Doctors as sellers of additional services

Doctors are increasingly offering additional services

Doctors as sellers of additional services: Cash patients increasingly pay for health care themselves.

08/12/2010

More and more doctors also distinguish themselves as sellers of medical services. Thus, a recent study by the scientific institute de AOK comes to the conclusion that every fourth patient annually health benefits are sold by their doctor, which are paid out of pocket.

Revenue of € 1.5 billion from individual health care
The study of the scientific institute of the AOK (WIdO) published on Wednesday explicitly dealt with the so-called individual health services (IGeL), which are not a cash benefit and have to be paid by the patients out of their own pocket. With such services, doctors now set 1.5 billion euros annually, the WIdO explained in the context of the current publication of their results. 2,500 health insurance patients had interviewed the WIdO regarding the IGeL, with astonishing results. More than a quarter of patients (28.3 percent) have received medical services from their doctors. Accordingly, the share of patients who have purchased a corresponding service from their doctor has risen from just under nine percent in 2001 and around 16 percent in 2004 to the current high of 28 percent. Ultrasound scans (20 percent) and glaucoma screening (16 percent) were sold most frequently, followed by medicines, medicines and aids (11 percent), as well as blood tests and laboratory services, the WIdO explained as part of the presentation of the study results.

Statutory health insurance companies consider the development critically
In view of the results, the AOK was rather critical, because the statutory health insurance would pay everything that has a proven benefit and is medically necessary. Gerhart Schillinger from the AOK Federal Association. Thus, his additional benefits actually not required and the model of the IGeL sale result in that some services are billed, which are actually included in the benefits package of the statutory health insurance. For example, medically necessary ultrasound examinations or skin cancer screenings are actually covered by the reimbursement of the health insurance companies and nobody should have to pay for it, explained Dr. med. Schillinger. In addition, the WIdO survey has shown that doctors often fail to comply with the legal requirements for billing additional benefits. Approximately 46 percent of respondents who requested additional benefits did not sign a necessary written agreement and around 15 percent of buyers said they had not even received an invoice, according to WIdO.

IGeL offer is directly related to income
The AOK also critically assessed that privately paid benefits were not offered to patients, depending on their state of health, but rather on their individual income levels. For example, patients with incomes above 4,000 euros a month were offered more than twice as often as patients with less than 1,000 euros in income. Only about one in six patients (16.9 percent) of the lower income group were offered the so-called IGeL, whereas more than one third (38.8 percent) of those in higher income had already received corresponding offers from their doctor. Almost every third patient who has a better earning has already used the services of his doctor.

Gynecologists and ophthalmologists most often offer IGeL
With regard to the sold IGeL there are considerable differences between the physicians of the different disciplines, explained the WIdO. Ophthalmologists and gynecologists offer individual health services on average six to seven times more often than general practitioners. Also urologists sell their patients about five times as often private additional services as the general practitioners on average. Orthopaedists and dermatologists are also increasingly offering their patients IGeL, selling around four times as often as the average general practitioner. However, the fact that physicians have massively expanded their offer of IGeL in recent years is not only due to the business acumen of the medical profession, but also reflects the fact that many patients do not have sufficient health insurance benefits. Thus, those insured by law are increasingly willing to spend more money for more power. Here, the legislature must ask whether this is the desired development. After all, doctors who, like insurance salesmen, try to push the patient to the eye with all possible benefits quickly, can not be in the interests of patient health. Since the normal earners in the statutory health insurance also does not have the option to take correspondingly frequent IGeL, they are thus automatically disadvantaged health. (Fp)

Also read:
Doctors are selling more and more benefits
Dispute between AOK and family doctors escalates

Image: Verena N..