10 "MARKET & COMPANY" The overall state of the economy is gloomy. Munici- palities, districts and federal states have all been drawn into the vortex of the financial crisis. Costs have to be cut. But because the steadily mount- ing social transfer payments cannot be reduced, the belt-tightening has to take place in other areas: schools, kindergartens, hospitals, social agencies, projects for funding distressed city districts, con- sumer consulting centres. There jobs are being cut, budgets slashed, investments postponed. In many places the consequences of this are run-down build- ings, outdated equipment and the closure of entire facilities. The question which many districts and municipalities in Germany have to ask themselves is an existential one: How will they be able to maintain at least mini- mum standards in education, healthcare and child- care? The only option left open to them is to rid their budgets of the biggest cost items and thus restore financial leeway for the provision of basic services ­ by privatising the biggest possible expense items in the budget and selling them to private companies. But this solution is only viable when there are ex- ternal payers to cover the costs: health insurance funds, nursing insurance or citizens themselves who can be made to pay for certain public services di- rectly (such as waste disposal). State universities, schools and kindergartens for the most part do not fall under this category. Senior citizens' homes have already been privatised in large numbers ­ their revenues are generated from their own occupants and from nursing insurance. But when it comes to hospitals, most municipalities and districts are far more hesitant, even though the burden these place on their finances is becoming increasingly onerous as the German legislator introduces more stringent OF OPPORTUNITIES, FEARS, AND SUCCESS STORIES TALES FROM THE LIFE OF A PRIVATE HOSPITAL GROUP The issue of hospital privatisations has come to be widely debated. The arguments have swayed to and fro between the State's responsibility for basic services which people consider to include healthcare provision, and the badly needed professionali- sation of the healthcare system to ensure its quality and future viability. The accom- panying music for this is supplied by emotions on the one hand and financial pres- sures on the other. We compare and contrast these rather theoretical contentions with some real examples from the practical experience of our company. By Joachim Weber* * Freelance journalist in Frankfurt am Main
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