German Reform Hits Upper House Buffers

The controversial third phase of the German coalition government'shealth service reform has met opposition in the upper house of parliament.

The first of the third-phase revisions was rejected by a majority of the federal states controlled by the Social Democrats (SPD), and the second was referred to a joint committee for mediation. However, neither requires unanimity to succeed, and further stages can be carried in the lower house with the Chancellor's majority.

The first revision obliges health funds to link contribution rises to higher patient charges, a 0.1% increase putting 1 Deutschemark ($0.58) on charges. When fund premiums rise, members can switch relatively quickly. The second sets a 5-mark rise in patient contributions for drugs and other services, and global drug spending limits through pack size guidelines which, says the government, will give doctors more control over their spending.