1. Social Insurance: The German System
The German system is a largely public net of interlinking insurance institutions. Health insurance, accident insurance, pension insurance, care insurance, and unemployment insurance are designed around the generic employee and wage-earner. Exemptions for public servants, freelancers, highly paid employees, etc. create a rather complex system of public, cooperative, and commercial institutions. The relevant institutions for me as an employee are, in order as they appear on my payslip, Rentenversicherung (statutory pension insurance), Arbeitslosenversicherung (unemployment insurance), Krankenversicherung (statutory health insurance) and Pflegeversicherung (care insurance).
1.2 Deutsche Rentenversicherung – DRV
The pension insurance, paid for by employers and employees, is the foundation of my retirement plan. My direct interaction with DRV is the annual overview of the entitlements I earned in the different status groups as student, unemployed, freelancer, and employee. This paper document is sent to me every year, attached with information how to correct potentially wrong information.
The web-based portal deutsche-rentenversicherung.de offers as an „Online-Tool DRV“ several services. Here I can submit applications for payout of my pension, for (health) preventative measures, for changes in my status (mainly relevant for civil servants and freelancers), for (physical or psychological) rehabilitation measures, for expat status, for correction of my insurance history, and to submit medical information or data protection issues.
The tool is basically a digital form with the possibility to attach scanned documents. The system is rather straightforward, protected by several possibilities for identification, such as electronic state ID card or PIN sent via mail.
Further, I have the option to register for a consultation appointment at a pension insurance office online. In a form I can enter my name and insurance number and pick an office and a date. The consultation itself is limited to an in-person appointment.
An online pension calculator offers to calculate the date and amount of my pension based on my current insurance information. Additionally, the calculator offers ranges of possible pension amounts based on life decisions and development of my income. A separate tool gives me an orientation on the buying power of my future pension. Last but not least, the calculator generates pension data regarding early retirement, employment as a pensioner, and partial retirement.
“Online-Tool DRV” offers the option to order a current insurance overview, to send in letters and documents, to change my personal information, and links to further avenues of communication, such as telephone numbers, office addresses, e-mail addresses, a contact form, and a link to the (still experimental) state secure e-mail service “De-Mail”.
The services of the “Online-Tool DRV” can be used by an insured person, by a legal representative or a third authorized person, such as relatives or social workers of an insured person. The tool is explained in German as well as several languages, Simple Language, in written information as well as in explanatory videos, including videos using sign language.
The web portal deutsche-rentenversicherung.de offers additional information resources on pension and health issues, sports a media library with e-books and video documentaries on related issues and problems. A certain selection of written materials can be ordered online via a web shop as printed leaflets, books, brochures, posters, etc. A section is dedicated to my rights and possibilities as a citizen in the “Sozialwahlen”, the elections of the self-governed public entity.
I personally used the calculator to estimate my future pension at some point. At some point I will use the digital service for my account clarification in order to complete the insurance information regarding studies abroad, freelance periods, etc
1.3 Agentur für Arbeit
The unemployment insurance, administered by the public agency for labour, guarantees me unemployment benefits for a year, afterwards the agency pays out a social insurance sum based on some sort of calculation of the minimum standard of living.
The web portal arbeitsagentur.de offers the range of applications for social benefits administered by the agency. Through a form with the possibility to upload scanned/ digital documents, the “eServices” allow me to register myself as unemployed. I can apply for unemployment benefits and for social insurance benefits – during the Corona measures completely online and via a phone interview. Further applications for extension of benefits, for vocational (re-)training support, bankruptcy compensation, or to change personal data are possible here as well. Special applications, such as asking for permission to leave the municipality as an unemployed person or to ask for reimbursement for job search costs round up the eServices. (The state family fund Familienkasse is administered by the agency as well, so the web portal offers digital applications for child support issues as well.)
The portal sports a job search data base, that works both ways. By entering a profile with CV, certificates, and letters of recommendation, I can be found by employers looking for my skill set. The same profile can be used by an agency consultant to inform me about suitable employment opportunities. On the other hand, the data base contains employment vacancies, enriched by further information such as collective agreements in effect etc. This data base is one of the largest job search engines in Germany, but entries of vacancies in this data base is not mandatory for employers.
Another large section of arbeitsagentur.de offers tools and information regarding career and education choices. The tool “Check-U” is an online personality test, offering hints for young people to find a suitable vocational training or a field of study. The tool “NewPlan” is directed towards adults looking for avenues for personal and professional development and further training through a questionnaire regarding professional biography, educational achievements, and fields of interest. Attached to both tests are search engines for training offers and education institutions. Further, databases with study programmes, vocational training ads, and assisted trainings programs for persons with special needs are part of the portal. Part of this section are online application tools for financial and pedagogical support measures for school students having difficulties to enter an apprenticeship or other forms of vocational training.
The portal arbeitsagentur.de offers legal information, explanation, and guides in several languages, including sign language and Simple Language, regarding unemployment, training, re-training, family issues, disability, migrants, and current affairs such as Ukrainian refugees, Corona, etc. A download section offers PDF-based brochures and leaflets about the agencies’ services, legal issues, as well as support services.
Contact forms, a hotline, an address-based search engine for agency offices, and a rudimentary chat bot show different avenues to gain further support from Arbeitsagentur.
I personally used the digital services extensively in search for jobs – both as a student and as an unemployed citizen. The drop-down menues for professional qualifications are somewhat dated and oriented towards vocational certificates. So my internships in marketing and business development had to be translated to “office aide”, nevertheless the service supported my entry to the job market. In my last two periods of unemployment I was able to apply for benefits completely online and by phone. Nevertheless, letters by mail seem to have higher priority than self-entries into the database and agency consultants did not have all information available I uploaded. Digital transformation is a process.
1.4 Innungskrankenkasse gesund plus – IKK gesund plus
Health insurance for employees is based on a number of self-governing bodies with roots in location- or industry-based insurance companies. Krankenversicherung (statutory health insurance) and Pflegeversicherung (care insurance) is formally a separate public service, in practice delivered by the same company. With the liberalization of the health insurance market, I can choose the insurance based on the (slightly) difffering insurance fees deducted from my pay slip, special treatments or special preventative measures covered etc. IKK gesund plus derives from a merger of three “guild” (Innung) health insurance companies, historically craftsman associations.
My chip card carries my personal information and proof of my valid insurance status. When visiting a medical appointment, this card is scanned and used by the clinic or practitioner to settle their bills directly with the health insurance. The same card doubles as a European health insurance card, allowing me to use health services within EU.
The mobile phone app “IKK Kunden-App” can be used to communicate with the insurance company about changes in personal information, booking additional private insurance, and download a range of legal and medical support information. Sick notes excusing me from work can be scanned by the app and sent in directly. A form allows me to enter the data from a medical referral with a service of the insurance company to look up specialized clinics etc. and to book appointments for me for my preferred dates. Additionally, the bonus program “ikk aktiv plus” – offering coupons and little perks for showing up to health-related programs, medical check-ups, etc., can be administered via the app. The app, secured via initial PIN via mail, serves further as two factor identification service when interacting with the insurance via their “IKK-WebCenter” on their portal ikk-gesundplus.de
This “IKK-WebCenter”, branded as the online service office, offers web forms for applications for special prophylactic and medical services, for administration of conflicts with the insurance, and to apply for measures of health-related rehabilitation. The online forms, together with the option to upload documents, substitute the correspondence by mail and the standardized application forms of the 20th century.
The web portal ikk-gesundplus.de, available in German, in Simple Language, and supported by videos in sign language, offers a contact form, a call-back-service, appointments via Skype and a office location search. The portal mirrors the services of the mobile phone app and sports further information, PDF brochures, and explanations on different insurance status groups such as employees, public servants, freelancers, students, etc.
Further services offered here are a medical hotline, access to the electronic patient file, search engines for practitioners, clinics, and pharmacies, as well as downloads for a living will, medical power of attorney, care directive, etc. An online calculator gives an overview to the costs of optional additional private insurances – such as dental insurance or private hospital room insurance. A second calculator gives an estimate for costs covered by dental issues, a third offers calculations on status as pensioner with additional income.
A large section of the web portal is dedicated on health and legal tips. Ideas and suggestions for exercises at the work place or hiking, cycling or various nutritional articles, even recipes and How-Tos for holidays, personal hygiene, cleaning, mental and social health, office work, physical work, allergies, and stress are being offered. Self-training schedules next to mandala downloads create a sense of universal care. Overview is given on more common health issues and their usual treatment. Medical issues and what to expect during treatment is being explained next to information on stem cell donations, organ donations, or maltreatment.
I personally used the app and the web portal to update personal information – but apparently the “customer” part of the data-base is not linked to the “statutorily insured person” of the data base, so I had to update information by app and by mail. The chip card is used mandatorily at every visit to a medical practitioner. Additionally, I made use of the medical appointment service via the app. This worked well for general practitioners. In the case of specialized services, the service had difficulties as they basically do a ZIP code search for the respective city center. As a result, Ii even had failed appointments with private practitioners, not accepting my public health insurance coverage.
1.5 Development Trends
The German Federal Office for Social Security defines as main areas of digitalization (Bundesamt für Soziale Sicherung, n.d.): education and counselling via mobile apps and online servies; digital medical services; prevention and rehabilitation; patient education and medical care; medical remedies and support; health applications; public health; as well as development of digital health competences. Digitalization of the welfare state – aimed at modernizing, citizen-friendlier, and less bureaucratic services – is anchored in the coalition treaty of the German governing parties (Der Spiegel 2021). Information, consulation, applications, communication is supposed to become easier and more digital.
Through service apps and online offices, digitalized administration and communication is becoming the norm. Sick notes, insurance bonus programs, membership and student status certificates are being digitalized. On the horizon, digital announcement and communication of administrative acts – in itself part of the legal framework to allow for digital sovereign acts – are supposed to become possible. The government wants to strengthen the federal health digitalization strategy. Explicit aims are better care work through digital and easier documentation, remote medical services, video consulations, telemonitoring, even telemedical emergency services.
The digitalization of pension insurance is pre-determined by legislative acts regarding online access to public services and develops through projects on digital rehabilitation services “RRV-Digital” and the digital strategy of Deutsche Rentenversicherung. Main visible mile stone of digitalization will be the German citizens’ portal, unifying public digital services within one system – encompassing besides the pension insurance federal, state, and municipal authorities and agencies. A “Chief Digital Officer” of DRV steers projects which are openly aimed at the visible parts of digital workflows within the insurance administration. The internal, “invisible” part, is dominated by debates and projects on AI, cloud computing, and automated administration of services. AI is supposed to prepare administrative decisions and to analyze possible wrong doing in the health sector. In early developmental stages the social security office is preparing for AI based language assistants.
Digitalization of health insurance companies focus on the digital patient file, a full medical history and treatment overview, including insurance information of all insured persons in Germany. This extreme move away from the decentraloized post-war system in Germany follows the logic of digitalization, but is met with reservations in the view of political persecution in the fields of reproductive rights and trans rights, at example. Nevertheless, the government coalition accelerates the development of the electronic patient file – but with an individual right to opt-out.
1.6 Critical appraisal of social insurance digitalization
Transparent information about my pension status, chances for online consultations, etc. from finding work to clarify insurance status simplify processes, reduce the amount of paper in my home, and create a feeling of being taken care of in a larger, improving system. Online information about prevention and rehabilitation lower the barrier of access to information, what could be wrong with me and what kind of help or rehabilitation could be available to me.
As a university graduate, i.e. a person trained in dealing with online services, forms, scanners, etc., I see that the administration of my existence gets easier. Appointment services and digital search engines save my time when I am moving to a new city and need medical services. Digitalized information helps my medical practitioners to continue where the last care worker left off. Ease of services, such as finding medical appointments online, help me to overcome procrastination or insecurity to apply for skin screenings, cancer screenings, etc. and might help to sustain my health. General availability of information on lifestyle, nutrition, exercise, etc. increase the probability that I actually make use of this information.
Digital unemployment service reduce stress in times of unemployment when I do not have to enter the depressing, anonymous building of the employment agency. Self-directed search for training or job opportunities give me a greater sense of independence than sitting across as “judging” public servant. Digital applications might guide me through the necessary documents and needed information, thus speeding up the process from losing a job to receiving unemployment insurance.
Nevertheless, the current stage of digitalization, depends on my ability to deal with forms and scanning documents. It depends on my access to internet connection and services such as a copy shop in order to scan paper documentations. Digital services rely on my ability to convey relevant information in text form and on my mental health in order to understand large digital portals. Eyesight and nimble fingers are a prerequisite to use keyboard and monitor. Should the physical presence of social insurance agencies decrease, should they reduce consultation staff etc. in order to gain from the so called digital dividend, I see actual disenfranchisement of the groups of the population who actually need social insurance.
In view of election results all over Europe, from Hungary to France, the data centralisation and transparency of people living here towards social insurance companies, medical practitioners, and the state create a risk for people targeted by chauvinism and racism. Policing of bodies and minds, exclusionary tactics against women and trans persons becomes easier. We have knowledge of Nazis in the police force, using information for attacks on democrats and minorities. We have now seen, that there are extremists as well within the medical community, even fake vaccinations have occurred. Criminal acts by medical practitioners are in danger of becoming more effective, when cantralised medical information – on drug use, on abortions, on non-heteronormative lifestyles, etc. – is available.
Digitalization of social security demands further development of explicit human rights. Access to information for citizens, non-citizens, and NGOs becomes are pressing concern. Watchdogs against right wing governments as well as against criminal persons within the system need to gain robust rights and funding in order to deal with centralisation of information, with functioning of AI systems taking over administrative decisions. Actual public debate and political processes are needed to evaluate the digital divide between the able-bodied, digitally trained persons and the more and more excluded parts of society – ranging from refugees to the elderly.
2. Digital Shopping and Services
2.1 Digital Take-Away restaurant order
When I visit the website linked on Google Maps of one of the surrounding restaurants, I am redirected to a landing page of Lieferando.de, the German brand of Dutch Just Eat Takeaway. Here I can order items of the standard menu to deliver or to pick up. I can pay via digital credit card, Paypal, or Klarna. When visiting the restaurant in person, I learn that the online portal Lieferando.de takes 30% of the consumer price. Using credit card or Paypal takes further fees off the restaurant’s revenue, ranging between EUR 1,50 and 1% of the order total. When calling in by phone for delivery or pickup and by paying with cash, the restaurant retains the full price of my order – for the same price as on the Lieferando.de platform. When possible, I chose the latter way to order food as my convenience to use a mobile app or a website to order food leads either to loss of profit of small independent businesses – whether food, hospitality, or retail industries – or to an overall price increase of these goods and services to still make reasonable numbers. Either way, I am paying a large chunk not for the quality of goods and services, but for the allocation system, meaning the middle man.
Of course, I could argue, that in the long run, businesses could create a trade-off between digital visibility and platform-generated revenue on the one hand and less expensive real estate in more suburban parts of the city. Nevertheless, I experience it as a loss of urban quality, not to have lively restaurants with guests filling up the streets. Further legislative action to protect independent businesses from parasitic forms of the platform economy is needed. Here, semi-public services such as the Yellow Pages or the Chamber of Commerce can step in in order to create equitable platforms while retaining the benefits of digitalization such as increased visibility of the diversity of places, businesses, and services available to me.
2.2 Digitalization and digital gap
Expanding on my findings in chapter 1.6 (Critical appraisal of social insurance digitalization), I see the risk for people not using virtual services of material exclusion. European rights such as free choice of profession and education, participation in the political process and in cultural life as well as consumer rights such as market transparency and the ability to make an informed decisions are increasingly tied to digital literacy and the readiness to engage with the virtual world. When even physical interaction – from social counselling to music concerts – are mediated solely by digital means, exclusion threatens to create insular groups of persons left behind in the virtual and the (growing) augmented reality.
The transfer from cash money to digital credit creates the challenge for excluded persons – such as the homeless or refugees – to use the little money they might have. Digital money transfers erase the chance to give anonymous donations, whether it might be to a radical opposition group surveyed by the government or to a poor person, whose extra “income” is being deducted from their social benefits.
The transfer from both journalism and advertising from newspaper boxes and billboards to the virtual realm implies the challenge for people without (mobile) web access to have information on current affairs and on goods and services necessary to participate in society. As a non-digital citizen, I cannot realize my right to an informed vote in the elections and as a non-digital consumer, I do not have access to “necessary” status items, medical or educational services.
The move of retail industry from city centers and malls to Amazon.com’s warehouses, accessible digitally, deprives non-digital persons from the benefits of centrality and urbanity. They have fewer opportunities to buy products or even to repair things they own, when stores close and inner cities become more and more the domain of the hospitality industry.
3. Digital Competence Test
I scored a solid 85% in the Digital Competence Wheel. My strongest Digital Competence Area seems to be “Information”.
4. Self-reflection
The research and writing process gave me the opportunity to actualize the state of digitalization beyond my narrow everyday life. The building of momentum in the digitalization of public services, here the social insurance system, gave me new insights. Especially how an ecology of information services and nudge-based “idea sections” start to grow around the core services of e.g. the pension insurance. It appears to me, that a blurring occurs between journalistic information, authoritative information from public services, and commercial sources.
This is visible as well et example when comparing job searches, digital mini-trainings, and self-evaluation tools provided by the unemployment agency with their commercial counterparts by portals like LinkedIn or the Digital Competence Wheel presented in this course.
This diffusion of information is simultaneously a lowering of barriers and a greater availability of health tips, job opportunities, and educational materials, among others. On the other hand it increases the importance of digital skills and competences to discern sources of information and of services. How information is dispersed to society at large and who are the players (or gatekeepers) in the information and network society – to use the term of Manuel Castells – is an area I will be interested in the future as well (Castells 2000).
5. Comments
I commented on the articles of sonjaju, Heini’s site, and Mirja’s blog.
References
Bundesamt für Soziale Sicherung, ed. n.d. ‘Digitalisierung in Der Gesetzlichen KV Und Der Sozialen PV’. https://www.bundesamtsozialesicherung.de/de/themen/digitalausschuss/fitness-und-gesundheits-apps-digitale-gesundheitsanwendungen/.
Castells, Manuel. 2000. ‘Towards a Sociology of the Network Society’. Contemporary Sociology 29 (5): 693–99.
Der Spiegel, ed. 2021. ‘Mehr Fortschritt Wagen. Bündnis Für Freiheit, Gerechtigkeit Und Nachhaltigkeit. Koalitionsvertrag 2021 – 2025 Zwischen Der Sozialdemokratischen Partei Deutschlands (SPD), BÜNDNIS 90 / DIE GRÜNEN Und Den Freien Demokraten (FDP)’. https://www.spiegel.de/politik/koalitionsvertrag-der-ampel-parteien-im-wortlaut-darauf-haben-sich-spd-gruene-und-fdp-geeinigt-a-3e25c4da-088a-4971-8a4d-4797a4ecf089.