>> On 6 July 2010, former Health Minister Rösler announced a major highlight of the loudly propagated health reform: an increase in contributions for those with statutory health insurance from 14.9% to 15.5%, in order to avert the impending bankruptcy of the system.
Instead of showing great outrage and searching for the causes of the escalating costs, “people” have obviously accepted this, assuming that things could have been worse.
This is already a serious concern, however, as numerous voices demonstrate the system's significant savings potential. These savings far exceed the volume of the contribution increase and would render it unnecessary for up to ten years. This is therefore about the incredible waste in the German healthcare system (the second most expensive in the world), which is practically designed to offer expensive acute and (too) late treatment, which only becomes profitable if preventative medicine is suppressed. In two detailed articles published in this journal at the end of 2009 (Wehling 2009) and the beginning of 2010 (Wehling 2010), the author estimated the savings potential in the German healthcare system at between 20 and 80 billion euros per year, based on an in-depth analysis, with a focus on approximately 60 billion euros; he is certainly not alone in this (SVR 2002).
Who cares?
At the beginning of 2010, as the discussion about the cost explosion and possible countermeasures intensified, the author sent these publications a total of 75 times in Germany to all relevant politicians (4), treasurers (4), and above all, journalists (14) from major magazines and contemporary television programs (11). The accompanying letter contained a clear offer of further discussion and support for related reactions, e.g., in political or journalistic statements on the topic. The outcome of this campaign, however, was more than sobering: Although data, research, and even cross-references for critical review through comparison with other authors were provided "free of charge," only 15 letters were answered. Of these, 11 only arrived after a total of 27 recipients had been contacted a second time. The replies essentially contained three contents: A) very interesting, thank you (3) – B) we are not responsible (1) – C) you will hear from us again (5). In one case, a concrete action consisted of an invitation to a meeting with a health policymaker; in the other cases, one or two written or telephone contacts were made. In the end, a year later, not a single discernible action resulted from this effort. The culmination of disappointment was the aforementioned contribution increase and the almost complete disregard for the savings potential in the healthcare system.
In February 2011, the author made another attempt to draw attention to waste in the healthcare system by writing to nine more editorial offices (print media and one TV station). Again, the response was disillusioning: either no response at all (4) or no interest (3 - recommendation to publish the article in an abridged form as a letter to the editor, forwarded to the specialist editorial staff without further response, rejected with rude and presumptuous language). Only two recipients showed some interest and basically shared the author's opinion. Unfortunately, these efforts also came to nothing.
The usual suspects?
It is completely incomprehensible why the waste documented in the publications (as a representative example of many, Germany, for example, has the highest density of cardiac catheterizations in the world) apparently requires no treatment, and so, in addition to financial losses, patient harm, i.e. unethical medicine, is tolerated. A disturbing suspicion arises: lobbyists are protecting their privileges, and politicians do not dare to take action. The necessary savings would in any case lead to revenue losses for device manufacturers such as Philips or Siemens, pharmaceutical companies, but also doctors and hospitals. The fact that politicians, under pressure from this lobby, do not dare to intervene is understandable, at least from an electoral perspective, even if it is still highly unethical.
But what is preventing the numerous journalists contacted from addressing this issue, despite their initial, clear interest? This raises a strong suspicion that dependencies exist in this area as well, which prevent it from being addressed. It is well known that print media, in particular, are under enormous cost pressure due to new media, especially the internet. They are therefore more dependent than ever on their advertising revenue, which could naturally suffer from reports that are unfavorable to some companies.
Whether this also applies to television news reports remains unclear. The few interactions that have taken place here have given the impression that the scandalous nature or "shock effect" of these facts is not large enough to attract sufficient attention. Although these assumptions are of course purely speculative, they do create a plausibility that journalists, as the last guardians of social honesty, should counter with a bolder stance. It is to be expected that, essentially, it "only" matters to finally publish the first report, the first feature on this topic. Since a lot of money is at stake, but above all, health and quality of care for many millions of voters, this should be a very rewarding journalistic topic with great explosiveness and a long runtime. However, arguments in the medical-scientific field are always somewhat cumbersome and dependent on "authorities." Which investigative journalist would want to be the first to seize this challenge and opportunity? It's worth it!