Dispute between midwives and health insurance companies

Health Minister calls for compromise between health insurance funds and midwives

07/09/2012

For months, the midwives have been arguing with the statutory health insurance companies about an appropriate remuneration for their services. If there is no significant increase, threatened by the enormously high contributions to professional liability insurance from the profession of freelance midwives, warned the midwives associations.

For the central association of the statutory health insurance an exaggerated presentation, especially since the midwives in the negotiations had already been offered a complete compensation of the increases in the contributions to professional liability. Before today's new round of negotiations, the Federal Minister of Health Daniel Bahr (FDP) has therefore called on the parties to the conflict to finally find a compromise. It will become clear later in the day whether the dispute over the increase in pay and the contributions to the professional indemnity insurance for obstetricians, which has been ongoing for months, can actually be settled.

Excessive contributions to the professional liability of midwives
The premiums for professional indemnity insurance for midwives have risen steadily in recent years. According to the German Midwives Association (DHV), in 2010, when the insurance contributions for midwives were raised from 2,370 euros to 3,689 euros, many midwives had abandoned the core area of ​​their profession - obstetrics. The planned increase in professional liability contributions from July to 4,200 euros would lead to a further strengthening of this trend, so the assessment of the DHV. The midwives have been resisting the huge increase in insurance costs in vain for years. Meanwhile, the fronts between the health insurance companies and the midwives are so hardened that at today's round of negotiations, an agreement seems hardly possible. The Federal Minister of Health has therefore once again clearly emphasized that finally a compromise must be found.

Federal Health Minister calls for compromise
In conversation with the „South German newspaper“ indirectly referred to the statements of the Federal Chancellor, who had promised the midwives support. „The nationwide provision of midwifery services is not only important to me“, so Bahr. In his opinion, the federal government already has „many demands of the midwives“, so now the „Cash registers and midwives are obliged to bring the negotiation process to a happy end.“ For example, the Federal Government has ensured that cost increases in professional liability are explicitly included in the negotiations, explained Bahr. Overall, according to the Minister of Health „all conditions created“, in order to „fair negotiations can take place.“ Whether his appeal will contribute to the compromise remains, however, for the time being open.

Escalation of the dispute between midwives and health insurances
The dispute between midwives and health insurances is mainly about raising the fees and compensating for the massive increase in the professional liability premiums of midwives. From the health insurance companies is an offer on the table that, according to the GKV-Spitzenverbandes a complete compensation of the contribution increase in the professional liability insurance of midwives and includes an additional 1.3 million euros per year. In the view of the midwives associations, this offer is not enough, they demand a total of four million euros. In a kind of mediation, initiated by the Federal Minister of Health, the conflict parties could not agree. Instead, the dispute continues to top and according to the GKV-Spitzenverband, the midwives associations had not even responded to deadline suggestions of the health insurance in the end. According to the midwives associations, this refusal was the result of a breach of trust by the GKV-Spitzenverband. Because this has passed on confidential information and arbitrarily the German Association for Home Obstetrics (DFH) involved, although this is not a professional association but a trade association with membership numbers in the two-digit range. The Fachverband für Hauszuburtshilfe was „not politically relevant in the past“ And even today it is not decisive, according to the current press release of the German Midwives Association, the Federation of Freelance Midwives of Germany and the Network of Birth Houses. „Therefore, we ask the GKV-Spitzenverband to give up these tactical games and hope very much that the DFH can not be abused by the health insurance companies to gambit against their own occupational group“, Write the midwife associations in an open letter.

Sustainable funding model required for professional liability of midwives
In their press release, the midwives associations also vigorously disagree with the statement that the health insurances would have been willing to fully offset the contribution increases in professional liability. „If the offer of the GKV to increase liability had compensated for the costs, we would have agreed to this. But in truth this is not exactly the case“, so the message of the associations. The calculation and compensation model favored by the statutory health insurance does not prevent midwives from having to give up their profession. Therefore, the GKV-Spitzenverband has repeatedly been presented a different calculation method for midwife remuneration, „which in sum does not come more expensive but could prevent a midwifery death“, so the message of the midwives associations. To date, however, the health insurance would have „not admitted to this sustainable financing model of liability costs.“

Mediation between midwives and health insurance companies next step
If no compromise is reached in today's negotiations, the next step will be a conciliation procedure in which the former Justice Minister Herta Däubler-Gmelin (SPD) is scheduled to act as mediator. The midwife associations showed interest in it, „submit this pressing issue to the Arbitration Board for decision.“ The Federal Minister of Health, meanwhile, hopes that today's negotiations will bring about an agreement and thus the conciliation procedure can be avoided. „I now expect cash registers and midwives to come to a conclusion“, so the urgent demand of the Federal Minister of Health. (Fp)

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