The electronic health card can not do much

The new electronic health card can do little more than the old health insurance card

10/25/2011

Currently, all German health insured persons receive the request to send their photographs to the health insurance company. The background is the introduction of the new electronic health card (eGK). Up to the present time the conversion from the old cash card to the new health card cost around 600 million euros. Critics complain that the new chip card can do little more than the old woman. In addition, there are still technical defects that do not correspond to a high level of data protection. Nevertheless, the distribution of pages of the black-yellow federal government with massive pressure is driven forward.

Hardly any additional functions
Although the new electronic health card has barely more functions than the old health insurance card, nevertheless caused the introduction to date around 600 million euros. The cost of this endeavor, which has been in the planning phase for five years, will ultimately have to be paid by the insured. The federal government will not provide any new funds for the changeover. The provision of the technical infrastructure in outpatient medical practices and hospitals alone costs an estimated 156 million euros. The distribution of the electronic health card for all of the 70 million cash patients in Germany will cost about 139 million euros, according to estimates of some experts. In addition, there are development costs, the costs of providing the data and bureaucracy.

The only visible change of the new card is the passport photo of the cardholder on the front. This is to prevent that third parties can no longer afford health benefits. Except for twin couples, the illegal use of insurance benefits is made almost impossible. In addition, insured persons can have chronic illnesses, the blood group, a living will or information about allergies stored on request. If the idea also preserves an organ donation readiness to store the required majority in the Bundestag, then in the near future also these data can be transferred to the card. All other innovations are so far only pure declarations of intent. These include, for example, medical findings and diagnoses, MRI or X-ray images that should be made available on the chip card. When this feature is feasible, is still in the stars, because the data protection there are still inconsistencies on numerous nooks and crannies despite the encryption technology. During initial test runs, there were significant delays in the retrieval of the data because, in some cases, reading was slow. Therefore, according to a survey by the Techniker Krankenkasse, two-thirds of the physicians surveyed were in favor of making the system stable before the new card was put into circulation.

Long planning phase to implementation
Anyone looking at the timing of the planning and implementation phase will find that due to internal discrepancies, organizational problems and technical difficulties, the introduction of the health card has repeatedly been postponed. Because actually the new map should be introduced already 3 to 4 years ago. However, in order to speed up the process, the federal government relented and ordered the funds to equip at least ten percent of the insured with the health cards by the end of the year. Otherwise, the individual cashiers are threatened with severe fines, which could lead to serious problems especially for smaller health insurances. The Federal Ministry of Health has announced that the distribution should be completed by 2013 at the latest.

Significant data protection concerns
However, the Chaos Computer Club (CCC) sharply criticized. There is, according to the initiative „Considerable concerns over whether the Electronic Patient File sub-section meets the high privacy requirements expected of patients and physicians“. In addition, according to the CCC, the „Building the complex infrastructure hardly makes economic sense“. In 2006, the CCC experts of the association were given evaluation data by the consulting firm Booz / Allen / Hamilton. It was read that the introduction of the card too „no savings“ in the health system. „On the contrary, in the first few years, the eGK will be a decent minus business for the health insurance companies and thus also for the insured“, summed up the CCC in a press release. The health insurance companies and the federal government see things more optimistic. Overall, one would expect billions in savings.

Refusal of the insured useless
A refusal of the insured will be difficult. Even if individuals refuse to hand over their passport photo, the changeover is delayed in one's self, but at the latest when the old cards have expired, these are no longer accepted in clinics and doctors' surgeries. Only in a handling time both cards should keep their validity. If there is no medical emergency, doctors can refuse treatment without an insurance card. At the latest then the conversion for each urgently needed. To make it easier to send the pictures, some large health insurance companies have started to set up special pages on the Internet. On this card members can upload their passport photos via secure connection. With some cash registers even the Upload by MMS is possible. All these measures should eventually lead to the implementation being completed according to plan by 2013. (Sb)

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Picture: Sample card of the AOK