Cash patients still have to wait longer

Cash patients have to wait a long time for treatment

09/10/2014

According to a draft by the Ministry of Health, long-term care patients will have to wait too long for a specialist appointment as the Grand Coalition softens the planned term guarantee.

Accordingly, the guarantee for an appointment is coupled within four weeks to certain conditions. So a treatment within this period actually has to „medically necessary“ his. „If there is no risk that the condition will worsen without treatment or a longer delay leads to an impairment of the desired treatment success“ the four weeks deadline is obsolete. Dates must then only in one „reasonable time“ be taught how the „Kölner Stadt-Anzeiger“ reported. What is a reasonable deadline, however, is not regulated in the draft work.

Another requirement is therefore the presence of a medical referral to the specialist.
Exceptions to this are only valid for appointments with the pediatrician, female or ophthalmologist.
If the planned service centers refused by the physicians do not offer an appointment within four weeks despite the fulfilled requirements, the patient must be offered an appointment at a clinic.

The experts see the cause of bottlenecks in appointments with medical specialists clearly: loud „Plus minus“ The needs assessment since 1993 has not been updated. Theoretically, there is therefore officially no shortage of specialists, but even a surplus. However, even the representatives of the Kassenärztliche Vereinigung doubt this.

"The statistics on the supply situation is one thing - the reality of how patients experience them in everyday life is the other," cites Plusminus Johannes Fechner. Also the expert advice health criticizes in his report, "that until today there is no real needs assessment".

Prof. Dr. Ferdinand M. Gerlach, Chairman of the Health Expert Council in the magazine: "Until today one assumes - as we believe wrongly - that this actually corresponds to the real need .That can not actually be so, because the humans got older, the Medicine has evolved, we actually need a new, science-based demand planning. "

How that could look, shows a study of the Bertelsmannstiftung. According to this, almost half of the districts in Germany, for example gynecologists, are underserved, whereas the official requirements planning does not see them.

Dr. Michael Elsberger, gynecologist confirms this in the ARD magazine: "Currently, in our practice, the waiting time for a routine appointment is about four to six months." To treat more patients, he would like to hire a doctor by the hour. However, he can only bill this if the Kassenärztliche Vereinigung approves it.

"Unfortunately, that did not work out, I tried to do that for a long time, but either it did not work or I pay it out of my own pocket." Rejected because there are supposedly already too many gynecologists in the district of Wunsiedel in Upper Franconia - according to requirements planning of the Association of Statutory Health Insurance Physicians. As the Minister of Health wants to achieve his term guarantee, experts is a mystery.

To enter into force „Act to strengthen the provision of statutory health insurance“ According to Kölner Stadtanzeiger, this will not happen until the autumn of 2015. In May next year, it will have to pass the Bundestag and the Bundesrat, after which the Kassenärztlichen associations will have six months to set up the service points. Whether the law can fulfill its purpose remains questionable in the light of the background. (Jp)