by passing resolutions. Each member of the Samarita Solidargemeinschaft eV is entitled to one vote at the general assembly . A simple majority of the members present is sufficient to pass resolutions . A 2/3 majority is required for a change in the statutes and for elections (for example of the board of directors). The ordinary general assembly meets once per financial year.
- The board of directors
- Consists of at least two members, currently Urban Vogel, who is the board spokesman, and Christian Werner. The board leads the association within the framework of the resolutions of the general meeting and the guidelines of the entire board.
- The regional boards
- The regional executive boards consist of at least two members and are the executive boards of the regional groups into which the association is divided. The regional groups are dependent member associations of the Samarita Solidargemeinschaft eV The regional groups are responsible for the regional representation of the Samarita as well as the development of the community.
- The entire board
- The entire board consists of the board of the Samarita Solidargemeinschaft eV and the boards of the regional groups. Further co-options are possible. The entire board develops the guidelines for the association's work within the framework of the resolutions of the general assembly.
The agency is carried out by the Andere Wegen GmbH, from which the Samarita Solidargemeinschaft eV also emerged.
membership
In principle, anyone who is not compulsorily insured by statutory health insurance can become a member of the Samarita solidarity community . According to the Samarita, there are currently "over 300 members". There are no general health or age-related exclusion criteria. However, since a lot of value is placed on personal interaction, admission always requires a personal admission interview. There is therefore an admission committee about new members. Membership is independent of the existence of a regional group in the member's area.
Contributions
The contributions of the members are based on the fee schedule, which, taking into account the statistical risk, the income of the respective member, the claimed medical costs in the community and the conscious handling of health and illness, forms guideline rates. These reference rates are graduated in 11 levels between "up to € 1,000" and "over € 8,000" monthly income and the family size. The target contribution is based on the total amount of the income in the tax assessment . The actual contribution is agreed in the course of the admission procedure and may differ from the target contribution. Half of this indicative contribution goes into the solidarity fund and the rest of the actual contribution - minus half the indicative contribution that goes into the solidarity fund - is allocated to the individual account of the respective member.
Scope of grant
The donations of the Samarita solidarity community are fundamentally characterized by a free choice of therapy. In this way, alternative healing methods can also be supported that are often not borne by conventional insurers.
In contrast to the benefit catalogs of legally recognized health insurances, a member has no legal entitlement to a specific treatment or medication, but only to reimbursement within a fixed grant framework that clarifies the amount of the costs. In the case of serious illnesses, the grant can be deviated from in favor of the sick member.
literature
- Konrad Schily : Does solidarity have to be organized by the state? ; in: Health 2030, quality orientation in the focus of politics, economy, self-administration and science ; Ed .: Nils C. Bandelow, Florian Eckert, Robin Rüsenberg; Wiesbaden 2009; ISBN 978-3-531-16804-3
- Claudia Mehlhorn: Problem area health insurance - A guide for advisors and those affected; 5th ed .; Martinroda 2012; P. 192 f.
Web links
Individual evidence
- ↑ Article from: Note July / August 2008. Archived copy ( Memento of the original from April 2, 2015 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. (PDF; 399 kB)
- ^ Statutes of the Samarita Solidargemeinschaft eV § 2 Abs. 2 a.
- ↑ Statutes of the Samarita Solidargemeinschaft eV § 2 Abs. 2 b.
- ↑ Small question in the Bundestag from January 10, 2011 - Small solidarity communities as other protection in the event of illness, BT-Drs. 17/4386, p. 2. [1]
- ↑ Information from Klaus-Peter Brandt (office), from the Bavarian State Social Court [2]
- ^ Social jurisdiction in the Federal Republic of Germany [3]
- ^ Statutes of the Samarita Solidargemeinschaft eV § 6 Abs. 1.
- ↑ No ominous mass report in the taz of September 2, 2005
- ↑ Contribution regulations of the Samarita Solidargemeinschaft eV [4]
- ↑ Grant framework of the Samarita Solidargemeinschaft eV [5]
