Cash patients are clearly disadvantaged

Discrimination of cash patients at the doctor

07/18/2011

Long waiting times, barely time for a detailed medical history and eternally long appointments. Cash patients experience this every day anew when they feel the injustices of the German health system. According to a study of the general local health insurance AOK Rhineland / Hamburg, the differences between health insurance and private patients are serious. The reason: Doctors get much more money for the care and treatment of the private insured and therefore treat privately insured persons with preference.

Partly three times longer waiting times for cash patients
It is no longer a secret, in Germany there is a so-called „Two-tier health care“. For insured persons of the statutory health insurance companies must expect in part with considerable waiting times, particularly when it comes to the consultation of a specialist. According to a study by the AOK Rhineland / Hamburg, injustice is felt the most, for example, by the cardiologist (cardiovascular specialist). Patients in the health insurance funds have to wait about 71 days to be admitted to the doctor, whereas private patients only have to pay 19 days. Anyone who wishes to register with a radiologist for a health insurance patient must set up a waiting period of 46 days, whereas private patients only have to wait 7 days. At the ophthalmologists the situation does not look better. Health insurance insured wait on average about 37 days for a doctor's appointment. The mostly wealthy private clientele only 16 days. In the meantime, the patient's condition may have worsened.

800 random samples at doctors
For the study, the local health insurance AOK Hamburg in June this year, about 800 medical practices have called. First, the testers pretended to be cash-on-demand and asked for an appointment in practice. A little later, a second call came. Now the test callers presented themselves as private patients and also questioned the medical assistants after a regular examination appointment without emergency care. In almost all cases, an appointment was soon offered. Wilfried Jacobs, head of the AOK Rheinland / Hamburg, was very angry about the results of the study. If the health insurance companies do not get the chance, there will be little change in the situation, according to Jacobs. For this reason, the health insurance would have „The right to no longer have to work together with specialists who do not give timely appointments to legally insured persons. "In practice, this would mean that the doctors would lose their censorship - a requirement in view of the strong medical lobby will hardly enforce.

No impairment of emergency care
„In an emergency, all people are the same“. This is at least the result of a study representative survey study commissioned by the German company health insurance funds. Anyone calling the doctor due to severe pain or serious health problems will get an appointment soon. In two-thirds of cases, a doctor's appointment was agreed on the same day.

Direct question about form of insurance is bypassed
Are office workers allowed to ask on the phone for the type of insurance. In principle, yes, but most medical assistants avoid the direct question with the wording whether one has ever presented in practice. After entering the name, the insurance form can be viewed. Thereafter, the medical assistant decides the appointment.

Private patients are more lucrative for the doctor
But why do cash register members have to wait longer than private patients? The answer is very simple, the treatment of a private insurance is on average 20 to 45 percent more lucrative and thus brings more money. To ensure that the patient is not lost to another doctor at the time of the request, the earliest possible date is given. But not only in the waiting time seems to give an unequaled care. According to a recent survey by the opinion and market research institute GfK, 83 percent of health insurance insured persons feel that they are treated worse than those with private health insurance.

„Doctors need private patients“
The medical profession, on the other hand, defends the practice of unequal treatment. Finally need „Doctors just private patients, in order to make ends meet“, said Dieter Bollmann, chairman of the Kassenärztliche Vereinigung in Hamburg. The accusation, the doctors would complain at a high level, the medical representative did not want to leave the Hamburger Abendblatt. "This may apply to those who generate the annual average annual turnover of 220 000 euros," said the chamber chief. In Hamburg, however, the doctors would make an average of 120,000 euros annual revenue. And finally, wages, taxes and maintenance costs have to be paid for. For the doctors, scarcely more than 60,000 euros a year remained. And that would be for „a 10 hour day not much“, the medical representative notes. (Sb)

Also read:
Doctor appointments: Cash patients are disadvantaged
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Numerous private health insurance plans to increase contributions for 2011
Separation of private health insurance and GKV a discontinued model?

Picture credits: Halina Zaremba