PKV base rate Doctors refuse treatment

PKV basic rate: doctors refuse treatment of patients

23/02/2011

Nationwide, it often happens that patients with a basic rate of private health insurers are rejected by doctors. As a result, the Bundestag faction of the Left launched a small request to the Federal Government. This weighed in an answer, „these are rare individual cases“. In principle, however, established physicians are allowed to refuse patient groups without giving reasons, as they said.

Apparently it happens again and again that physicians refuse private patients, because these show only a basic tariff of the private health insurance (PKV). The basic rate must be offered by all private insurers in order to ensure medical care for financially weaker private patients. The tariff is based one to one on the health services of the statutory health insurance. Therefore, there should actually be sufficient basic services.

Physicians are allowed to legally refuse basic tariff patients
The Left Party, however, are aware of numerous cases in which doctors refused base-rate patients. Therefore, the group launched a small request to the Federal Government (printed matter 17/4782). The answer that the editorial „Heilpraxisnet.de“ present, contains about 50 replies from the Federal Government. In the text, the black-yellow coalition claims that in Germany only a few cases are known in which actually doctors or dentists refused treatment. However, the base rate does not automatically lead to one „Immediate extension of the treatment obligation of the individual contract doctor or contract dentist to this patient group”. This means in plain language that doctors are not subject to any legal obligation to actually treat the patient. The doctor does not even have to explain why he rejects the person concerned. Because even here, the federal government has clearly stated. „An explanation does not have to be given for the refusal“, as lapidary in the letter is called.

Federal government rejects responsibility
It should also be noted that the Federal Government can not influence the current situation. Responsibility in such matters would be held by the Panel Medical Associations. These have the job, the „Ensuring the medical and dental care of basic policyholders“ to ensure. Affected persons should therefore contact the Association of Statutory Health Insurance Physicians in case of rejection. These can then call contract doctors in the regional environment. The doctors and dentists would obligatorily also treat basic care patients. Since the problem is relatively small in the opinion of the Federal Government, no political intervention is considered. If necessary, the institutions can rely on the help of the supervisory authorities, the statement of reasons. Furthermore, there are few people who actually use the base rate. According to the Federal Ministry of Health, only about 20,000 people are currently affected by the basic tariff of PKV. However, the number has almost doubled compared to the previous year. In 2009 there were only 13,000 insured.

The left sees a scandal in the process. In this question, the legislator is very much in the responsibility. As the health spokeswoman for the Left, Martina Bunge said: "The federal government looks on passively, as thousands of citizens are poorly supplied." The federal government must finally come to action.

How high actually the numbers of the rejected „Isolated cases“ none of the participants can answer exactly. However, it can be assumed that the base rate will be used in perspective by a much larger number of insured persons. Thus, the individual case can quickly become a mass phenomenon. Whether then the policy can continue to evade responsibility remains questionable. Until then, sufferers need to be mediated by doctors' associations. (Sb)

Picture credits: Gerd Altmann