Health insurance chief calls for practice fee abolition

The head of the Techniker health insurance is the practice fee for expendable

12/08/2012

More and more decision-makers are calling for the abolition of the practice fee. For the first time, a head of a statutory health insurance now demands the cancellation of the quarterly fee for the doctor's visit. One study had already determined that the practice fees missed the original goal of minimizing unnecessary physician consultations. The chairman of the Techniker Krankenkasse Jens Baas appeals to this investigation: „The practice fee does not prevent unnecessary medical visits.“

A nuisance for the sick and doctors
As chief cash officer, the chairman of the Techniker Krankenkasse, Jens Baas, calls for the complete abolition of the legally prescribed practice fee. So far, only health politicians, patient representatives and the medical profession had demanded the deletion. „Health insurance funds and health funds are currently very well financially there. There is no reason to hold the patient meaningless in the bag“, explained the TK boss to the „Picture on Sunday“. In addition, the practice fee could not prevent unnecessary medical visits and also not control patient flows. Rather, the quarterly fee „simply a nuisance, for the sick and doctors“.

Since the 2004 healthcare reform, every adult cash-and-carry patient has to pay 10 euros per quarter for the first visit to a general practitioner, dentist or specialist. The central association of the legal health insurance (GKV) pleads for a maintenance of the practice fees. Finally, the fee flushes around two billion euros per year into the coffers. In the opinion of Baas but this source of income for the health insurance would be dispensable. The abolition could not only relieve the insured, but also doctors, as they would have much less bureaucratic tasks to accomplish. Another positive effect could be effective: „With the pointless issuing of remittances in stock would be finally over.“

Baas has been in the position of chief salesman for a short time. In June of this year, his predecessor, Norbert Klusen, had in an interview with the „Frankfurter Allgemeine Zeitung“ still pleading against a withdrawal. Instead, the health insurance companies should provide for bad times and force the creation of additional reserves.

Practice fee missed sense and purpose
In international comparison, Germany is the leader in doctor contacts. The additional fee, which is charged on a flat-rate basis, should be paid by patients „unnecessary consultations“ scare off. However, a study of the central institute for the Kassenärztliche supply in Germany showed that over 50 per cent of all medical therapies goes to the account of approximately 16 per cent of the insured persons, who are primarily chronically ill. As a result, on average, every health insurance patient goes to the doctor about 17 times a year. However, if the 16 percent of permanent visitors are deducted, a cash-on-average patient visits an in-house doctor or specialist on average only four times a year. In addition, the evaluation came to the conclusion that the additional payments do not achieve the desired effect, „not necessarily necessary cash benefits to prevent“.

77 percent of Germans vote against the fee
A representative survey of the Opinion and Research Institute „Emnid“ asked on behalf of the „Picture on Sunday“ 503 Germans on the topic of practice fees. More than two-thirds of respondents (77 percent) were in favor of abolition. Only 22 percent said, „the fee should be maintained“.

Federal Health Minister for the practice fee abolition
Due to the billions surpluses in the health fund also the federal health minister Daniel Bahr (FDP) spoke out for a practice fee reform. „The funds currently have 20 billion euros in reserves“, reports the minister. In view of the high surpluses, the practice fee could be abolished. However, the coalition partners from the CDU and CSU reject this and point to the need for reserves. The GKV-Spitzenverband warned that by 2014 at the latest, surpluses will be used up due to the economic downturn, demographic change and rising healthcare spending. Nevertheless, the practice fee is to be decided in the next coalition committee.

Only in June 2012, several federal states had voted for a revision, but missed the required majority. At the Health Ministers Conference in Saarbrücken, eleven of the sixteen ministers had voted in favor of abolishing the € 10 fee. For a Federal Council initiative, however, thirteen countries must be of the same will. (Sb)

Please also read about the practice fee:
Bahr calls for abolition of practice fees
DGB: practice fee should be abolished
Private funds are no longer acceptable
Health insurance: What changes 2016351a2cc0b08c03> Photo credit: Matthias Preisinger