PKV wants to save costs for doctors' fees

The PKV is currently arguing with physicians about steadily rising fees. The cost of outpatient treatment has increased since 2001 for private patients by 41 percent. The Federal Association of Private Health Insurance (PKV) now calls for freedom of contract, allowing for separate negotiations. The doctors, however, announce resistance "by all means".

09/12/2010

On Thursday, a fierce dispute broke out between the doctors, dentists and the private health insurance. The private health insurance company urges to freely negotiate the fees in the future. For the medical profession, the suggestions are one „serious threat to medical and dental care in Germany“. The private health insurance wants to increase their profit by separate negotiations and distract from their own problems, as it was called in a joint statement of the Federal Chambers of Physicians.

Treatments of private patients almost twice as expensive
The costs rise above all with the outpatient health measures of established physicians. In the last ten years, according to the Association of Private Health Insurance (PKV) recorded a substantial increase in expenditure of 41 percent. Because under increasing costs not only the statutory health insurance, but for some time, the private insurance providers. For example, expenditure on outpatient medical treatment per capita has increased from the original 583 euros (1999) to 822 euros (2009) over the last ten years. The growing medical fees were thus above the general price increase of 17 percent and also over the cost increases of the statutory health insurance companies (24 percent). In statutory health insurance, per capita spending in these ten years rose from € 297 to € 370. „This can not continue unabated. For this we fight in the interest of our insured. Because otherwise they have to pay the bill in the end.“ said Reinhold Schulte, chairman of the private health insurance association. For a private insured, the physicians now charge twice as high a fee as with cash patients.

PKV Verband demands freedom of contract between doctors and insurance companies
The Federal Government is now planning a reform of the medical and dental fee regulations. So said Reinhold Schulte, chairman of the PKV Association: „Especially with the decades old fees for doctors, the urgent need for reform is obvious. The GOÄ lag behind the medical progress, contains unreasonable assessments of medical services and also gives disincentives to medically useless volume increases. The private health insurance therefore calls for a fundamental structural reform of the GOÄ.“ The PKV is now pushing for a massive cost brake on the doctors' fees. In future, for example, there should be freedom of contract between insurance providers and doctors. The doctors criticize for their part that such a contractual freedom would partially cancel out the state-prescribed fee system. The medical representatives therefore speak of a new one „discount clause“ and for their part announce fierce resistance.

Federal Government keeps out of the dispute for the time being
So far, the Federal Ministry of Health has kept out of the dispute. However, for a few weeks, a new fee schedule for dentists has been filed without clarifying the exact details. Parliamentary State Secretary Daniel Bahr said that a fee schedule for doctors was in the works. „In the course of this reform we will then deal with the details.“

PKV wants to distract from its own problems
The doctors and dentists see in the proposals of the PKV one „serious threat to medical care in Germany“. With such individually negotiated contracts, the insurers want to undermine the statutory fee structure and distract from the self-inflicted problems. According to a statement jointly presented today by the German Medical Association and the Federal Chamber of Dentists for the high expenditure side in the PKV and the „exorbitant high brokerage commissions“ responsible.

Instead, private health insurance companies would like to use misleading slogans „create real competition“ for the opening clause. „De facto, however, exactly the opposite would be the case“, BZÄK President Dr. Ing. Angel, „the implementation of an opening clause, which ultimately nothing more than a 'discount clause´ in reality leads to a ruinous price competition between the medical profession, to less treatment quality by cost pressure and one-sided dependence of the contracted doctors from the PKV.“ „The free choice of physicians and the freedom of doctors would successively fall victim to the price dictates and the one-sided saving requirements of private health insurance“, Supplemented DGVP President Wolfram-Arnim Candidus. Both medical associations quit against the proposed clause „with all means available“ according to the announcement of the medical representatives.

The PKV Association emphasized, however, that with the proposals no one is forced. Rather, it should go to conclude an agreement that is acceptable to both sides. However, it must also be a goal that doctors can not charge higher costs for the same health services, just because a patient is privately insured. (Sb)

Also read:
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Health insurance: Higher contributions inevitable
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Image: Benjamin Klack