Volt on health and care

Volt wants a single health insurance system that also covers civil servants and the self-employed. It would first be set up in Germany and become European in the long term. To fund it, the income ceiling for contributions would rise, and health and long-term care insurance would be merged.

Volt wants one health insurance for all people. Civil servants and self-employed people should be in it too. At first this should apply in Germany. Later there should be one insurance for all of Europe. People with high pay should pay more.

The contribution assessment ceiling, meaning the income level up to which contributions are charged, would be raised to the level used in pension insurance. Insurer benefits that are wanted for social policy reasons would be paid for entirely from taxes. Merging health and long-term care insurance is meant to simplify care and administration. The platform expects a solidarity-based system to deliver better care and lower administrative costs.

Volt wants to merge the statutory health insurers into four nationwide funds and organize them as nonprofit cooperatives. Insured people would have a say through cooperative shares instead of the current social insurance elections. The platform expects this to bring more transparency, efficiency and participation.

Today there are many health insurers. Volt wants only four for all of Germany. These insurers should be cooperatives. A cooperative belongs to its members. Insured people buy shares and then have a say.

The plan is for a federal AOK, one Ersatzkasse, one company health fund and the Knappschaft-Bahn-See, each with branches at state or company level. The agricultural health fund, the guild health funds and statutory accident insurance would be absorbed into these funds. The administrative boards would be dissolved. The associations of the individual fund types would be folded into the GKV-Spitzenverband (national association of statutory insurers), and the Federal Office for Social Security would supervise all funds. The Federal Joint Committee would be developed into a federal health commission in which all health professions are represented equally.

Volt wants to unify how medical services are paid for and base payment on quality and need. Statutory insurers would no longer pay for services without scientific proof of effectiveness, such as homeopathy. According to the platform, the goal is to avoid overtreatment, undertreatment and inappropriate care.

Volt wants new rules for paying doctors and hospitals. Quality and need should count. Insurers should no longer pay for homeopathy. There is no proof that homeopathy works. No one should get too much or too little treatment.

The uniform payment system would combine several elements: money for keeping services available, flat rates per case and per treatment complex, and fees for individual services. In the platform's view, this would remove misguided financial incentives. Volt wants to tackle overtreatment that results from commercial incentives. It also wants to counter undertreatment caused by appointments being kept scarce.

Volt wants health care to be planned region by region according to local need. In rural areas, regional care centers staffed by several health professions are to be set up. Patients who see a specialist without a referral would pay a share of the cost themselves.

Volt wants to plan health care for each region separately. Rural areas should get new health centers. Different health workers work together there. People who see a specialist without a referral should pay a fee.

Regional planning is to bring together social ministries, the associations of statutory health insurance physicians and dentists, health insurers, and care providers. The family practice would be the first point of contact; the co-payment for specialist visits without a referral is meant to ease the load on specialist practices. Regional care centers (RVZ) would combine health professions and public services under one roof. Through a structural fund, Volt wants to convert small hospitals into such centers and make them part of outpatient care. The platform cites the French Médecins Solidaires model as an example, in which doctors take turns week by week running practices in underserved villages.

Volt wants to expand remote treatment and send mobile health units to remote areas. At the same time, uniform digital standards are meant to make it easier for everyone involved to exchange medical data.

Volt wants more treatment by video and phone. Mobile clinics should drive to remote places. Doctors' offices and hospitals should share data using the same rules.

Telemedicine and remote psychotherapy are to be expanded and linked to the regional care centers. So-called Klinikmobile (mobile clinics) would offer regular consultation hours in remote areas. The new licensing regulations for physicians are to be passed quickly so that primary care carries more weight in medical training. For digitalization, Volt calls for end-to-end communication standards such as HL7/FHIR and a uniform filing structure such as KDL for the electronic patient record. Software makers, hospitals, and practices would cooperate under the lead of gematik, the national agency for digital health.

Volt wants medicines to be produced in Europe again in order to prevent supply shortages. In addition, prices within Europe are to be aligned, advertising and discounts regulated, and pharmacies paid in a different way.

Volt wants medicines to be made in Europe again. This should stop medicines from running short. Prices should become more similar across Europe. Pharmacies should be paid in a new way.

The manufacturing of medicines is to return to Europe. Volt wants to reduce price differences between European countries so that drugs are not shifted between markets. Advertising and discounts would be regulated to avoid improper use. Quantities dispensed would be matched to actual need, which the platform says cuts overuse and environmental harm. Pharmacies would be paid based on effort rather than per package.

Volt wants to give priority to the emergency care reform already under way and finish it quickly. The rescue service is to gain legal standing of its own, be digitally connected, and be supported by telemedicine. This is meant to secure care and address staff shortages.

Volt wants to improve help in emergencies. A law on this has already been started. Volt wants to finish it fast. The numbers 112 and 116117 should be linked digitally with hospitals.

The ongoing legislative process for the emergency care reform is to be prioritized. The rescue service would be written into Book V of the Social Code (SGB V), which governs statutory health insurance, as a separate category of services. Volt wants to expand pilot degree programs for rescue personnel, make them permanent, and add further training options. The emergency numbers would be digitally connected to hospitals and other levels of care. Tele-emergency medicine would be available everywhere and help direct responses more precisely.

Volt wants to make professions such as physiotherapy, occupational therapy, psychotherapy, and midwifery more attractive. This includes pay during training, uniform nationwide standards, secure funding for advanced training, and a say in the Federal Joint Committee.

Volt wants to strengthen health professions. These include physiotherapy and midwifery. Trainees should be paid. These professions should get a vote in an important committee.

Training and advanced training in the health professions would follow the same structures nationwide; training and examination rules would be reformed and university-level education expanded. All health professions would learn across disciplines during training. Advanced training would be funded the way it is for physicians, and inpatient facilities would create permanent posts for it. In the Federal Joint Committee (G-BA), which decides what statutory insurers cover, these professions would be able to file motions and vote. Hospitals that provide training would receive higher payments.

Volt regards the climate crisis as the century's greatest health threat and wants to expand prevention. The plans include a heat strategy with the states, more funding for cooler city centers, and more resilient hospitals.

Volt says the climate crisis is a big danger to health. So there should be a plan against heat. Cities should become cooler, for example with more green spaces. Hospitals should be better prepared for crises.

The heat strategy is to be based on data and include heat action plans and funding programs. Projects that lower temperatures in city centers, such as greening and new urban planning approaches, would get more support. Hospitals would be developed further using concepts from the global initiative "Health Care Without Harm." Volt also counts reducing air pollution and noise, as well as promoting pandemic research and international cooperation, as part of prevention.

Volt wants to expand everyday health promotion regardless of income. Plans include more money for grassroots sports, easier access to healthy food, a rating system for food, nutrition as a school subject, and health kiosks across the country.

Volt wants people to be able to live healthier lives. Sports clubs should get more federal money. Schools should teach about nutrition. There should be health kiosks everywhere. People can easily get advice there.

Infrastructure projects are meant to allow safe physical activity for every age group, and sports clubs and volunteer initiatives would get more federal funding. Regional and organic food would be easier to obtain; a Food Compass Score would make choosing healthy products simpler. People with Long Covid, PostVac, and ME/CFS would get better participation in society and easier access to diagnosis and therapy. Volt also calls for medicine that addresses the needs of all genders and for more investment in research. Advice would also be offered in several languages and in a culturally sensitive way, and workplaces would be brought into prevention programs.

Volt wants to introduce a tax on sugar, sugar substitutes, and sweeteners. It is meant to push manufacturers to use less sugar, help prevent diseases such as diabetes, and relieve the health system.

Volt wants a new tax on sugar and sweeteners. Sweet drinks will then cost more. Companies should therefore put less sugar in their products. This is meant to prevent diseases like diabetes.

The levy is designed as an excise tax with a health policy purpose, meant to steer behavior. Non-alcoholic drinks above 3 grams of sugar per 100 milliliters would be charged 25 cents; light and zero versions and energy drinks are included. A comprehensive plan with specific thresholds is to be drawn up for substitutes and sweeteners and for taxing further products. Volt points to WHO recommendations and to neighboring European countries. As an example, the platform cites the United Kingdom, where according to a Cambridge study the sugar content of many soft drinks fell sharply after 2018.

Volt wants to prevent mental illness early through prevention and make psychotherapy easier to access. To that end, more insurance-funded therapist licenses are to be created, and resilience is to be fostered from daycare age.

Volt wants to strengthen mental health. There should be more therapy places paid for by health insurance. Even small children in daycare should learn to cope with stress. Volt also wants to act against bullying and loneliness.

The needs-based planning that determines how many psychotherapists may bill statutory insurers is to be changed. Teachers and other professionals would receive training to help build children's mental resilience. Psychosocial services would offer preventive, proactive support. Against bullying, Volt plans awareness programs and mediation, especially for violence on social media. Measures against loneliness are also included.

Volt wants to give more support to services that make drug use safer, including drug checking, supervised consumption rooms and substitution treatment. It also calls for education, less stigma, and addiction prevention that covers gambling and media use as well.

Volt wants to help people who use drugs. They should be able to use drugs more safely. One example is drug checking. Experts test what is in a drug. Volt also wants more education about addiction.

The program names three building blocks. First, drug checking, consumption rooms and a range of substitution options are to receive more support. Second, it wants to strengthen people's ability to use substances responsibly, reduce the stigma around psychoactive substances, and expand community-based prevention. Third, addiction prevention is to pay more attention to other forms of dependency such as gambling and media use.

Volt wants to reduce the disadvantages that women and people of other gender identities face in health care. To do so, it would expand research, training for medical staff and low-cost screening. The platform points to research gaps, faulty diagnoses and poorer access to therapies.

Volt says medicine pays too little attention to women. So there should be more research on this. Doctors should get training. Women should get cancer screening at low cost.

Clinical trials would have to record data by gender, and research on gender differences would grow. Medical staff would receive regular training, with particular attention to marginalized groups. Civil society education initiatives on issues affecting women, lesbians, inter, non-binary, trans and agender people would be funded in schools and medical degree programs. Women would get yearly cancer screening and hormone screenings at cost price.

Volt wants to decriminalize the possession and use of all psychoactive substances and do without sanctions. The partial legalization of cannabis would stay and be extended to sales in specialized shops. The party treats the use of such substances as part of bodily self-determination.

Volt no longer wants to punish people for having drugs. This should apply to all drugs. Cannabis should stay legal. People should be able to buy it in special shops. Education should protect health and young people.

Pilot projects would test the regulated sale of individual substances that are still illegal to adults. Cannabis shops would offer advice as well as sales. Industrial use of hemp would be made much simpler. The platform wants to secure health and youth protection through education and prevention.

Volt wants more physical activity at school, at work, and in leisure time, because the platform says it prevents lifestyle diseases. The plan includes daily exercise offerings in schools, free municipal sports programs for adults, and more uniform health insurer bonus programs.

Volt wants people to move more. That keeps them healthy. Schoolchildren should be able to exercise every day. Towns should offer free sports for adults. Health insurers should reward exercise more.

Schools are to offer daily physical activity with team and individual sports, on top of regular PE classes. Municipalities are to provide adults with sports and exercise programs at no charge. Health insurers' bonus schemes are to be standardized and made more attractive, and are to cover club memberships, municipal programs, and apps and wearables. Such digital tools are also to be built into national exercise programs, mainly to reach young people.