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Krainer, Josef junior - Kranzmayer, Eberhard (21/25)
Krankenhäuser Krankl, Hans


Health Insurance, guarantees compensation for medical expenses and loss of earnings during sickness or maternity. It also provides measures for the prevention and early diagnosis of diseases by way of medical examinations and health programmes. Nearly all Austrians are insured under the General Social Insurance Act (Allgemeines Sozialversicherungsgesetz, (ASVG)) and other social insurance laws. Persons without compulsory health insurance can obtain private insurance under the ASVG. Health insurance for employees is mainly administered by regional health insurance agencies (Gebietskrankenkassen) and by the insurance agencies for civil servants (BVA) and railway employees.

Insurance benefits cover medical care by physicians, drugs and devices supporting the healing process. The insured person has a right to medical care in a public hospital (hospitals) or to home care. The relations between insurance agencies and public hospitals are regulated by contract, but public hospitals are compelled to treat patients referred by insurance carriers. Social insurance institutions pay a lump sum per patient to the provincial hospital finance funds of the performance-related hospital financing system (LKF).

Health insurance also includes compensation for dental treatment and dentures as well as benefits in case of disability (subsidies for devices). If the employed is unable to work due to illness, he/she has the right to sickness benefits - according to the ASVG - for a time of about 26 weeks, which can be prolonged to 78 weeks.

Under the ASVG health insurance is financed from contributions, which amount to 6.4% for salaried employees, 7.4% for blue-collar workers, and by an additional contribution of 0.5%. Employees and employers have to pay half of these contributions respectively. In order to alleviate the financial burden of health insurance agencies, retention has to be paid for some services, e.g. prescription fees; insurance certificate fees by salaried employees and blue-collar workers, 20% retention fees for medical treatment by civil servants and self-employed, as well as for farmers and others.

Historical background: Forerunners of health insurance were local self-help groups. A decree issued by the imperial chancellery in 1837 required employers to pay for the hospital treatment of their employees for four weeks, the General Mining Law of 1854 made the establishment of common insurance agencies for miners ("Bruderladen") compulsory, the commercial code of 1859 required owners of large and dangerous enterprises to introduce health insurance agencies at company level. The Vienna Workers' Education Society (Wiener Arbeiterbildungsverein), founded in 1867, had a section for the support of the sick, which was merged with general health insurance in 1928. In 1887 accident insurance was prescribed by law, and on March 30, 1888 (in force from August 1, 1889) a law on social health insurance was passed. In 1917 family insurance and maternity allowances were introduced. Health insurance for civil servants was laid down in a law in 1920, that of salaried employees in 1926 (together with old age pensions and unemployment benefits), health insurance for blue-collar workers (without old age pension and unemployment benefits) was introduced in 1927 and for agricultural workers in 1928. In 1933 company insurance agencies took over the function of the "Bruderladen", in 1935 a law on social insurance in commerce and trade was passed, providing for new regulations of the insurance for blue-collar workers and salaried employees (benefits were cut). On January 1, 1939 the German laws (including old-age pensions and unemployment benefits for workers) entered into force; they were taken over by Austria in 1945. In 1948 social insurance was reorganised. The General Social Insurance Act (ASVG), which took effect on January 1, 1956, provided for new regulations. Health insurance for farmers was introduced in 1965, for tradesmen and craftsmen in 1966.

Literature: M. Binder in: T. Tomandl, System des österreichischen Sozialversicherungsrechts (loose-leaf collection).

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