GKV calls for closure of 12,000 medical practices

Health insurance companies plead for closure of 12,000 medical practices

08.07.2011

About 12,000 doctors' practices could be closed according to a report prepared by the Prognos Institute on behalf of the umbrella association of the statutory health insurance funds, without which deficits in the medical care would occur. The GKV-Spitzenverband therefore demanded that the associations of statutory health insurance physicians should be obliged by law to buy surplus doctors' seats when the former operators retire.

According to Andreas Köhler, chairman of the board of directors of the National Association of Statutory Health Insurance Physicians (KBV), the current demands of the GKV-Spitzenverband, however, are on the rise „completely past the reality“ and take into account „not the interests of the patients“. The report on „Purchase of medical practices as a tool to reduce regional disparities in the supply of medical care“ The Prognos Institute ignores key factors, as the „criticized oversupply often exists only on paper and does not reflect the need“, Köhler emphasized. The deputy spokeswoman of the GKV-Spitzenverband, Ann Marini, underlined, however, that the adjustment of the pension law opens up the possibility that currently „correct unfavorable distribution of doctors“.

Lack of doctors in the countryside, medical surplus in metropolitan areas
Over the past few months, discussions have repeatedly focused on a possible lack of doctors, especially in rural areas. The statutory health insurances have always pointed out that the shortage in rural areas is offset by an excess of doctors in the metropolitan areas. It therefore only needed a redistribution to compensate for the deficit in the peripheral regions, so the position of the GKV-Spitzenverbandes. In this context, consideration should also be given to the closure of medical practices in over-served conurbations. The GKV Spitzenverband has now substantiated this point of view with the report of the Prognos Institute. Accordingly, 12,000 doctors' practices could be closed without the supply deficit occurring. About 7,000 doctors could already retire in the next five years, without the closure of their practices would reduce the degree of care in the affected regions below 130 percent, so the result of the Prognos Institute. With the previous requirements planning, however, already considered a supply of 110 percent as over-served. According to Prognos, based on a 110 percent degree of care, this would mean that around 12,000 doctors' practices could be closed in the medium term. Since the practice sale is an essential factor in the old-age insurance of physicians, the practices in the overstaffed regions should be bought by the Kassenärztliche associations and then closed, according to the demand of the GKV-Spitzenverbandes. The Prognos Institute estimated the necessary financial resources at a maximum of 1.5 billion euros, spread over a period of five years, corresponding to less than one percent of the annual fee volume in outpatient care.

Kassenärztlichen Federal Association criticized the GKV proposal massively
The chairman of the Kassenärztliche Bundesvereinigung (KBV), Andreas Köhler, however, criticized the initiative of the GKV-Spitzenverbandes massively and explained this go „completely past the reality“. Because „In Germany, we are currently experiencing an increasing shortage of doctors and a simultaneous increase in the need for care. More and more people are getting older and need a good outpatient care“, Köhler emphasized. Especially in the „Conurbations such as Berlin and Hamburg show that the oversupply criticized by the health insurance companies often only exists on paper and does not reflect the need“, continued the KBV boss. The Prognos report also ignores the fact that general practitioners in metropolitan areas often take care of patients from adjacent areas. Before the physicians 'associations are obliged to buy up doctors' surgeries, it should therefore be examined in detail whether there is a real oversight or only an arithmetic oversupply, Köhler emphasized. Otherwise, it is to be feared that the changes are clearly at the expense of patient care. A similar position is also taken by the Medi Verbund Deutschland, whose chairman Werner Baumgärtner after the announcement of the new report to the „German Medical Journal“ stated: „Health insurance companies, which publicly claim that there are too many doctors in Germany, should finally name the regions to which this applies and then inform their local members that for them the outpatient medical offer should be significantly reduced.“

Closure of medical practices in over-supplied regions demanded
The deputy spokeswoman of the GKV-Spitzenverband, Ann Marini, said, however, that „Today the oversupply with doctors in conurbations de facto not degraded, but even solidified“ will. These are at the expense „of doctors and patients in economically weak regions“, so Marini opposite the „Doctors newspaper“. In view of the criticism of the Kassenärztliche associations explained Marini: „Instead of discussing solutions for a possible shortage alone, we finally have to talk about the other side of the coin, the reduction of oversupply“. Here, the current Prognos report provides a good basis, because it also shows a way that takes into account the interests of retiring physicians and provide them with financial compensation for the closure of their practices. The GKV Spitzenverband therefore pleaded for one „Clarification in the law that in over-supplied areas doctors' practices must be bought up by Kassenärztlichen associations if a doctor leaves and a replacement is not necessary for the care.“ (Fp)

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Image: Claudia Hautumm, Pixelio.de