“Rationing through the back door”
11.01.2010 14:04
The Professional Association of German Internists (BDI) fears that specialist medical care in the outpatient sector will dry up
The majority of politicians have spoken out in favor of retaining freelance medical work in the outpatient sector, including specialist medical care. Prioritization and rationing ideas in medical care have also been vehemently condemned. Nevertheless, the path taken will inevitably lead to a drying up of specialist medical care in the outpatient sector.
This is explained using the example of gastroscopy. Depending on the location of their practice, gastrointestinal specialists receive between €30 and €40 per quarter for all-round care for a legally insured patient, although this so-called standard benefit volume has fallen by up to 40% over the course of the year. This money, which hardly any plumber would be willing to pay to repair a dripping faucet, is used to cover all medical and equipment services that arise in a quarter, with the exception of the colonoscopy. This also applies to gastroscopy, an examination that is carried out by gastrointestinal specialists around 1,000 times a year. This service alone, without taking into account just one cent of the doctor's fee, costs around €100 in material and personnel costs. In other words: with every gastroscopy the doctor subsidizes the healthcare system with €60 or more. What is the consequence? It is completely clear that this service can no longer be offered in the necessary numbers. This is called rationing!
The immediate consequences are clear: waiting lists, delays in diagnosis and treatment. It is time for responsible citizens and voters to be correctly and comprehensively informed about the grievances in the healthcare system. It is not right to use global manslaughter arguments to denounce doctors and talk about “distribution problems of money”. Either we have to openly and honestly enter into a rationing debate or we have to ensure that adequate remuneration follows the quality-assured service. Nobody wants rationing through the back door!