MDK in the stranglehold of health insurance?

Medical services of health insurance under direct influence of health insurance

08/11/2014

The medical services of the health insurance (MDK) should actually ensure an independent assessment of specific medical issues, not least to safeguard the interests of patients and to take appropriate account. But have searches of the ARD political magazine „Report Mainz“ result in the MDK board members often full-time employees of the health insurance companies are represented. Thus, the MDK is subject to a significant influence of health insurance and independent assessment is at risk, so the critique of experts such as the social rights professor Professor Ingo Heberlein.

According to the results of the ARD research, the Federal Minister of Health Hermann Gröhe has decided to take a law after the summer break in order to reduce the influence of health insurance in the MDK boards on the medical services. The Federal Minister of Health also sees the independent assessment in the interests of the patient at risk. In the course of the preparation of the bill is currently being examined, „whether we either come to a limitation of the number of full-time employees from health insurances in these bodies or even to an incompatibility of a committee membership with a corresponding full-time activity“, Gröhe is quoted in the ARD press release.

Cashiers with significant influence in the MDK Board of Directors
The ARD political magazine „Report Mainz“ according to the sender „All MDKs nationwide asked how many current or former full-time employees of the statutory health insurance currently sit on the boards.“ It became clear that the influence of health insurances on the MDKs is sometimes quite dominant. For example, in Saarland and Saxony, 60 percent of directors are full-time employees of health insurance companies. For MDK Nord this applies to over 50 percent and in Berlin-Brandenburg to more than 40 percent of the members of the Board of Directors. „As a result, full-time employees in all MDKs are on the boards of directors throughout Germany“, reports the ARD.

Independence of the MDK in danger
Social lawyer Professor Ingo Heberlein emphasizes in the press release of the station that he sees the independence of the MDK in danger. „If the cash coworkers directly in the boards of directors on this extent can influence the happening with the MDK, then the MDK is in the firm access of the health insurance companies and becomes more and more to a field office, to a branch of the health insurance“, so the criticism of the social lawyer. „That was originally not intended“, because for the patients this means, „that the assessment by the MDK can not be the desired and desired independent assessment“, continued Heberlein. The expert himself was for many years managing director of a medical service and is quite familiar with the attempts to influence him.

Will the MDK be taken to the cash register??
How strong the influence of health insurance on the MDKs actually is, is also clear that the nationwide survey of „Report Mainz“ According to him, full-time cashiers are head of the board of directors in nine out of 15 medical services. In Rhineland-Palatinate, there are even two heads of sales, the broadcaster continues. Professor Heberlein explained that the „MDK on checkout line“ to be brought. „One could also say, these are conditions in which the MDK comes into the stranglehold of the coffers“, so the charge of the expert. In the case of doubt, this can bring considerable disadvantages for the patients if, for example, the dispute about the level of care or incapacity to work tends to be assessed in favor of the health insurance companies. (Fp)