Doctors president criticizes cash registers abuse of power

The health insurance funds abuse their power in the fee negotiations with the medical profession?

07/09/2012

The President of the German Medical Association, Prof. dr. Frank Ulrich Montgomery, has accused the health insurance in the current dispute with the medical profession about the future remuneration abuse of power. Opposite the „Stuttgarter Zeitung“ Montgomery explained that the power of the top association of statutory health insurance (GKV-Spitzenverband) „extremely strengthened by the legislation of recent years“ but this was „more and more lost the relation of reality to patient care“ have „and become a mere bureaucratic body“ be.

The considerable surpluses of health insurance in 2011 and in the first half of 2012 seem like water on the mills of criticism of the President of the Federal Medical Association. Here you go „ hoarded more and more money instead of using it to care for the patients or to reimburse the contributors“, criticized Montgomery. „The Association behave like a lobbyists association par excellence, from public interest obligation no trace. "The Association of Statutory Health Insurance Association (KBV) announced meanwhile, starting Monday by targeted actions, the health insurance the displeasure of 150,000 doctors and established Although no practices are closed, in the coming week, for example „informal cash inquiries no longer answered in writing“, the KBV boss Andreas Köhler in a current press release.

Health insurance companies scratch the dignity of doctors
For the medical profession, the reports of record surpluses of 21.8 billion euros in the statutory health insurance companies, an additional argument in the context of the current fee debate. The negotiators of the doctors had demanded an increase in remuneration of around 3.5 billion euros, not least to offset the significant increase in operating costs and inflation since 2008. The GKV-Spitzenverband, on the other hand, based on an extra expert opinion, had initially started proposing reduced compensation in the negotiations and had finally agreed to increase the doctors' fees by a total of 270 million or 0.9 percent. The medical president Frank Ulrich Montgomery criticized this approach sharply: „Negotiating for doctors with a ten-percent-minus offer in three rounds and only offering 0.92 percent plus in the end, even though a ten percent increase in cost is detectable, that clashes with the dignity of the negotiating partner - the doctors.“ Due to the questionable procedure of the health insurance companies, the situation in the current fee dispute was similarly heated up as in the hospital strike of 2005.

Limit power of the GKV-Spitzenverbandes?
In the opinion of the President of the Federal Council of Physicians, the power of the GKV-Spitzenverband should be clearly limited due to its behavior. The GKV-Spitzenverband feels like a savings bank, completely forgetting that doctors need to treat patients. How else would it be? „explain that cashiers, who all do not make a bad living, keep hoarding more and more money instead of using it to care for the patients or to reimburse the contributors.“ According to Frank Ulrich Montgomery should urgently be questioned, „whether it is wise to let the doctors negotiate for all health insurances with only one top association.“ In his opinion, it would be wiser to allow more differentiation in the past. „Since we negotiated with alternative funds and local health insurance companies in the competition - that's why it was more about the patient care“, explained Montgomery. The behavior of the GKV-Spitzenverband illustrates, „How dangerous monopolies are when they exercise power irresponsibly.“

Kassenärztliche Federal Association plans policy of pinpricks
The Kassenärztliche Federal Association has meanwhile announced with what actions from next week their „Policy of pinpricks“ against the health insurance companies should begin. In the approximately 100,000 practices of general practitioners and psychotherapists „a broad potpourri of staggered actions“ from which targeted measures are implemented week by week, according to the KBV Communication. First, it is planned to answer informal cash inquiries no longer in writing. Every day, 145 health insurance companies overwhelm doctors' surgeries with such informal inquiries, in which, for example, it is a matter of whether a rehabilitation measure was also carried out or insured persons are still sick, the KBV reports. To mediate the employee of health insurance, „As long as doctors usually work, they must restrict their requests and requests either to the time before 8 o'clock in the morning or after 8 o'clock in the evening“, explained the KBV. The remainder of the day would require physicians to care for their patients.

Vote on strikes and practice closures
Also, the established physicians and physiotherapists want from Monday refuse to cancel the bonus books. The planned „Measures hit the biggest cause of bureaucracy in the practices, namely the health insurance companies. As a result, the doctors even have more time for their patients“, explained the KBV boss Köhler. „The health insurance companies will feel our targeted needlesticks“, However, the actions are not at the expense of the patients, Köhler continued. In addition, the Kassenärztliche Bundesvereinigung has decided to bring action before the Social Court Berlin-Brandenburg against the current proposal of increase in fees. In addition, in the middle of next week, the independent medical associations called for a strike-ballot on strikes and practice closures.

Surpluses of health insurance cause criticism
Due to the significant surpluses of 12.8 billion euros in the health insurance and nine million euros reserves in the health fund, the bargaining position of the bar is not strengthened. So were also from ranks of the policy already allegations of money hoarding loud. The Federal Minister of Health Daniel Bahr (FDP) has repeatedly argued that particularly well-behaved health insurance companies in the form of premiums to repay the surpluses to their members or at least for significant performance improvements. However, the health insurance funds seem to prefer to keep their money together, something which they can not really take away from because of past experience. For until three years ago, the discussion was actually only about the deficits of the funds and possible bankruptcies. The fact that the health insurances initially use the current surpluses to create financial cushions is therefore a comprehensible procedure. However, you should not overstay your hand, because ultimately the well-being of the patients must be the focus. (Fp)

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