Doctors leave the negotiating table strike approaching

Negotiation between health insurance companies and doctors burst: medical profession plans strike

03/09/2012

Today, the next round of negotiations between doctors and health insurances should finally bring about an agreement in the conflict for an appropriate remuneration of the physicians. But the Kassenärztliche Bundesvereinigung is so disappointed by the results so far that they surprisingly left the negotiating table. The negotiations were not only because of the concrete results, but also because of the atmosphere in which these negotiations have taken place, explained the Kassenärztliche Bundesvereinigung.

According to the announcement of the National Association of Statutory Health Insurance Physicians (KBV), the relationship of trust between health insurance funds and the medical profession has suffered considerable damage during the last weeks of the negotiations. KBV Chairman Dr. Ing. Andreas Köhler spoke to over seven hundred contract doctors and psychotherapists in Berlin on the weekend „constantly new hate campaigns, whose only goal seems to be to represent doctors as buggers, fraudsters and greedy rip-offs.“ The negotiations are to be called at the present time as burst. There is „currently no current decisions, neither on the level of the prices of the medical services, nor on the total remuneration due to the change in the state of ill health of the population“, so the KBV communication. The arbitrator is now requested within 14 days to convene a new meeting, depending on the interim discussions with the boards of the GKV-Spitzenverbandes, whether the medical profession will be present then. If no consensual solution is reached, strikes and closures threatened.

Trust relationship between doctors and health insurance companies is disrupted
At the weekend, KBV leader Köhler had sharply criticized the behavior of the health insurances in the current negotiations at a short-term special representative meeting of the National Association of Statutory Health Insurance Physicians in Berlin. Dealing with the doctors was „an attack on the dignity of an entire profession, which enjoys the highest regard in the population like no other“, Köhler emphasized. By the behavior of the legal health insurance (GKV) have the „Trust between the two sides in the past few weeks has suffered considerable damage“, so the message of the Kassenärztliche Federal Association. The arbitration award, which should actually point the way to an agreement, had brought the barrel to overflowing. The mediation committee of physicians and statutory health insurances (extended evaluation committee for the contract medical care) chaired by the independent health economist Professor Jürgen Wasem last week adopted a proposal for the future remuneration of physicians, which increases the total of about 150,000 physicians and psychotherapists 270 million euros (0.9 percent) provided. Thus, the remuneration per doctor according to the calculation of the health insurance companies could rise by an average of 1,800 euros per year. Today, negotiations should be finalized on the basis of these figures.

Action against planned increase in the doctors' fees
However, according to the doctors, the adjustments proposed by the Evaluation Committee are far from adequate. In the current negotiations, the National Association of Statutory Health Insurance Physicians has called for an increase in remuneration of a total of 3.5 billion euros (eleven percent), so that the substantial increase in operating costs and inflation since 2008 can be compensated. The now proposed increase in fees by 0.9 percent would amount to a real income loss of around ten percent, reports the Kassenärztliche Bundesvereinigung. The indignation in the medical profession about the compromise proposal of the arbitration panel was correspondingly high. This would jeopardize the maintenance of the outpatient contract medical care, criticized the KBV. Several medical associations had already threatened with protests, praxis closures and strikes, should be held on the 0.9 percent fee increase. KBV boss Köhler demanded that „Federal Health Ministry to criticize the decision of the Extended Assessment Committee to raise the benchmark by 0.9 per cent“ and „also announced that it would bring an action before the Social Court Berlin-Brandenburg“, so the message of the Kassenärztliche Federal Association.

Discussions between representatives of the health insurance funds and medical profession in a small circle
After the official exit from the negotiations, now with the top representatives of the health insurance association prompt discussion in small groups will be conducted, reports the KBV. Here, first of all, some basic questions have to be clarified before the physicians in the practice return to the negotiating table, explained Andreas Köhler. The leaders of the GKV-Spitzenverbandes had accepted the invitation of the medical profession for a top discussion in the coming days. If these talks continue without a consensual outcome, strikes and closures will be the last option. In view of the doctors' strike and complaint threats, the GKV-Spitzenverband awarded the physicians yesterday „more reason and return to objectivity“ asked. Because „The doctors in the practice are concerned with a professional group that really earns very well on average. Since it does not necessarily much more money, as it is all about the fair distribution between the various groups of doctors, so that, for example, the land doctors are paid appropriately“, Florian Lanz, spokesman for the GKV-Spitzenverband. According to the statements of the Kassenärztliche Bundesvereinigung, many physicians are simply concerned about their existence.

Federal Minister of Health does not want to get involved in the negotiations
The Federal Ministry of Health, despite the request of the medical profession to intervene so far extremely covered. Federal Health Minister Daniel Bahr (FDP) had already announced that he did not want to get involved in the negotiations. The disputes of the health insurance companies and physicians about an appropriate remuneration, must be led by the negotiating partners to an end. Only the formalities or the procedure could be reviewed by the Ministry. A general complaint of the contested arbitration award from the Extended Assessment Board is not incumbent on the Ministry. If the health insurances and physicians agree on another solution, the arbitration award can be revised within two months. It is difficult to estimate the prospects of success that the previously announced lawsuit would have before the Sozialgericht Berlin-Brandenburg, since an agreement could usually be reached at the latest by the Extended Assessment Board. However, the action has suspensive effect, so that the decision of the arbitration panel for the time being does not become final. (Fp)

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Picture: Gerd Altmann, Pixelio