Health insurance companies demand reduction of doctors surplus

Statutory health insurance companies demand reduction of doctors surplus

31/05/2011

While medical associations and politicians warn of an impending lack of doctors, especially in rural areas, currently calls the Association of Ersatzkassen (vdek) in the run-up to the 114th German Medical Conference in Kiel, a reduction of oversupply to doctors.

On the doctor's day, among other things, the change planned by the Federal Minister of Health Daniel Bahr (FDP) of the supply law will be discussed. With the help of the new regulations, the Minister of Health hopes to counteract a threatening shortage of physicians, which could cause significant shortages in medical care in the future. But the association of the substitute funds denies an imminent shortage in the primary care and instead calls for a reduction of the surplus doctors.

Medical shortage or medical surplus?
The positions could hardly be more different: politics and medical associations warn of an imminent shortage of doctors, while the association of alternative health insurances of one „Surplus of doctors“ emanates. Thomas Ballast, chairman of the Association of Alternative Health Insurance Funds (vdek), said that the density of physicians reached a new high in 2010 with 397 physicians per 100,000 inhabitants. In total, around 31 percent more doctors were working in Germany last year than in 1991, emphasized the vdek chairman. There could be no question of a threatening lack of doctors, because the health of the population had hardly deteriorated in the same period or it was not significantly more medical services required. However, physicians need to be more flexible in order to avoid the shortage of doctors in underserved areas, Ballast said. While „in cities the demand is far more than covered“ is missing „well-trained doctors in certain rural areas“, so the vdek chairman on.

Verband der Ersatzkasse: Do not invest in oversupply
How the physicians are to be moved to settle increasingly in the rural regions, however, is only slightly apparent from the representations of Thomas Ballast. „We should use the insured's contribution money where there are problems or bottlenecks, but not invest in oversupply“, so the little concrete statement of the vdek chairman. Also, the explanation that diagnosis and therapy should be concentrated on the medically necessary level, leaves relatively much room for interpretation. At the end of his message, the vdek chairman emphasized: „Less is often more, too much medicine can harm the patient.“ The underlying message is likely to be understood as a call to limit the number of registrations for established medical practices in the cities in order to increase their settlement in rural areas. But concrete statements of the vdek chairman are missing here.

„In 20 years 50,000 doctors are missing“
The medical associations, however, warn of a massive shortage of doctors, which is already evident today. Frank-Ulrich Montgomery, Vice President of the German Medical Association, has interviewed the „Passauer New Press“ explains that the working conditions are so unattractive that many physicians work after completing their studies abroad or in the industry instead of settling down as a doctor in Germany. Be in the past year „3,500 German doctors have gone abroad again“, stressed Montgomery. The Vice President of the German Medical Association added: „If things continue as they have been doing in the past 20 years, we will be missing around 50,000 doctors.“

Kassenärztliche Federal Association warns of lack of doctors
The National Association of Statutory Health Insurance Physicians (KBV) also warned against the impending lack of doctors and explained that the first signs are already evident today. For many physicians in private practice, no successors had already been found in the past year, so that in 2010 almost 700 doctors' practices had to close, emphasized the chief executive of the KBV, Andreas Köhler. In its projections, the National Association of Statutory Health Insurance Physicians estimates that 66,830 practicing physicians will retire by 2020. However, demographic change requires that the population in the same period „getting older and therefore sicker“ Köhler explained. This could result in the foreseeable future a medical shortage. The medical associations therefore hope that appropriate measures will be taken within the framework of the new health care provision to counteract the shortage of physicians. In addition, the Vice President of the German Medical Association called for a reform of the medical fee schedule until the end of the legislative period in order to increase the financial incentives for physicians.

Minister of Health plans new supply law
As part of the health care law, the Federal Minister of Health Daniel Bahr (FDP) wants to remedy the impending medical deficit in rural areas, primarily through financial incentives and improved earning potential in rural areas. He could „yes, do not force a doctor to settle in the country“, if he prefers to work in Cologne, Berlin or Munich, Bahr explained in an interview „World Online“. In addition, according to the Bahr proposals, doctors' practices should be closed in metropolitan areas. But with these proposals, the Federal Minister of Health in principle confirms the statements of the Association of Ersatzkassen. Because Bahr proposes to remedy the shortage of physicians by redistribution or increased mobility of medical professionals. But if the medical associations are right with their warnings, there are generally not enough doctors available to ensure patient care at the current level. The new incentives of the supply law of which Bahr speaks when he explains how the impending lack of doctors should be avoided, probably fall short at this point. The number of physicians who work in Germany will hardly be influenced by the planned changes. Also, the improvements in working conditions and earning potential demanded by the medical associations have so far been discernible. (Fp)

Also read:
Temporary clearance for doctors
Physician's fees lead to higher cash contributions?
Soon deaths due to lack of doctors?
Strong increase in doctors' fees