Coalition agreement: State takes over the healthcare system

07.02.2018 15:38

The Federal Chairman of the Association of Resident Doctors in Germany (NAV-Virchow-Bund), Dr. Dirk Heinrich, position:

“The agreements on health policy breathe the spirit of mistrust and regulatory rage. With a variety of detailed regulations and the creation of new institutions and committees, politicians are securing access to the healthcare system and expanding their influence to the detriment of existing self-administration. The coalition partners are not even addressing the actual structural problems caused by the ongoing budgeting. While there is apparently enough money available in many areas, the corresponding funds are denied here.

An increase in the minimum consultation hours by 25 percent was agreed without making any statement about counter-financing. An interesting project within a budgeted system, as such an increase in medical working hours also entails follow-up costs, such as extending the working hours of our medical assistants. But here it becomes clear: both medical freelance work and medical independence should be significantly restricted.

If all other planned instruments are implemented, this coalition agreement will be the death certificate for self-administration and medical freelance work.

The following points are the indications for this:

• Medical fees will be transferred to a scientific commission with the aim of standardizing them. A new GOÄ, the basis of the freelance profession of doctor, is intended to become a bargaining chip in this commission for doctor's fees. The new GOÄ, which has already been largely completed, is becoming a long way off.

• A federal-state working group with the participation of the government factions will further develop cross-sector care in the areas of requirements planning, approval, remuneration, coding, documentation, cooperation between health professionals and quality assurance.
• Appointment service centers should, in conjunction with an additional “coordinating service” in general practitioner care, take over appointment management for as many general practitioner and specialist referrals as possible.
• The states with the right to consult and apply should be involved in the admissions committees.
• Instead of abolishing the existing and outdated requirements planning, it should become “smaller-scale”.
• The KVen's security mandate is undermined by a joint guarantee of emergency care by state hospital companies and statutory health insurance associations with joint financing responsibility.

Degrees of freedom that have made our world's best healthcare system so far are being abolished. Elements of competition and quick access to innovations, however, are not addressed at all. Compared to all of these negative regulations, meaningful improvements such as greater support for outpatient care in rural and structurally weak regions take a back seat.