Law on medical care is being revised

The law on medical care is to be revised in 2011: health insurance companies require temporary licenses instead of previous doctor approvals.

31/12/2010

With his push to revise the hospital sector, last week Jens Spahn, health expert at the CDU, has re-launched the discussion on the problems of medical care. In the coming year 2011, the Federal Minister of Health Philipp Rösler (FDP) wants to submit to the Cabinet not only a proposal on care reform but also a new care law for the treatment of patients in the hospital or at the doctor for decision.

The suggestion made by Jens Spahn with regard to the reform of medical care, in the future also to guarantee cash-patients twin rooms in clinics, was, after initial skepticism, taken up benevolently by the Federal Minister of Health: „The goal of accommodating even insured persons only in double rooms is a good approach.“ But such demands can be difficult to implement at the federal level, because the individual federal states are responsible for the clinics. Whether these in view of the threat of higher costs in proposals such as the twin room rule, however, is questionable. Therefore, in preparation for the bill, the Federal Minister of Health, in collaboration with the federal states and associations of physicians, health insurances and hospitals, wants to work out exactly what a corresponding provisioning law might look like.

Kassenverband demands revision of the system of doctor approvals
Also the chairman of the top federation of the legal health insurance funds (GKV top federation), Doris Pfeiffer, announces itself in view of the projects of the Federal Minister of Health and stressed that she looks forward to the negotiations with great confidence: „I am glad that we now talk about the care of patients and not just more money for doctors and hospitals, "Pfeiffer told the news agency dpa. In particular, the rigid system of doctor approvals must be urgently revised under the new supply law, so also the opinion of the chairman of the Kassenverband. „A major problem is the legal guarantee for any practitioner that his practice can be resold even in a totally oversupplied region“, Doris Pfeiffer explained.

Temporarily limited licenses instead of the previous approvals
Thus, the head of the GKV-Spitzenverbandes addresses a critical issue for most physicians, because the resale of established practices has so far been an essential aspect in the old-age insurance of physicians. Over the years, this has caused a maladministration in the distribution of medical practices, so there is currently an overhang of 25,000 doctors in the areas with an oversupply, in certain regions with a shortage of physicians, however, estimated only 800 doctors, said Pfeiffer. Altogether, the number of physicians in private practice and those working in clinics in Germany, at around 140,000, is higher than ever before, according to the chairman of the GKV-Spitzenverband. „Obviously, we have a distribution problem and not a quantity problem,“ emphasized Pfeiffer. While it would be quite appropriate in the sparsely populated areas to incentivize home visits, these supplements should only be granted if, in return, discounts are paid in over-medicated areas.

Align medical care to actual needs
„Simply to spend even more money for underserved regions, I consider fatal“, warned Doris Pfeiffer. The problems of doctors in rural areas can not be solved by a renewed burden on the contributors, according to the chairman of the health insurance association. Rather, it is about aligning the medical care to the actual needs, which also means to build capacity in the underserved regions and reduce them in the oversupplied regions, said Pfeiffer. One of the proposals of the GKV-Spitzenverbandes for the implementation of the goals are temporary licenses instead of the previous unlimited doctor's licenses. A suggestion that has so far received little support from the doctors. On open ears, however, the proposal meets in rows of politics. Thus, Johannes Singhammer, health politician of the CSU, explained that he considers the current system of medical approvals to be too rigid, since this sometimes has the character of a life decision - the motto is: Once a country doctor, always a country doctor.

Physicians should be able to choose more flexible
In the future, more mobility would be needed to encourage medical professionals to open a practice in underserved, rural areas in the short term, addressing the country's shortage of physicians, said Johannes Singhammer. The long-term commitment of physicians to a particular doctor's office rather disadvantageous, because „It would be easier for them to move to an unattractive region if they could realign themselves after a few years“, so the CSU health politician. However, Singhammer believes that market forces could counteract the rural medical shortage anyway. The easier access to the profession, the attractive environment and the high quality of living and the family-friendly conditions will increasingly attract medical professionals from the metropolitan areas to the rural areas in the future, according to the hope of the health politician. However, Singhammer warned against compromising on the remuneration, because money is not everything, but a good income is an essential factor for the choice of location. On average, German taxpayers donate some 300,000 euros to educate students on medical professionals, but out of 10,000 graduates, 2,500 go abroad, primarily for income, Singhammer said. Therefore, the development of medical fees should not fall short of the income of doctors in Scandinavia or the UK, stressed the CSU health politician.

Collaboration between family doctors, specialists and hospitals
The GKV-Spitzenverband has, in addition to the introduction of licenses instead of the previous approvals, the easing of the too rigid border between physicians and clinics in the treatment of patients for discussion. Frequently, patients in a clinic would only be treated for an hour or a day, which should encourage thinking about the function of hospitals, according to the chairman of the GKV-Spitzenverband. Also, the purpose of a nationwide supply of lung specialists or surgical ophthalmologists to question, said Doris Pfeiffer. In the future, there will be far more to the good cooperation between the family doctors, specialists and hospitals, and the negotiations could be extremely difficult at this point, stressed the head of the Kassenverbandes. „It is obvious that we have to drill a thick board here“, so Pfeiffer. However, politicians, health insurances, doctors 'and clinicians' associations agree on one point: The health care law must be urgently addressed in the coming year in order to secure long-term medical care. (Fp)

Picture: Rike