In July 2021, the Health Care Expansion Act (GVWG) came into force, obliging care facilities to pay a tariff wage to their care staff. As of September 1, 2022, therefore, only those care facilities that pay their care staff at least the standard rate were allowed to be licensed to provide care and to bill the care insurance fund.

This means that care facilities that are not yet bound by tariff agreements with their staff must pay their care staff in accordance with the relevant regional care agreement, an in-house care agreement (which applies in at least one other facility in the region of the same federal state) or in accordance with church labor law regulations. However, the remuneration may not fall below the level of the tariff agreement as of September.


In short, this means that care facilities that are not yet bound by collective agreements may not continue to pay their staff below the level of the collective agreement, but must increase their wages accordingly. This results in an increase in the minimum wage for care staff.

For the workers in the care this is at first sight a good message, because they already fought for many years for higher wages and better working conditions. However, this reform also has its downsides. Not only are the wages for nursing staff rising, the costs for those in need of care and their relatives also rise. Some relatives report an increase in care costs of over 37 percent. This means that the price of a person's stay in a care facility can increase by as much as 600 euros.


For relatives who have to finance the stay of their parents in a care home, this is a slap in the face, because even before this new regulation, the costs to be paid for a stay in a care home were enormously high. The reason for this is that the nursing care insurance funds only cover part of the costs for accommodation in a nursing care facility. The remaining costs form the personal contribution, which must be paid by those in need of care and, if they are unable to do so, by their relatives.


A data analysis by the association of substitute health insurance fund, which was conducted at the beginning of the year, came to the conclusion that the average monthly contribution of a person in need of care for inpatient care was more than 2,100 euros, despite the benefits of statutory long-term care insurance. In four federal states, the average contribution was even higher.


And that was before the obligation to comply with rates came into force. The fact that costs are now rising even further will make a place in a care home virtually unaffordable for most people and thus drive many more relatives of people in need of care into poverty.


Since the costs of these wage increases are not covered by the nursing care insurance funds, the care facilities have to bear them. As a result, the care facilities simply pass them on to those in need of care and their relatives. On the other hand, however, many care homes, especially smaller ones, are now facing massive financial problems and are in danger of having to close. These financial problems can be overcome on the one hand by passing on the costs to the relatives, but also by making savings in various areas within the care facilities.

This means, for example, that a care home can make savings in the quality and quantity of food for the residents, employ fewer care staff and no longer offer excursions for the facility's residents.


So the consequences of the Affordable Care Act will not only be that care homes will now be taking more money out of our pockets to care for our loved ones in need of care, but also that the quality of life for our elderly and sick in care homes will decrease.

With the way this minimum wage increase in care is being implemented, we see how the demand of care workers for higher wages is being played off against the demand of care recipients and relatives for affordable care. This is an attempt to play off the masses against the masses, and we must not allow it.


The demand for higher wages and better working conditions for care workers and the demand for affordable care are demands that must be made together as the demand for an affordable and functioning health system in the interest of the people.


We must not fall for the disgusting attempts of the rulers to play us off against each other. If the state has enough money to spend hundreds of billions on its military to fight its criminal wars, then it also has enough money to finance a decent health care system.