FDP demands self-payment in case of lack of doctors

FDP health politician calls for a self-payment of patients with a shortage of doctors

09/01/2011

In many, especially rural regions, there is a veritable shortage of doctors. In order to counteract the shortage of physicians, the FDP calls in such regions, a general self-payment of the patient for each visit to the doctor. In the view of the FDP, this could be counteracted by the shortage of physicians, since the self-payment obligation could encourage physicians to go to the areas in which a shortage of doctors prevails.

Self-payment obligation against lack of doctors
In order to counteract the increasingly rapid increase in the shortage of physicians, insured persons should, according to the wishes of the FDP, settle the doctors' fees themselves in some regions and submit the treatment costs to their health insurance. So the FDP member of parliament Lars Lindemann on Friday against the news agency dpa in Berlin a self-payment obligation of the patients on. The doctors could thus earn more money in such areas. The attractiveness of opening a practice in a problematic area would increase. The upper limits of the statutory health insurance accounts for the self-payment obligation, the doctors could thus demand higher treatment costs from the health insurance. "For the insured, I consider that reasonable," said the FDP politician, who is also a member of the health committee of the Federal Government. "The patients then get the costs back to 100 percent from their health insurance."

The concept of reimbursement is not a new model. For a long time, the FDP brings again and again the reimbursement model in the health debate. According to Lindemann, the reimbursement of costs for all persons with statutory health insurance should become compulsory in regions with a low level of attendance by physicians. In other regions, the existing model of the principle of "in principle" should instead be retained. In regions with lower physician density, it would be more attractive for physicians to open a practice. "For example, we have become accustomed to the fact that a substantial proportion of the physicians' medical services are not remunerated, so if the operation of a medical practice is no longer attractive, it is not surprising that this also produces undersupply in the area", says Lindemann own website.

Doctors for reimbursement of patients
Some medical representatives favor the model of reimbursement. For one, they would be able to settle fees promptly with the patient and would no longer have to agree with the health insurance, whether the treatment costs are taken. Because the bills are paid anyway, even if the cash register does not refund the patient's bill. If in doubt, then patients would have to pay the treatment costs themselves, if the funds refuse the reimbursement.

FDP disagree about future regulations
But in this controversial point, there is also no agreement within the FDP. The deputy FDP faction leader and health spokeswoman for the party, Ulrike Flach, evaluated the proposal Lindemann as a "single opinion". The FDP politician holds against: „I would like to initiate a debate„, explained Lindemann. The self-paid project could first be implemented in model regions to see if it succeeds. At the same time, Lindemann criticized the demands of the medical associations for reforming the requirements planning in the event of a shortage of doctors. Demand planning regulates, among other things, the distribution of doctors to individual areas of Germany. Even a reworked needs planning does not increase the attractiveness for physicians in problem areas to go, so Lindemann.

Health insurance companies criticize self-payment for patients
Clearly the criticism of the health insurance Barmer GEK failed. Its chairman Brigit Fischer suspects behind the proposal a clientele-oriented policy. "The FDP proposal is outlandish, wrong and guided by clientele interests," Fischer told dpa. "Private health insurance shows that reimbursement is not an appropriate way to increase the quality of care." The victims would be the patients, because they would have to open up new income opportunities for doctors with a higher effort.

Negotiations with doctors and clinics planned
Federal Health Minister Philipp Rösler (FDP) will soon be negotiating with clinic, health insurance and medical representatives to discuss the Doctors and Clinics Act. The consultations should also deal with the increasingly rapid increase in doctors' shortages in numerous regions. According to a recent evaluation by the Association of Statutory Health Insurance Physicians (KV), 234 general practitioners and 47 medical specialists are missing in Thuringia alone. During the debate about setting the course of the health care reform, Rösler had also spoken out in favor of the prepayment model at the doctor's visit. Under pressure from the CSU, the FDP had to refrain from this concept. After all, consumer advocates also spoke in favor of setting up a "three-class medicine". Almost through the back door, the debate is now rekindled by the FDP. (Sb)

Also read:
Doctors are in favor of reimbursement
Rösler plans payment in advance at the doctor's visit
CSU criticism of reimbursement: Rösler fights back

Image: Michael Grabscheit