Health insurance companies are calling for the reduction of surplus doctors

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Statutory health insurance companies are calling for the reduction of surplus doctors

While medical associations and politicians are warning of an impending shortage of doctors, particularly in rural regions, the Association of Alternative Health Insurance Funds (vdek) is currently calling for the oversupply of doctors to be reduced in advance of the 114th German Medical Conference in Kiel.

Among other things, the change to the health care law planned by the Federal Minister of Health Daniel Bahr (FDP) will be discussed at the doctors' day. With the help of the new regulations, the Minister of Health hopes to counteract an impending shortage of doctors, which could cause considerable bottlenecks in medical care in the future. However, the association of replacement health insurance companies denies an impending shortage of general practitioner care and instead calls for a reduction in the surplus of doctors.

Shortage of doctors or surplus of doctors? The positions could hardly be more different: politicians and medical associations warn of an impending shortage of doctors, while the association of health insurers assumes an "excess of doctors". Thomas Ballast, Chairman of the Association of Alternative Health Insurance Funds (vdek), explained that the number of doctors reached a new high in 2010 with 397 doctors per 100,000 inhabitants. Overall, around 31 percent more doctors worked in Germany last year than in 1991, emphasized the vdek chairman. So there could be no question of an impending shortage of doctors, because the health of the population had hardly deteriorated in the same period or there was not much more medical services required. However, doctors need to be more flexible so that the shortage of doctors can be avoided in the underserved regions, Ballast explained. While “in cities, the need is far more than covered”, “well-trained doctors in certain rural regions are missing,” the vdek chairman continues.

Verband der Ersatzkasse: Do not invest in oversupply How the physicians should be moved to settle more in rural areas, however, is only roughly apparent from Thomas Ballast's presentations. "We should use the insured person's contribution money where there are problems or bottlenecks, but not yet invest in oversupply," said the vdek chairman, who is not very specific. The explanation that diagnostics and therapy should be concentrated on what is medically necessary also leaves a lot of room for interpretation. At the end of his communication, the vdek chairman emphasized: "Less is often more, too much medicine can also harm the patient." The statement behind this is probably to be understood as a call to limit the admissions for medical practices in cities, in order to increase the number Achieve settlement in rural areas. However, concrete statements by the vdek chairman are missing here.

"50,000 doctors will be missing in 20 years" The medical associations, on the other hand, warn of a massive shortage of doctors, which is already becoming apparent. Frank-Ulrich Montgomery, Vice President of the German Medical Association, said in an interview with the "Passauer Neue Presse" that the working conditions are so unattractive that many doctors work abroad or in industry after completing their studies, instead of working as a doctor in Germany to settle down. Last year, "3,500 German doctors went abroad again," emphasized Montgomery. The Vice President of the German Medical Association added: "If things go on as before, we will be missing around 50,000 doctors in 20 years."

The National Association of Statutory Health Insurance Physicians warns of a shortage of doctors The Federal Statutory Association of Statutory Health Insurance Physicians (KBV) also warned of the impending shortage of doctors and stated that the first signs can already be seen today. The head of the KBV, Andreas Köhler, emphasized that many resident doctors had no successors in the past year, so that almost 700 medical practices had to close in 2010. In its projections, the National Association of Statutory Health Insurance Physicians assumes that 66,830 general practitioners will retire by 2020. However, the demographic change means that the population will “get older and therefore sicker” in the same period, explained Köhler. This could result in a medical undersupply in the foreseeable future. The medical associations therefore hope that the new supply law will take appropriate measures to counteract the shortage of doctors. In addition, the Vice President of the German Medical Association called for a reform of the medical fee schedule by the end of the legislative period in order to increase financial incentives for medical professionals.

Health minister plans new health care law As part of the health care law, Federal Minister of Health Daniel Bahr (FDP) wants to remedy the impending medical deficit in rural regions primarily through financial incentives and improved rural earning opportunities. Bahr explained in an interview with "Welt Online" that he "couldn't force a doctor to settle in the country" if he would rather work in Cologne, Berlin or Munich. In addition, according to Bahr's proposals, medical practices in metropolitan areas should be closed. However, with these proposals, the Federal Minister of Health in principle confirms the statements of the Association of Replacement Funds. Because Bahr proposes to remedy the shortage of doctors by redistributing or increasing the mobility of doctors. But if the medical associations are right with their warnings, there are generally not enough doctors to guarantee patient care based on the previous standard. The new incentives of the supply law that Bahr speaks of when he explains how to avoid the impending shortage of doctors are likely to fall short here. Because the number of doctors working in Germany will hardly be influenced by the planned changes. The improvements in working conditions and earning opportunities demanded by the medical associations have so far only been recognized to some extent. (fp)

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