Emergency medical service in Bavaria before the end?

Stand by emergency service and emergency medical service in Bavaria from collapse?

07/26/2012

In Bavaria, the emergency medical service according to the announcement of the Association of Statutory Health Insurance Physicians of Bavaria (KVB) is about to collapse, unless fundamental reforms take place. This means that it also requires increased financial support from the statutory health insurance. So far, however, the health insurance companies have strictly refused to provide physicians with more money to build up an improved medical infrastructure.

„At an urgent meeting, the representative meeting of the Kassenärztliche Vereinigung Bayerns yesterday in Munich debated the massive problems in the medical emergency service and in the emergency medical service in Bavaria“, This is the current communication from KVB. Everyone involved agreed that it was one „Keep it up!“ can not exist if the on-call service and emergency medical service is to be maintained. The representatives of the medical profession strongly criticized the point of view of the health insurances, which for their part have declared themselves prepared for no additional financial benefits for the development of the medical infrastructure.

Criticism of the spending policy of the statutory health insurance
The Chief Executive Officer of KVB, Dr. Ing. Wolfgang Krombholz, explained that „Although the statutory health insurance funds are currently in a comfortable economic situation, the insured funds do not invest in their care.“ Dr. Ilka Enger, second deputy chairman of KVB, added: „Instead of investing the contributions into the care of their insureds, costly marketing or questionable studies are funded.“ One could not afford such luxury, as long as both the outpatient standard care as well as the on-call service and the emergency medical service are not sufficiently remunerated, so the tenor of Dr. med. Krombholz and dr. Enger.

For years no fee increase with the doctors
Dr. Krombholz went on to say that there had been no real increase in fees for the medical profession in Bavaria for years. The increase in remuneration is due solely to the growing number of treatments. „Not even an inflation compensation has taken place“, criticized the KVB CEO. The first Deputy Chairman of the Executive Board of KVB, Dr. med. Pedro Schmelz, emphasized that the evaluation of the fee and case development showed that since 2007, no real increase in fees took place. This „can not go on like this“, because the doctors could not live permanently on their substance, said Schmelz. „In this way, the comprehensive backup job can not be done for much longer“, so the conclusion of the deputy head of KVB ...

On-call service without far-reaching reforms before collapse
According to Dr. Krombholz's low remuneration combined with extreme service burdens has made the establishment in private practice rather unattractive for young physicians. Therefore, missing „not only the offspring in the standard care, but also in the care outside the usual consultation hours“, so the message of the KVB. According to the head of the KVB, the on-call service can not be maintained nationwide without deep reforms due to the shortage of young talent. The core of the reforms must, according to Dr. Krombholz may be the pooling of service areas to have more doctors per service area. The individual doctors would be less likely to have to do the strenuous, in the country less lucrative weekend services. The aim of the readiness service reform was to reduce the number of service groups from 481 to 177 and increase the number of standby practices from 40 to 109.

Seventy new standby practices required
However, the proposal of the KVB would require about seventy new stand-by practices, but this could not be done without financial support from the health insurance companies. Although statutory health insurers had agreed to pay ten euros from the second quarter and five euros per case in the third and fourth quarters, respectively, to support readiness practices, this was not enough given the current problems Dr. Krombholz. The KVB demanded not only an approximation of the travel allowances and an appropriate reimbursement of material costs, but also start-up funding for the new emergency services to be set up.

Emergency medical service in Bavaria also threatened
The second Deputy Chairman of the Executive Board of KVB, Dr. Ing. Ilka Enger, also complained that currently not even all paid emergency medical services are remunerated at all. Often the health insurance companies questioned their necessity. In this way, a deficit of just under eleven million euros was incurred at KVB in the years 2009 to 2011, which required a reduction in the remuneration for emergency medical service from the fourth quarter of 2012 ... „This decision was difficult for us and contradicts our conviction that the work done by Bavaria's emergency physicians belongs decently remunerated“, explained Dr. Closer and added: „But as long as the health insurance companies do not recognize legitimate fee claims of the emergency doctors, we have no other choice.“ Reducing compensation will probably make it even harder to fill the service in the future, according to the expert. Thus, the emergency medical service faces similar problems as the on-call service. (Fp)

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Picture credits: Paulwip